‘Start Smart’ hopes to get Indiana children caught up on routine immunizations

Few, if any, aspects of daily life have escaped disruption in some way due to the COVID-19 pandemic. Routine childhood immunizations are no exception. Almost two and a half years after the first case was diagnosed in Indiana, the rates of routine childhood immunizations, which protect against disease like measles, mumps and chickenpox, have fallen about 10 percent across the state.

A team of Indiana Department of Health (IDOH) Division of Immunization and Emergency Preparedness (DEP) experts are working to improve those vaccination rates, using what they’ve learned from their experiences with COVID-19 to help Hoosier kids get caught up on required immunizations, just in time for the start of a new school year.

Jab jabber

Megan Lytle and Dave McCormick have the endearing camaraderie of people who’ve seemingly worked together for decades, even though it’s been only a couple of years since the two IDOH divisions truly converged. If necessity is the mother of invention, then in some ways Lytle, who serves as Emergency Preparedness division director, and her Immunization counterpart McCormick are a little bit Edison and a whole lot of Tesla. They assessed a problem and then leveraged all the tools they had to address it.

With their teams’ work on COVID-19 mobile clinics serving as a solid foundation, the divisions are turning their attention toward mitigating some of the consequences of the pandemic, notably a marked drop-off in the number of kids who have received all the vaccinations they’ll need to attend school this fall. The program is called “Start Smart” and involves a media blitz and clinic mobilization to help kids get back on track as they prepare to return to the classroom, particularly those who will begin kindergarten, sixth grade, or their senior year of high school. Emergency Preparedness and Immunization are working with internal and external partners, such as Local Health Department Outreach and the Indiana Immunization Coalition, to name only a couple, to help spread the word.

McCormick said approximately 46 percent of children are missing at least one recommended vaccination. Those numbers reflect an unfortunate trend statewide and aren’t relegated to any particular city or county. Recommended and/or required vaccinations include those for inactivated poliovirus; measles, mumps, and rubella; and diphtheria, tetanus, and acellular pertussis (DTaP), among others.

Caption: IDOH’s Start Smart back-to-school immunization campaign includes statewide advertising that includes radio and digital ads and gas pump ads in key areas.

Catching up

Start Smart focuses on hosting and promoting back-to-school immunization clinics across the state and launched earlier this month. McCormick said making sure that vaccination sites were accessible in all counties was a priority. To make it as easy as possible for Hoosiers to find a clinic in their area, the team posted a Routine Immunizations Catch-Up map on the Immunization Division’s page of the IDOH website. More than 150 clinics are currently available and searchable by county. Users can click on a specific location to learn its address, phone number, hours of operation, and scheduling information. A tab at the right of the page contains a list of all Indiana counties with a drop-down menu that allows users to click each location to learn more about it.

“I’m thrilled that we can say that we have a clinic identified and on our map for every single county,” said McCormick. The map is nearly identical in form and function to the “Our Shot” COVID-19 immunization map that helps Hoosiers find where they can get a COVID-19 vaccine or booster. That means it’s easy to use and is updated regularly with the latest information.

That’s by design.

“We didn’t reinvent the wheel; we just kept spinning it, if you will,” McCormick said.

One vital aspect of Start Smart that helped determine where the team concentrated more of its attention (as necessary) was the use of data. Several factors were used to determine a community’s risk score, which itself was part of a spectrum that relied upon rates of vaccination that were broken down by grade level and type of vaccine. But the risk score was only one component, Lytle explained.

“We have some [communities] that are at highest risk, but they have really high vaccine completion rates,” she said. “But at the same time, we did outreach to every single county and said, ‘What are you doing to prepare for back to school?’ So, what kind of clinics and outreach are you doing?”

The responses helped guide the team so it could concentrate efforts where they were needed most. Lytle noted that communities that had adequate coverage for the clinics were aided by IDOH by advertising those communities’ planned clinics on the Start Smart map, which helped improve accessibility. The team also offered assistance for those clinics if needed. It’s been a holistic approach that attempted to cover all the bases and account for each community’s unique needs.

Behind the vaccines

Start Smart launched July 12 and is slated to run through Aug. 30. The team is considering one final large-scale immunization event to close out the program -- if the stars align for that to happen. Lytle is hopeful it will, and she credited McCormick, with whom she and her team have worked closely throughout the last three years or so, with the idea for a grand finale.

Behind the “scenes,” Start Smart is steered by a dedicated crew of experts with the same level of dedication to serving Hoosiers as their division directors. McCormick and Lytle cited Immunization division assistant director Jill King for the work she and her team have put into coordinating the logistics of vaccine distribution. Public health administrator Missy Layman is deeply involved as well, and the team has no small task in determining how and where the vaccines are stored and located prior to finding their way into the arms of kids who need them. McCormick said there are 14 different types of vaccines that students can from the Start Smart campaign. And that means 14 different types of storage and 14 different means of delivery.

They also highlighted the contributions of Kathrine Lamoreaux, Emergency Preparedness clinical director. McCormick called the mobile clinics headed by Lytle and her team “the backbone” of the effort. He and Lytle also discussed collaborations with the Center for Deaf and Hard of Hearing Education, the Division of Lead and Healthy Homes, and others, showing how partnerships are key in helping Hoosiers stay healthy. The camaraderie and closeness forged through two years of difficult public health concerns have helped the team meet the challenges of the day, and that experience is helping create better outcomes.

“If it wasn’t for the infrastructure that we were able to build during COVID, we would not be able to pull off these clinics,” said McCormick.

Story by Brent Brown, Indiana Department of Health