WIP 101 - An Investigation on Increasing Childhood Vaccination Rates by Introducing Direct Primary Care in an Urban Family Shelter

Poster Number: WIP 101
Publication Number: WIP 101.912

Background: Undervaccination in the homeless population has been well researched and continues to show an inequitable process to one of our most vulnerable populations. Many reasons for this have been cited, but a strong theme emerged including transportation and a general distrust for the healthcare system. Vaccination rates amongst children experiencing homelessness is not as well researched, particularly when discussing the efficacy of interventions. Children experiencing homelessness have an increased risk of undervaccination even when compared to general children experiencing poverty. Detroit includes a large population of children experiencing homelessness with difficulty in maintaining their vaccination status. COTS (Coalition on Temporary Shelter) is the largest family based shelter in Detroit, MI, hence the setting of our study.

Objective: The primary objective of this research project is to increase vaccine administration by 25% within a 6 month period among children living at COTS Shelter in Detroit. This will be accomplished through expanding access to vaccines, improving health literacy of parents and children experiencing homelessness, and integrating the use of primary care.

Design/Methods: Subjects in our study are children experiencing homelessness ages 0 to 18 residing at COTS Shelter in Detroit, MI. The vaccination status and demographics of each child is determined through self-reporting and the Michigan Care Improvement Registry (MCIR). The primary intervention of the study included a monthly pop-up clinic for pediatric care including vaccinations which began in January of 2023. To determine a baseline vaccination rate within the shelter, we retrospectively assessed vaccination status from July 1, 2022, to December 31, 2022. To assess the success of our primary objective, a prospective investigation was performed from January 1, 2023, to June 1, 2023. In both arms, vaccination status was assessed upon entry to the shelter and again three months later. Vaccination rates pre-intervention were compared with the post-intervention vaccination rates of subjects.