Commonwealth of the Northern Mariana Islands: Strategies to Improve Influenza Vaccination Rates

Strategy

The Commonwealth Healthcare Corporation (CHCC) immunization program, in the Commonwealth of the Northern Mariana Islands (CNMI), serves a population of about 50,000 residents. The program developed and refined strategies to increase access to immunization services and vaccinations, specifically influenza vaccines. The program continuously collaborated with educational institutions such as school and daycare facilities, private and government agencies, Vaccines for Children (VFC) providers, pharmacies, and community-based events to increase influenza vaccine coverage for all CNMI residents ages 6 months and older.

Challenge

In CNMI, influenza vaccination coverage rates for eligible individuals 6 months and older have been lower post-COVID-19 pandemic compared to pre-COVID-19 pandemic. This decline has been demonstrated in populations of focus including young children, young adults, and older adults. Lower vaccination coverage rates have the potential to increase community transmission, hospitalizations, and possibly death. Although the severity of the infections varies between seasons, there are definite flu infection peaks throughout the year.

Solution

A variety of solutions were implemented to increase awareness and access of services to community members, such as:

• Increase messaging through social media, as well as implementation of other mediums such as radio and newspaper ads.
• Increase access through targeted community-based outreaches in high traffic areas such as grocery stores, community centers, etc.
• Conduct school- and daycare-based outreach onsite through coordination with educational institutions, as well as strengthen routine vaccinations by combining availability of influenza and routine vaccines.
• Strengthen partnerships with VFC and adult providers to provide influenza vaccines to eligible individuals.
• Strengthen collaborations with pharmacies that offer influenza vaccines by providing technical assistance and support in reporting vaccine administrations to the immunization information system (IIS) for accurate patient vaccine history and coverage rates.

Outcome: The strategies were implemented in collaboration with partners to improve access, increase reach, and to provide services that reduce overall morbidity and mortality.

Post-COVID19 pandemic coverage rates for flu vaccine continue to rebound and maintain both the overall and specific age groups.

CNMI Influenza Coverage Rate, by year (2021-2025) 

Source: CNMI WebIZ vaccination data

The CHCC immunization program continues to implement its strategies and assess their impact on increasing influenza vaccination coverage rates. Through a blend of education, awareness, and outreach, these interventions aim to combat mis/dis-information, gain public trust, and offer accessible services for the community.