Strategy
Children’s Wisconsin implemented a 10-week pilot of a mobile family vaccine clinic to address declining influenza vaccination coverage in the community.
Challenge
Influenza vaccination coverage in Wisconsin has declined in recent years, falling from 44% in 2020-2021 to 34% in 2025-2026, demonstrating the need for new strategies to increase access to and uptake of influenza vaccination. Health care systems and emergency departments (EDs) see large numbers of patients and families throughout influenza season, creating an opportunity to reach individuals who may not otherwise seek vaccination. Children’s Wisconsin identified parents and siblings accompanying pediatric patients as a missed opportunity for influenza vaccination. Although the health system had an established vaccination program for its patients, family members were not routinely included. This presented an opportunity to extend vaccination services beyond the individual receiving care and use an existing healthcare encounter to reach additional members of the household.
Solution
Children’s Wisconsin developed a mobile ED Family Vaccine Clinic to offer influenza vaccination to eligible family members accompanying pediatric patients. The program adapted an existing ED patient vaccination model and used a separate workflow to allow family members to be assessed and vaccinated while the pediatric patient continued receiving emergency care.
The family vaccine clinic brought together clinic nurses, pharmacy students, and other pharmacy staff to support registration, eligibility and interest assessment, vaccine verification, administration, and documentation. Family members were screened for vaccine eligibility and interest, while the pediatric patient continued through the standard ED workflow. This created two parallel processes that allowed vaccination services to be provided without requiring substantial changes to the patient’s medical care.
Children’s Wisconsin used the IM-ADAPT Framework to guide implementation. The team assessed the fit of the existing program, identified staffing, information system, and regulatory needs, and then adapted the electronic health record interface and billing process. The team also developed an interprofessional education rotation for pharmacy students, who were trained to recommend, counsel, vaccinate, and document vaccine administration. The pilot was implemented over 10 weeks during fall 2025. The approach was designed to make vaccination more convenient for families while limiting the impact on existing ED workflows. The program also provided an opportunity to test a model that could potentially be adapted to other hospital settings and populations.
Outcome
The Family Vaccine Clinic demonstrated that emergency department visits can provide an opportunity to reach additional members of a patient’s household with influenza vaccination. During the 10-week pilot, 56% of families arriving during clinic hours were screened, representing 2,729 families. A total of 3,903 family members were screened, and 70% were eligible for vaccination. Of the 2,691 eligible family members, 519, or 19%, received an influenza vaccine.
Cost was the most common reason adults declined vaccination, highlighting an important consideration for immunization programs exploring similar partnerships. The experience suggests that simply making vaccination available in a convenient setting may not be sufficient when financial barriers remain. The team subsequently partnered with the Milwaukee Health Department and payers to provide free vaccines to adults in need.
The model was also feasible from an implementation perspective. Family vaccine clinic staff reported feasibility and acceptability, while emergency department staff reported high acceptability and limited impact on existing workflows. Children’s Wisconsin leadership agreed to continue the program beyond the grant funding period.