In 2012, an innovative public health program using the slogan “Spread Democracy Not the Flu,” found a way to efficiently provide essential disease-prevention services to adults. The initiative, Vote & Vax, allows people to get flu vaccines at polling places.
The public health program administered approximately 9,379 vaccines in 48 states as well as Washington, D.C., Guam, Puerto Rico and the U.S. Virgin Islands, during the 2012 elections. A total of 651 clinics were set up in polling places. Organizers also placed 934 clinics in pharmacies to see how the demand for shots compared with polling places. Voting sites dispensed significantly more vaccines than pharmacies (5,710 compared to 3,669). There was also a significant participation from African-Americans and Hispanics at polling places.
Organizers analyzed data from both venues and found that people who get flu shots at polling places tend not to be regular flu shot recipients. More than half of the white Vote & Vax recipients (51 percent), more than two thirds of African-American recipients (72 percent), and more than three quarters of Hispanic recipients (94 percent) were not regular flu shot recipients. Participants had varied insurance arrangements, with about 37 percent reporting being uninsured or having Medicaid coverage.
“Over the last two presidential election cycles, we’ve successfully achieved a ‘proof of concept,’” said Douglas Shenson, M.D., M.P.H., an associate clinical professor at the Yale School of Public Health, who published an analysis of the program in the April 2015 edition of the American Journal of Public Health. Moving forward, he would like to see the program broadened to include cardiovascular screening and appointments for smoking cessation programs. Shenson would also like to see Vote & Vax piloted in international settings, perhaps delivering other kinds of preventive services.
Polling places are logical locations for health care practitioners to reach adults because national elections draw sizeable numbers and occur during the flu shot season. More than 120 million Americans go to the polls in presidential elections, and more than half of the voters are age 50 or older. There are 186,000 polling places in the United States, representing a significant platform to provide mass vaccinations, especially to those who are most vulnerable to influenza.
Vote & Vax began as part of a larger initiative to expand delivery of clinical preventive services beyond the clinician’s office, and has spun off on its own as a separate project funded by the Centers for Disease Control and Prevention. Shenson said the program would be active in 2016, largely serving as technical support for others who are committed to the program or for those who would like to work on its deployment.
Shenson said one significant change that has occurred since Vote & Vax was first launched nearly 20 years ago is a decreasing proportion of people over 65 who are getting vaccinated at polling places. “By early November, most older folks have already had their flu shot.”
“Vote & Vax reinforces the public health principle that that it is important to go where people are already congregating, rather than expect the public to come exclusively to health-related venues for vaccines,” said Shenson. “When it comes to disease prevention, this is important because health-related venues ‘select’ for folks who are already interested in addressing health issues. If we are only at such places, we will miss those who can benefit from the intervention but whose priorities may lie elsewhere.”