Vaccination Programs: Special Supplemental Nutrition Program for Women, Infants & Children (WIC) Settings

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) recommends vaccination programs in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) settings when used with additional components–to increase vaccination rates among children.

The full CPSTF Finding and Rationale Statement and supporting documents for Vaccination Programs: Special Supplemental Nutrition Program for Women, Infants & Children (WIC) Settings are available in The Community Guide Collection on CDC Stacks.

Intervention

Vaccination programs in WIC settings include the following:

  • Assessment of infants’ and children’s immunization status
  • On-site vaccinations or referral to vaccination providers
  • Additional interventions such as client reminder and recall systems, manual tracking and outreach efforts, or adoption of monthly voucher pickup schedules that require more WIC visits when vaccinations are not up-to-date

Vaccination services may be provided in WIC clinics, or through collocation and coordination of WIC programs with other healthcare services.

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2009 (15 studies, search period January 1980-November 2009). A more recent search (2009-February 2012) did not identify new studies.

Study Characteristics

  • All included studies evaluated WIC programs in urban settings and populations

Summary of Results

Fifteen studies were included.

  • Overall, vaccination rates among children increased by a median of 10.5 percentage points (8 studies with 10 study arms)
  • One study evaluated interventions used alone and found no effect
  • Additional interventions most often used were monthly voucher pickup (5 studies) and vaccine administration on-site or in collocated healthcare facilities (4 studies)

Summary of Economic Evidence

Three studies looked at childhood vaccination series (search period 1980-2012). Monetary values in 2013 U.S. dollars.

  • Intervention cost per child per year averaged $17.77, and cost per vaccinated child averaged $67.96 (2 studies)
    • Cost estimates varied because interventions were for monthly voucher pickup programs with different referral types or additional monitoring
  • Third study provided incomplete estimate, reporting only cost of assessment for age-appropriate vaccination status (range: $1.90 to $3.93)

Applicability

All included studies evaluated WIC programs in urban settings and populations.

Evidence Gaps

  • How effective are intervention when implemented alone?
  • What are the effects of collocating WIC and health care services, requiring monthly voucher pickup, or providing WIC interventions outside of the medical home?

Implementation Considerations and Resources

WIC services provide opportunities for regular and ongoing contact with families who may have limited access or substantial barriers to vaccination services.

On-site or collocation of vaccination services can greatly enhance access. They require ongoing communication and coordination between WIC programs and healthcare providers to minimize missed vaccination opportunities and maintain continuity of care.

Crosswalks

Healthy People 2030 icon Healthy People 2030 includes the following objectives related to this CPSTF recommendation.