Evaluation of Baltimore City Health Department Influenza Immunization Initiative

Challenge

There is concern about an increase in rates of both influenza and COVID-19 illnesses and deaths this coming 2020-2021 flu season and Baltimore City has committed to reaching the ambitious target of vaccinating at least 70% of its residents against influenza. Last season, although reporting may have been incomplete, it was estimated that fewer than half of older adults in Baltimore City were vaccinated, an age group at increased risk of serious complications and death related to influenza infection. Moreover, the added strain of seasonal influenza morbidity on health services is cause for concern during the COVID-19 epidemic.

Based on data from previous years, Black and Latinx communities are immunized at substantially lower rates than White communities. This is in part due to high levels of distrust of vaccines and the institutions that provide them. This distrust will likely be amplified when considering future COVID-19 vaccines. Therefore, in an effort to vaccinate at least 70% of Baltimore residents, a special effort will be made to reach and build stronger relationships with these underserved communities.

Approach

The Baltimore City Health Department (BCHD) is conducting a city-wide initiative to vaccinate high risk residents in various populations. As part of the initiative, they are coordinating with various partners, resident service coordinators and local universities to offer flu vaccines to older adults living in senior housing units. BCHD is partnering with JHU’s International Vaccine Access Center (IVAC) and Morgan State University (MSU) to conduct a community-centered evaluation of the influenza vaccination initiative in senior housing units. The primary aim of the project is to measure effectiveness of the initiative, including vaccination coverage rates, feasibility, and sustainability of the initiative. Due to the potential for underreporting in state-level registries, a vaccination coverage survey will be conducted in a subsample of senior housing buildings to validate official estimates. The secondary aim is to assess knowledge, attitudes, and behavior regarding influenza and influenza vaccine, as well as with future COVID-19 vaccines to identify potential concerns. IVAC and MSU are participating in Flu Vaccine Task Force Meetings organized by BCHD to bring together community voices. Additionally, to further understand the needs and perceptions of older adults in Baltimore City, help build trust and community acceptance of influenza vaccination, and participation in the evaluation, IVAC and MSU are also working with Pastor Terris King (Liberty Grace Church of God) who represents a network of Faith Leaders in Baltimore to engage with the Baltimore City faith community. The information from this project will be used to inform the design of a future COVID-19 vaccine campaign.

Resources

Evaluation of Baltimore City Health Department Flu Vaccine Initiative In Senior Housing Buildings 2020: Lessons Learned for COVID-19 Vaccination

CDC: Baltimore African American Faith Community is Key in Promoting Vaccine Confidence