The READII Program in Bexar County, Texas

Since 1988, the San Antonio Metropolitan Health District (SAMHD) Immunization Division has promoted influenza and pneumococcal vaccine education and service delivery efforts in the Bexar County area. Despite the universal availability of these Medicare-covered vaccines nationwide, influenza and pneumococcal immunization coverage rates for minority population 65 years of age and older are disproportionately lower than that of their Anglo counterparts. This trend also exists in San Antonio.

To reduce these racial and ethnic disparities in vaccination coverage for those 65 years of age and older, the Department of Health and Human Services launched an adult immunization initiative known as the Racial and Ethnic Adult Disparities in Immunization Initiative (READII) in 2002. SAMHD was selected as one of five sites throughout the nation to engage in this two-year demonstration project.

Working in conjunction with relevant stakeholders, the San Antonio READII project formulated a community action plan that focused on collaborative efforts involving diverse groups of Hispanic senior community partners to promote the uptake of influenza and pneumococcal immunizations and coordinated promotional activities with pharmacy groups, private providers, managed care organizations, and other agencies that serve the elderly.

The READII project worked with the State Medicare Quality Improvement Organization, local long-term care and nursing home agencies, and professional medical societies/organizations and ensured that patients and health care providers were educated on the benefits of receiving the influenza and pneumococcal vaccinations. Evaluating the effectiveness of these READII activities is crucial to assess the issues of greatest concern to stakeholders and determine the different levels of impact with the resources that were available.

The READII program’s target area consisted of nine ZIP Codes clustered in central and south central Bexar County. The San Antonio Metropolitan Health District designated these ZIP Codes as high-priority areas due to the large Hispanic senior population and the degree of health disparities.