Strategy: In 2023, to improve immunization rates for kindergarten-aged children, Colorado created an evidence-based Public Health Detailing Program to 1) share practice-level immunization information system (IIS) coverage data and 2) drive change at the practice level to improve immunization service delivery. The program included standard best practices for immunization delivery and one-on-one provider visits, which cultivated relationships between providers and public health agencies. While evaluating the program, Colorado found that providers valued receiving a current listing of kindergarten-aged children associated with their clinic in the Colorado Immunization Information System (CIIS), which included MMR and DTaP vaccination status. In receiving this data, providers were able to implement strategies to increase uptake of vaccines and improve workflow using information from CIIS reports.
Challenge: Despite improvements to some provider level MMR immunization rates, due to the program being sustained by supplemental funding, Colorado no longer had the personnel resources to sustain the Public Health Detailing Program. So, Colorado launched the Kindergarten MMR Provider Honor Roll/Recognition Program as a replacement for, and to build off the success of, the Public Health Detailing Program.
Solution: The Kindergarten MMR Provider Honor Roll Program is designed to continue provider outreach and support kindergarten MMR vaccination efforts, while adapting to reduced state staffing and resources. The idea for the recognition program was based on provider interest in attaining higher vaccination rates and it was built on the framework of the Immunize.org Hepatitis B Birth Dose Honor Roll. The primary goal of the Kindergarten MMR Provider Honor Roll is to increase provider-level MMR vaccination rates to ≥ 95%. The objectives of the program are to encourage best practices among providers, publicly recognize high-performing providers, improve patient outcomes and reduce preventable outbreaks, and to increase kindergarten MMR rates in Colorado. Providers are eligible for the program if they: administer MMR vaccines and report to the CIIS, have at least one point of contact in CIIS, have at least 50 kindergarten age patients and at least a 30% MMR rate, and provide data by October 15 and January 15 of each school year. Performance is evaluated by clinical data that measures the percentage of children eligible for kindergarten who have two doses of valid MMR vaccines on their IIS record. In October 2025, Colorado announced the program to eligible providers in an email to the main point of contact in CIIS. The announcement also included the providers’ current MMR rate, with an offer to send patient lists from Colorado’s internal dashboard and to provide other technical assistance as needed. Note: Patient lists are sent via encrypted email.
Colorado operates the program on the following timeline:
- July 1: The immunization program (IP) pulls baseline MMR data for the upcoming school year.
- Note: Data is calculated as of July 1 for each school year. For provider outreach, the data is pulled in October and January.
- August/September: Prepare email templates for provider outreach.
- October: Announce the program to providers (see above for further details).
- October-January:IP tracks provider engagement.
- Late January: IP announces new honor roll inductees.
- February-April: Evaluate change in MMR rates for current school year.
New honor roll inductees include providers whose data, pulled after the annual January 15 Colorado aggregate school reporting deadline, shows their kindergarten MMR rate at ≥ 95%.
The recognition methods for providers with ≥ 95% vaccination rate include: digital certificate (branded, dated, and sent via email), immunization newsletter shoutout(s), recognition in the Licensed Practitioner of the Healing Arts (LPHA) Community of Practice meeting, and inclusion on the Colorado Department of Public Health and Environment (CDPHE) Immunization Branch Kindergarten MMR Honor Roll webpage.
Outcome: There are currently 15 pediatric clinics recognized in the Colorado Kindergarten MMR Honor Roll. Those clinics are representative of seven different counties across Colorado. For evaluation, the clinics were split into two cohorts.
| October 15, 2025 – Baseline Cohort | January 15, 2026 – Final Cohort |
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Overall, 242 clinics were included in the October and January cohorts. Of those 242 clinics, 25 (11.5%) of those clinics received technical assistance (three additional clinics received technical assistance who were not included in the January cohort).
Of the 25 clinics that did receive technical assistance:
- Nineteen (76%) clinics saw an increase in their kindergarten-aged MMR up to date (UTD) rates
- Five (20%) clinics saw a decrease
- One (4%) clinic saw no change
Of the 217 clinics that did not receive technical assistance:
- Ninety-three (42.9%) clinics saw an increase in their kindergarten-aged MMR UTD rates
- One hundred and nineteen (54.8%) saw a decrease in rates
- Five (2.3%) clinics saw no change
Evaluating these statistics shows that clinics that received technical assistance were statistically more likely to increase their kindergarten-aged MMR UTD rates. Clinics that received technical assistance also showed a larger increase in rates compared to clinics that did not receive technical assistance.
Supplemental Materials