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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. Vaccination Programs in WIC Settings

Approach. Establish vaccine programs in WIC settings to increase childhood vaccinations.

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Overview. Vaccination programs in WIC settings include the following:
- Assessment of infants’ and children’s immunization status
- On-site vaccinations or referral to vaccination providers
- Additional interventions such as client reminder and recall systems, manual tracking and outreach efforts, or adoption of monthly voucher pickup schedules that require more WIC visits when vaccinations are not up-to-date
Vaccination services may be provided in WIC clinics, or through collocation and coordination of WIC programs with other healthcare services.

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • WIC immunization screening and referral data
  • WIC participant satisfaction surveys
  • WIC staff training and fidelity data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of WIC clinics partnered with Title V implementing vaccination programs. (Assesses adoption of strategy)
  • Number of WIC staff trained by Title V in immunization assessment and counseling. (Measures capacity building)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of WIC clinics partnered with Title V with established protocols for vaccination assessment and referral. (Measures systemic approach)
  • Percent of WIC appointments that include immunization status checks monitored by Title V. (Assesses integration into routine care)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of partnerships led by Title V formed between WIC clinics and local healthcare providers for vaccination services that report high levels of engagement. (Shows collaborative approach)
  • Number of reminder/recall systems implemented for WIC participants' vaccinations that results in increased vaccination rates. (Assesses proactive outreach)
  • Number of WIC clinics showing sustained improvements in participant vaccination rates. (Quantifies long-term impact)
  • Number of community-wide vaccination initiatives sparked by WIC program successes. (Measures broader public health impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of partnerships led by Title V formed between WIC clinics and local healthcare providers for vaccination services that report high levels of engagement. (Shows collaborative approach)
  • Percent of reminder/recall systems implemented for WIC participants' vaccinations that results in increased vaccination rates. (Assesses proactive outreach)
  • Percent of WIC clinics showing sustained improvements in participant vaccination rates. (Quantifies long-term impact)
  • Percent of community-wide vaccination initiatives sparked by WIC program successes. (Measures broader public health impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Bardenheier BH, Yusuf HR, Rosenthal J et al. Factors associated with underimmunization at 3 months of age in four medically underserved areas. Public Health Reports 119(5):479-85.

[2] Ashkar SH, Dales LG, Averhoff F et al. The effectiveness of assessment and referral on immunization coverage in the special supplemental nutrition program for women, infants, and children. Archives of Pediatrics & Adolescent Medicine 2003;157:456-62.

[3] Cortese MM, Diaz PS, Samala U et al. Underimmunization in Chicago children who dropped out of WIC. American Journal of Preventive Medicine 2004;26(1):29-33.

[4] Ghosh TS, Patnaik JL, Bennett A, Trefren L, Vogt RL. Assessment of missing immunizations and immunization-related challenges among WIC populations at the local level. Public Health Rep 2007;122(5):602-6.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.