Common Challenges

& HOW TO ADDRESS THEM

Listed below are come of the challenges and barriers that public health agencies reported during a survey from Safeguard Iowa Partnership when they explained why they haven't made more progress on adult immunization rates in general, and workplace/employer partnerships in particular.

Staff Time & Resources are Scarce

Myths about Adult Vaccinations Persist

Building and expanding partnerships can be time-consuming work. In a time of budget cuts and furloughs, it's tough to make a case for adding to a vaccination program's workload.

As described in greater detail below, other public health staff have found ways to work through their vaccination coalitions or other groups, such as business coalitions and emergency preparedness groups. These other groups can help share the tasks of approaching employers and educating employers about various options.

Sometimes, investing scarce health department resources in adult vaccinations requires an internal sales job first. Internal champions have made a strong case for workplace partnerships as:

advancing community health and broader goals (e.g. Healthy People 2020)
strengthening relationships with business/industry or new partners
increasing public health's visibility in the community
increasing the amount of people public health serves

Vaccination program staff and coalition members have heard these all before; many adults are unaware of the need for adult immunizations, are skeptical that they do any good, are concerned about side effects or long-term problems related to vaccine, do not have access to a regular source of health care - and even it they do, do not hear about vaccinations orget reminders from their physicians. All of this conspires to move adult vaccinations far down an individual's priority list.

As members of the general public, employers naturally share many of the same misconceptions held by their employees. They also have some of their own, related to the decision about whether or not promoting or offering adult vaccinations through the workplace is worthwhile. For example, many employers believe that their employees with health insurance will obtain their immunizations from their health care providers, but that is often not the case.

These myths and misconceptions do provide some small openings, though. For example, for many people, the difference between getting a vaccination or not is a matter of convenience. Employers can create a healthier workforce by removing the vaccination hassle factor - an appointment, a doctor's office visit, time off work, etc.

Many employers also are not aware of resources such as community vaccinators that can directly bill their insurance plans, reducing some cost objections. Health agencies have opportunities to address these sources of employer resistance or lack of knowledge.

Business are not our Priority Population

There is not a strong connection to business/industry

Workplace Wellness Programs Emphasize Chronic Disease Prevention

Public health agencies may have stronger ties to public sector and nonprofit agencies than they do to the private sector. In addition campaigns, programs, and partnerships to vaccinate adults have not been the primary focus of vaccination programs in the past. It may also be hard for public health to envision a change. For example, many vaccination programs from public health are target at children instead of adults, and many agencies have experience great success with those programs. There's no doubt that adult immunizations are a tougher sell. Regardless, public health is meant to serve the entire community, and targeting businesses provides opportunities to access this portion of the population.

By providing vaccinations to businesses, not only does it increase the percentage of the population that is vaccinated, but it helps increase the visibility of public health within the community, changes the perception that people may hold about public health, and allows public health to operate like a business. With budget cuts and loss of funding, it is increasingly important that public health agencies generate revenue in order to fund their other programs that may have lost funding.

While public health agencies have many strong and

long-standing partnerships across their states and

communities, connections to the private sector are

not always as prominent or central as some others.

Public health is often poorly understood, invisible,

and unfamiliar. As result, many employers mistakenly believe public health has little to offer them or their employees.

Health agencies that do not yet have connections to

employers need not start from scratch or build these relationships one employer at a time. Working through groups of employers - such as Chambers of Commerce, Rotary Clubs, industry specific, or large or small employers is one efficient approach. Another is to identify many potential influences of workplace health decisions at once - i.e. by reaching out to groups of human resource of continuity of operations managers. Emergency preparedness groups and coalitions offer their own connections to employers as well as an understanding of public health approaches from pandemic and other preparedness work.

Workplace wellness programs have become increasingly common, especially among larger employers. While we do not have detailed data on how many of these programs include a focus on adult immunizations, anecdotal information suggests that most do not. Workplace wellness programs most commonly focus on chronic disease prevention and management and lifestyle changes, as well as workplace-specific areas.

Chronic disease are worthy health targets, but adult vaccinations are likely to have an even more immediate impact on bottom lines and productivity. There's no reason for vaccination to compete with chronic disease for workplace wellness attention. Both should be included in a comprehensive program - and this adds occupational health groups to the list of potential partners for adult vaccination initiatives.