The COVID-19 pandemic has caused significant disruption to the nation’s public health and healthcare infrastructure. In Year 4 5 of the the Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation's Health by  by strengthening adult immunization practices in health centers serving high risk vulnerable populations, the  the National Association of Community Health Centers, (NACHC) will apply lessons learned from COVID-19 to address Flu, Pneumococcal, and other adult immunizations.  

NACHC’s strategies in year 4 to close immunization gaps includes working with up to 10 primary care associations, health center-controlled networks, and up to 80 health centers to get more shots in arms by:
• Applying in evidence based quality improvement efforts and  engage high risk vulnerable populations through:  

• Data driven quality improvement tools (assessment, feedback, incentives and coaching) 

• Application of CDC Standards for Adult Immunization

• Practice  

• Harmonization of adult immunization service delivery with clinical and data

• workflows  

• Working with care extenders such as pharmacists and community health

• workers  

By applying Human Centered Design (HCD), LEAN Informatics, and implementation science methods science methods NACHC’s proposal includes blended learning model using the following elements:
• HIT informed quality improvement working with HCCNs and PCAs
• Quality improvement focused learning community to share lessons learned and promising practices of health center teams
• Documentation and data integrity
• Patient facing FHIR App to document vaccine status
• Understanding actionable SDOH data to enhance clinical management of high-risk patients, improve health outcomes, and drive health equityA collaborative approach that starts at point of care and builds on existing assets in the health center network will result long term in cost savings, shared knowledge, patient and provider engagement, and increased coordination.  

• Data analytic plan for adult immunizations for participating sites 

• Team focused coaching and data intervention  

• Mixed method learning models for scale and spread of adult immunizations 

• Quantify the results of the past 5 years of the Cooperative Agreement