Bexar County
Immunization
Collaborative
Immunize
San Antonio! (IZSA)
By Pamela S. Agbevey
The immunization status of our
community should be of great
concern to all of us. The average
levels of immunization for children
two years and younger in many
parts of Bexar County consistently
remain lower than 60%. Despite the
introduction of the Vaccines for
Children Program (VFC), and Medicare
coverage for vaccines for the elderly,
immunization rates in several areas of
Bexar County still remain significantly
low. Economic, racial, age and ethnic
disparities exist, with rates disproportionately
lower among minorities and
adults. Improving immunization delivery
and rates will require a better
understanding of the reasons for our
current low rates and greater collaboration
among individuals and agencies
providing this care.
On August 30, 2007, the Centers for
Disease Control and Prevention (CDC)
released the results from the 2006
National Immunization Survey (NIS),
which surveyed 1500 children in Texas
aged 19-35 months. These children
were born between January 2003 –
June 2004, indicating that the NIS is a
measure of the effectiveness of strategies
and activities that were in place up
to three years ago. The 2006 results
show that, Bexar County’s average
immunization rate increased by 3.4%
from 71.3% to 74.7% (+/- 6.8%) for
the 4:3:1:3:3:1 series (4 doses of DTaP,
3 doses of Polio, 1 dose of Measles, 3
doses of Hepatitis B, 3 doses of
Haemophilus Influenzae type b, and 1
dose of Varicella). This means that our
actual immunization rate could be as
low as 67.9% or as high as 81.5%.
Despite this increase, we are still a long
way from the 2010 goal of 90%. It is
IZSA’s aim that, through collaborative
efforts in the community, Bexar County
would be among the cities and counties
to achieve the Healthy People 2010
goal of having 90% of all children
immunized by their 2nd birthday.
Today, only about 77% of all U.S
children have been fully immunized by
their second birthday. Delayed immunization
is a major public health problem
that has been associated with several
vaccine preventable diseases or
outbreaks in recent years. Improving
the timely delivery of childhood
immunizations has thus become a
national imperative. Despite this mandate,
more than 25% of children 19-35
months of age in Bexar County and
Texas remain vulnerable to vaccinepreventable
diseases.
The dawn of June 19, 2007 gave rise
to the San Antonio Immunization
Collaborative, popularly known as
IZSA (Immunize San Antonio!). This is
a volunteer organization that represents
stakeholders in the community
concerned about raising immunization
rates among children and adults alike.
One may wonder whether coalitions
are successful in raising immunization
rates. Even though this may be hard to
prove, the answer is yes. For example, “from 1993-1996, immunization rates
in Norfolk, Virginia rose from 49% to
66% for children under 2 years old as
a result of CINCH (Consortium for
Immunization of Norfolk’s Children),
a CDC funded research demonstration
project that led to a community-driven
coalition project.” (Butterfoss et al.,
1998)
Although coalition building has
become a popular approach to address
problems in society, the concept of
coalition building is not new. In 1840,
Alexis de Tocqueville, the first noted
international researcher on American
society, remarked that “... Americans
are a peculiar people ... If, in a local
community, a citizen becomes aware of
a human need that is not met; and
then discusses the situation with his
neighbors; suddenly a committee
comes into existence. The committee
thereupon begins to operate on behalf
of the need, and a new community
function is established. It is like watching
a miracle.” As we can see, coalitions
are useful for accomplishing a
broad range of goals that reach beyond
the capacity of any individual member
organization.
IZSA exists to “promote immunizations
across the life span through
increased collaboration, education, timely immunization and access for
all people, with focus on hard to
reach and high-risk populations of all
ages.” Its vision is to “have a community
with all residents protected from
vaccine preventable diseases.”
Currently, there are over 120 members
representing about 102 organizations
in the Bexar County Immunization
Collaborative. Almost half of
these members attend the collaborative
meeting on a regular basis. Since
its inception, the group has had four
planning sessions to establish the
mission, vision, goals and objectives,
committees and strategic plan.
Current goals include:
• Increase collaboration between community
stakeholders and immunization
providers in our region
• Increase education, awareness and
outreach in the community
• Increase accessibility
• Increase immunization rates in
our region
Committees Include:
• Senior
• Adolescent/Young Adults (18+)
• Children (3-18)
• Infant (0-3)
• Influenza
Sub-committees Include:
• Service delivery
• Outreach and Education
• Marketing
• Registry / Provider Training
Benefits of being a member include:
• Opportunities for involvement in
IZSA decision making processes and
projects
• Free immunization updates, training,
and educational materials
• Networking opportunities with representatives
from healthcare organizations,
vaccine providers, childcare
providers and other stakeholders in
the community
• An arena to voice your immunization
concerns
Since IZSA is a volunteer organization,
anyone interested in improving
immunization rates in Bexar County
is welcome to join.
We look forward to your participation.
For more information about the
Bexar County Immunization Collaborative’s
activities and how to
become a member, please contact
IZSA at 210-207-2869 or 210-207-
8867 or by fax at: 210-207-2081 or
email us at: IZSA@sanantonio.gov.
References
Butterfoss FD, Morrow AL, Rosenthal
J, et al. CINCH: An Urban Coalition
for Empowerment and Action.
Health Education Behavior. 1998;
25:212-225
de Tocqueville, A. 1840.Vol. 2.
Democracy in America.
www.cdc.gov
Pamela S. Agbevey will receive her MS in
Healthcare Administration (MHA) from
Trinity University in December 2007. She
received her BA in Business Administration-Finance & Economics from Truman
State University.
Born in Ghana, Pamela moved to the U.S.
in 2001. She currently serves as an administrative
resident with the San Antonio
Metropolitan Health District in order to
fulfill the practical portion of her graduate
studies in Healthcare Administration at
Trinity University.
Prior to this position, she served as the
assistant administrator for a cardiology
group practice in San Antonio. In the past,
she worked at the University Health
System in San Antonio as a research assistant
for the surgery/trauma department.
While at Truman, she served as an economics
tutor and research assistant for the
social science division and was awarded a
grant to undertake a research on “USAfrica
Trade and the Impact of the African
Growth and Opportunity Act (AGOA) on
trade,” which was presented at Truman’s
Annual Research Symposium.
Pamela enjoys reading, learning new languages,
biking, cooking, volunteering and
exploring new cultures. As a founding
member of IZSA, she loves serving her community.
