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Vaccination Information and Reminder System (ViRS) - because babies do not come with instructions

One community's approach to engaging new moms in vaccinating their babies using a low-tech, high-touch system of supports.

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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

The Alliance aims to increase immunization rates of toddlers in Merced, California, by implementing a comprehensive system including in-person education by a health worker, vaccination reminders via novel technology, & access to vaccinations at home.

Explain the idea (less than 2,000 characters)

California law requires the immunization of all children who are enrolled in school or daycare. However, where immunization gaps still occur are among our 0-2 year-olds. In 2018, the lowest rates of immunizations among this age group occurred in Merced County (63%), one of the 3 counties where we provide care to low income families and their children. Through patient surveys we uncovered that mothers lack awareness of when vaccines are due or forget to attend their well-child appointments. With this in mind, we will focus our efforts on creating a solution to improve awareness and practical knowledge around vaccinations to increase immunization rates in our 0-2 year-olds in Merced County. Our solution is dependent on a system of people working together to support new mothers. Starting at the hospital, after the birth of the baby, the discharge planner will provide a warm hand-off to their primary clinic. The clinic will then schedule a home visit by their prenatal service worker (PSW). Trained PSWs normally provide prenatal education and resources prior to delivery; however, postpartum visits will be an added service to support mothers in their new role. During the visit the PSW will educate the mother on the importance of immunizations and vaccinating her baby, and teach her to use our novel, ViRS technology. The device provides a visual cue, notifying the mother when vaccines are due and should be kept in a visible location (e.g., on the refrigerator). If the mother fails to make the well-child appointment, the PSW, who is also aware of when the child's vaccinations are due, will contact the mother to identify and work to mitigate any barriers to vaccinating the child. If the barrier is related to limited time or lack of transportation, the PSW will schedule a home visit by the clinic nurse to administer the vaccines. Our goal is to provide the supports necessary to develop a sense of agency and confidence in our new mother's over the health of their children.

Which part(s) of the world does this idea target?

  • Northern America

Geographic Focus (less than 250 Characters)

Merced County in California, USA

Who are your end users and how well do you know them? (750 characters)

The Alliance is the health plan that manages the care of low-income families and their children in Merced County. As of 2016, Merced's population was estimated to have grown to 268,455 people, with 58% of its residents being Hispanic/Latino. Merced is considered a rural county, with the majority of the residents living in urban centers. The median age of its residents is 30, with 31% of the county being younger than 18 years old. Although Merced County's teen pregnancy rates have dropped in the last decade, teenage birth rates are much higher than state rates. There are race/ethnicity differences in who receives basic childhood vaccinations; Hispanics have the highest level of compliance (71.9%) with whites having the lowest level (57.1%).

How is the idea unique? (750 Characters)

Our idea provides a simple yet comprehensive solution. While many ideas focus on the importance of education, our idea also addresses social determinants of health challenges faced by our members that education alone may not always resolve. We utilize a variety of resources and supports (i.e. notification technology, follow-up phone calls, targeted solutions to personal barriers, increasing access to vaccinations via home visits) to minimize missed vaccination opportunities. Finally, we have a unique advantage in the existing relationships with other providers and organizations in the healthcare system and community to coordinate the care of our members. If successful, this program can be spread to other Medicaid health plans.

Idea Proposal Stage (Select 1)

  • Blueprint: We are exploring the idea and gathering the inspiration and information we need to test it with real users.

How many months are required for the project idea? (140 characters)

Our project requires 1 yr to pilot this system of services. Additional time may be necessary to develop and create the proposed technology.

Organization Name (less than 140 characters)

Central California Alliance for Health (CCAH or The Alliance)

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Locally/community-led organization
  • Medicaid managed care health plan

Organization Location (less than 140 Characters)

Scotts Valley, California, USA

What is the current scale of your organization’s work?

  • Community (working within one or a few local communities within a region)

Website URL

Tell us more about your organization/company (1-2 sentences)

The Alliance is a regional, non-profit, Medi-Cal managed care health plan established in 1996 to improve care and access to health care for lower income residents. We serve approximately 350,000 members across 3 counties and work with over 7,900 providers to deliver medically-needed care. We strive for quality care to improve the health outcomes of our members. One of the most basic methods for the prevention of diseases is immunization, which is why this idea aligns perfectly with our mission.

Who will work alongside your organization in the project idea? (750 characters)

We have relationships with Merced county hospitals, public health department, local immunization coalition, and local immunization registry organization, whose partnerships will be integral in executing this idea. Except for the hospital, these entities have all been actively engaged as part of the local immunization coalition to improve immunizations in Merced. We do not foresee challenges in facilitating these relationships further. Identification of an engineering and product development group to design and create our simple, low-tech notification device will be dependent on appropriate funding. Given our proximity to innovative technology organizations in the Silicon Valley, barriers are not anticipated.

How many people are on your team?


Tell us more about you and your team

Our team includes our Quality Improvement (QI) Director, two (2) QI Managers, four (4) QI Nurses, and four (4) QI Analysts. We assist our clinics in making improvements to enhance the quality of care and improve outcomes for our members by empowering them with information and in-clinic technical support.


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