The Atlantic Quality Innovation Network (AQIN) – the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving New York, South Carolina and the District of Columbia – has committed to changing the way South Carolinians think about immunizations.

“Family is very important in the South, especially among rural populations. We’re finding that when we’re talking to seniors about getting vaccinated, it really hits home to say, ‘Do it for yourself, but also do it for your family and grandkids.’”

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Seeking to build on its ongoing vaccination efforts, AQIN, in partnership with the South Carolina Department of Health and Environmental Control (DHEC), launched a coalition in early 2015 of nearly 40 organizations in the state, including the South Carolina Office of Rural Health, the South Carolina Academy of Family Physicians, the South Carolina Pharmacy Association, and the Medical University of South Carolina. Now the coalition has started reaching its goals of sharing best practices, tools and resources in an effort to increase immunizations, and to encourage providers to document and report immunization rates.

“We knew from the start that community outreach would be the key to success, so we incorporated immunizations into our other quality improvement work and engaged partners that helped attract new collaborators,” said Melinda Postal, Quality Specialist at AQIN-South Carolina. “That led us to our initial work with the Governor’s Office.”

With encouragement from AQIN, former South Carolina Governor Nikki Haley issued a proclamation that recognized Senior Vaccination Season and the need for expanded vaccination awareness efforts across the state. According to Postal, this recognition was an important tool that helped draw attention to the coalition’s work.

The partnership developed educational bookmarks that have now been distributed to approximately 15,000 seniors and nearly 200 public libraries statewide. One side of the bookmark focuses on flu prevention and the other side on shingles, which also impacts seniors at alarming rates. Coalition members also started a vaccine-awareness monthly newsletter that is disseminated to stakeholders across the state. It aims to encourage providers to prioritize vaccinations, implement best practices and collaborate with peers.

The coalition’s efforts yielded dramatic results during the 2015 flu season, and early numbers for the 2016 season are expected to be equally impactful. From August 2014 to March 2015, 29 out of the 40 counties in South Carolina saw an uptick in influenza immunization rates, and from January to December 2015, all counties achieved higher pneumonia immunization rates.

Nevertheless, barriers still exist. Many seniors aren’t able to access clinics because they lack transportation, and more education is needed – particularly around the fact that Medicare Part D covers many vaccinations.

Given these needs, the coalition is looking to expand its efforts, using county-level data to determine where to target efforts.

In the fall of 2016, coalition members launched the next phase of their strategy, a partnership with Walgreens to host immunization clinics in rural areas. Through collaboration with Walgreens and other local stakeholders, the coalition has been successfully hosting three community events per quarter, with topics ranging from immunization awareness to assisted living options. They also have begun preparations for 2017 events, including a State Immunization Resolution, championed by pharmacist and Senator Ronnie Cromer, in March, and a statewide immunization day in August.

The coalition views culture-specific messaging as critically important moving forward, as it strives to continue the upward trend in immunization rates. “Family is very important in the South, especially among rural populations,” said Postal. “We’re finding that when we’re talking to seniors about getting vaccinated, it really hits home to say, ‘Do it for yourself, but also do it for your family and grandkids.’”