Creating alternative immunization clinics to maintain and improve community immunization rates.

Immunization campaigns are among the most effective means for improving community health, yet underimmunized groups leave communities at risk for vaccine-preventable diseases. In 1993, the Childhood Immunization Initiative (CII) was implemented to address this risk. The goal of the CII, to achieve immunization coverage 90% or greater among 2-year-old children, was reached nationwide by 1996. However, individual states ranged from 81% to 99% for specific vaccines (Centers for Disease Control and Prevention, 1997b). The work of the CII is ongoing and was expanded in 1996 to address the immunization needs of adolescents. The purpose of this article is to present a model for providing immunization services in alternative sites, in which the community health nurse takes the service to the people. Building linkages with local communities, preparing the clinic site and supplies, arranging for staffing of an alternative clinic, and evaluation after service provision are key elements to a successful outreach clinic.