READII READII	READII (one-page) .pdf
Racial & Ethnic Adult Disparities in Immunization Initiative

• The burden of vaccine-preventable diseases in adults in the U.S. is staggering – over 40,000 adults die each year from vaccine-preventable diseases.
    
• Each year approximately 200,000 people in the United States are hospitalized because of influenza. An average of 36,000 people die annually due to influenza and its complications– most are people 65 years of age and over.
    
• Annually there are approximately 40,000 cases of invasive pneumococcal disease in the United States and approximately one-third of these cases occur in people 65 and older. About half of the 5,000 annual deaths from invasive pneumococcal disease occur in the elderly.
    
• African Americans and Hispanics have significantly lower influenza and pneumoccal immunization rates compared to the rest of the population. Influenza vaccination coverage among adults 65 years of age and older is 68 percent for whites, 48 percent for African Americans, and 54 percent for Hispanics. The gap for pneumococcal vaccination coverage among ethnic groups is even wider, with 60 percent for whites, 38 percent for African Americans, and 36 percent for Hispanics. (Source: Behavioral Risk Factor Surveillance System, 1999 & 2001.) Little is known about the best intervention strategies for these populations.

Top

The Department of Health and Human Services (HHS) has made the elimination of racial and ethnic disparities in influenza and pneumococcal vaccination coverage for people 65 years of age and older a priority. To address these disparities and to assist in reaching the 2010 national health goal of 90% influenza and pneumococcal vaccination rates among persons 65 and over, HHS, in collaboration with the Centers for Disease Control and Prevention (CDC) and other federal partners, launched the Racial and Ethnic Adult Disparities Immunization Initiative (READII) in July 2002.

Top

• AARP - American Association of Retired Persons
• AMA - American Medical Association
• APHA - American Public Health Association
• ASA - American Society on Aging
• NCOA - National Council on Aging
• NHMA - National Hispanic Medical Association
• NMA - National Medical Association
• OMH - Office of Minority Health

Research supports the continued need for efforts to reduce these disparities. The October 10, 2003 issue of Morbidity and Mortality Weekly Reports contains the article "Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccination Levels Among Persons Aged >65 Years - United States, 1989-2001," which summarizes analyses of results of National Health Interview Surveys (NHIS). Analyses indicate that marked differences in vaccination coverage continue to exist by race and ethnicity, and these differences are observed even among persons most likely to be vaccinated (that is, persons with the highest education level and persons with frequent visits to healthcare providers). These disparities in influenza and pneumococcal vaccination coverage have persisted over time, and a variety of approaches are recommended for reducing them, such as use of standing orders for vaccination. Read the complete article.

Top

During the period August 20-27, 2002, the National Immunization Program (NIP) at the Centers for Disease Control and Prevention (CDC) commissioned a series of consumer focus groups and physician interviews to collect qualitative data about beliefs, behaviors, and barriers that cause low influenza and pneumococcal immunization rates among older African-American and Hispanic populations. Historically, immunization rates for these relatively high-risk groups have been low. Focus groups and interviews were conducted in Chicago, IL; Jackson, MS; Milwaukee, WI; Rochester, NY; and San Antonio, TX.

The research was intended to

• Identify beliefs and behaviors in these populations directly related to immunization against influenza and pneumonia
• Increase understanding of physicians' attitudes and behaviors related to these immunizations
• Assess impact and appeal of messages intended to increase immunization in these target populations

This study showed that members of these under-immunized groups are responsive to appeals to protect the younger generation and act for their families. To see the detailed results of this study and find out more about this kind of research, visit Influenza and Pneumococcal Immunization.

Top

READII is a multi-year demonstration project being conducted in five sites (Chicago, IL; Rochester, NY; San Antonio, TX; Milwaukee, WI; and 19 counties in the Mississippi Delta region) to better understand ways to increase influenza and pneumococcal vaccination rates for African-Americans and Hispanics 65 years of age and older. CDC is implementing the READII project with the support of the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Administration on Aging, the Agency for Healthcare Research and Quality, and other federal agencies.

READII sites have developed partnerships with public health professionals, medical providers and community organizations (e.g., large health plans, insurers, minority health professional organizations, churches, local community groups, and civic leaders). They are collaborating with these stakeholders to develop and implement community-based plans focusing on evidence-based interventions and innovative approaches to increasing immunization levels.

Interventions vary by site and are based on state and local choice. READII interventions include:

• provider-based interventions (assessment and feedback to providers, multi-component provider education, standing orders, and provider reminder/recall);
• increasing community demand for vaccinations (client reminder/recall and multi-component interventions including communitywide and clinic based education);
• enhancing access to vaccination services (expanding access in health care settings and reducing out of pocket costs); and
• vaccination interventions in non medical settings.

Each site has developed multifaceted evaluation plans containing outcome, intervention specific and process measures.

At the conclusion of the multi-year demonstration project, CDC plans to share lessons learned from the READII project.

Top

Chicago, IL (updated October 2003)        - Print version (.pdf file)        - Screen-reader device version (.htm file)

Milwaukee, WI        - Print version (.pdf file)        - Screen-reader device version (.htm file)

Mississippi        - Print version (.pdf file)        - Screen-reader device version (.htm file)

Rochester, NY        - Print version (.pdf file)        - Screen-reader device version (.htm file)

San Antonio, TX        - Print version (.pdf file)        - Screen-reader device version (.htm file) Top

READII web video

READII is featured within the Adult Immunization, a National Immunization Program satellite training course that originally aired on June 26, 2003. You can view the video right now on your computer screen (select one below).   12-minute READII segment (*quick download) 12-minute READII segment (*dial-up speed) 2-hour Adult Immunization training course READII Script (screen-reader accessible file) (.txt file)     If you have any difficulty with the training course video, consult Technical Support for assistance. *RealPlayer is required.

This page last modified on October 1, 2004