In August, the CDC revised its recommendations for mask wearing, advising fully-vaccinated individuals to wear a mask indoors in public if they are in an area of substantial or high transmission. To help raise awareness for the importance of COVID-19 vaccination and, in many cases, masking to help curb the spread of the highly contagious Delta variant, Immunize Colorado has created “Masked & Vaxxed” face masks. The masks are for sale on Immunize Colorado’s online store. A portion of the proceeds will be donated back to Immunize Colorado to support efforts to make sure all Coloradans have access to lifesaving COVID-19 vaccines.

From June 23 to July 24, Immunize Colorado ran a Facebook ad campaign to promote the safety, efficacy, and importance of COVID-19 vaccination to Coloradans, with specific focus on those in rural areas and communities of color. The campaign was made possible by the World Health Organization’s Vaccine Safety Net, of which Immunize Colorado is a member, and their partnership with the Facebook Health Partnerships team. The campaign reached nearly 700,000 Coloradans, garnered 5.6 million impressions, and prompted over 30,000 clicks, which directed users to sign up for vaccine appointments. Immunize Colorado has made available the campaign creative for others to utilize in their own COVID-19 promotion efforts.

The Colorado Vaccine Equity Taskforce (CVET) has created new video and graphic testimonials from Colorado teens who have gotten the COVID-19 vaccine on why they got vaccinated. The videos and graphics are available in English and Spanish and can be downloaded and shared to social media or other mediums. Follow the CVET on Facebook to view and share this and other vaccine equity-related content.

Many Colorado providers were instrumental in the passage of Senate Bill 20-163, regarding immunizations for Colorado’s school entry process. As of July 1, 2021, this new law is in effect and applies to students returning for the 2021-2022 school year. This new law creates a system for increased education for parents and caregivers seeking a nonmedical exemption from vaccines required for school entry. The measure also improves the tracking and reporting system for all immunizations.

In an effort to support pediatric professionals across our state as they help to implement these changes, the Colorado Department of Public Health and Environment (CDPHE), American Academy of Pediatrics – Colorado Chapter, and Immunize Colorado have partnered to create a toolkit: Colorado’s New School Entry Immunization Law: Implementation Guidance and Tools for Primary Care Providers.

The toolkit includes:

• modifiable templates,
• vaccine safety discussion points,
• best practices regarding the Colorado Immunization Information System (CIIS), and
• official Certificates of Medical and Nonmedical Exemption.

These templates and tools are for primary care providers to utilize and customize as helpful for their practice and unique to their community and patient population. Our aim through the Colorado School Entry Immunization Toolkit is to assist providers in continued efforts to reach families whom they serve, help them understand the importance of vaccinations, and emphasize the role providers play together in keeping students and schools in our communities safe and thriving. (Please note the toolkit link is to a Google folder, which will always have the most up-to-date PDF version of the document, including answers to new questions and resources as needed.)

In addition, our organizations held a webinar on the implementation of Colorado’s new school entry immunization requirements. Access the webinar recording.

Immunize Colorado was awarded a new $100,000 grant from the Urban Institute as part of their national Boosting Vaccine Confidence and Coverage through Community-Based Organizations initiative. This funding is being passed through to Immunize Colorado as part of a larger CDC effort to expand vaccine confidence and access, by partnering and supporting national, state, and community-level agencies and organizations. The goal of the initiative is to increase confidence in and access to COVID-19 and influenza vaccination in racial and ethnic populations that are disproportionately affected and/or have low vaccination rates. As part of the award, Immunize Colorado will receive technical assistance and participate in a national learning collaborative that includes both group and peer learning.

A new video series for non-English speaking community members shares information about COVID-19 vaccines and explains how to sign up for a vaccine appointment at Denver Health. The videos were created in partnership with Denver Health, Immunize Colorado, and the Colorado Vaccine Equity Taskforce. They are available in Burmese, French, Karen, Nepali, Swahili and Vietnamese, with additional languages available soon.

With recent polling showing that some people in the U.S. who remain unvaccinated need help to take the final step toward vaccination, Colorado funders today announced additional support for on-the-ground efforts in communities across the state to increase COVID-19 vaccination levels and to ensure equitable access to the vaccination. The 39 additional community-based organizations receiving grants are using an array of personalized approaches to answer questions, increase understanding about COVID-19 and the vaccine, and make it easy for more Coloradans to get vaccinated. Personalized outreach efforts to underserved communities and communities of color include door-to-door canvassing, engaging promotoras, providing translation and transportation, and having a presence in trusted community spaces such as churches.

The $1.7 million in funding builds on a first round of more than $2.5 million in grants, supporting a total of 88 community-based organizations statewide. The funding is provided by Together We Protect, a partnership of Immunize Colorado, Colorado Vaccine Equity Taskforce, and 14 funders (listed below) that came together to create Colorado’s COVID-19 Vaccine Equity Fund.

On April 1, 2021, Immunize Colorado hosted a presentation for Somali community members in Colorado about COVID-19 vaccines. In the presentation, Dr. Anisa Ibrahim discusses COVID-19 vaccine information, the Colorado vaccine distribution plan, clinic information, and the importance of routine vaccines during the pandemic. Dr. Ibrahim also answers questions from the Somali community about COVID-19 vaccination. Dr. Anisa Ibrahim is the Medical Director at the Harborview Medical Center, Pediatric Clinic in Seattle, WA. Additionally, she is an Assistant Professor of Pediatrics at the University of Washington and serves on the Board of Directors of the Somali Health Board.

The Colorado Health Institute (CHI) has launched online vaccine equity maps that identify populations and communities disproportionally impacted by the COVID-19 pandemic and track vaccination progress across the state. The data show that in many of the state’s more vulnerable areas, vaccination rates are far behind the state average. The data also show, promisingly, that in much of the San Luis Valley and in other communities with lower incomes, more than a third of adults have been vaccinated. The maps were created to support Colorado’s vaccine equity efforts, led by Immunize Colorado and the Colorado Vaccine Equity Taskforce. The data is also supporting Together We Protect, Colorado’s COVID-19 Vaccine Equity Fund, as it prioritizes funding for vaccine equity efforts across the state.

In 2019, healthcare charges to treat vaccine-preventable diseases (VPDs) like measles, flu and whooping cough in Colorado adults and children reached $1.1 billion. That was before COVID-19 emerged. The same year, vaccine-preventable diseases were the culprit in over 14,000 hospitalizations and emergency department (ED) visits in children, and over 20,000 in adults. That’s according to a new independent report jointly released today by Children’s Hospital Colorado (Children’s Colorado) and Immunize Colorado.

The Vaccine-Preventable Diseases Report, prepared by researchers in the Department of Epidemiology at Children’s Colorado, examines CDC National Immunization Survey data and 2019 Colorado Hospital Association inpatient and emergency department data to determine the health and economic burdens resulting from VPDs in Colorado. According to the report, the economic toll of VPDs is highest for publicly insured and uninsured children and adults, with hospitalizations and ED visit charges for these groups totaling over $900 million in 2019.

The report also finds that only 64% of Colorado’s children born in 2017 were fully vaccinated by age two, ranking our state 43^rd in the nation. By age 35 months, the rate bumps up slightly to 78%—still well below national goals. This likely explains why, for children, ED visit and hospitalization rates for VPDs (excluding influenza) are highest during the first three years of life when on-time vaccination rates are lowest. As the report notes, “under-vaccination early in life leaves children vulnerable to serious diseases.”

In 2020, Colorado’s already-low childhood vaccination rates dropped further when the COVID-19 pandemic hit. Compared to the number of doses delivered January to March 15, doses delivered after March 15 to May were 31% lower for children 0-2 years, 78% lower for 3-9 years, and 82% lower for 10-17 years of age. Although vaccination rates have improved since this initial drop, they have not returned to pre-pandemic levels.

“The consequences of this period of under-vaccination may only become clear as pandemic mitigation measures ease up over the next year; low rates could leave children vulnerable to diseases like measles when they head back to in-person learning and when people start traveling more,” said Dr. Jessica Cataldi, the report’s main author and infectious diseases pediatrician at Children’s Hospital Colorado.

In fact, a March 2021 Immunize Colorado analysis of data from the 2019-20 school year shows nearly 45,000 Colorado students would potentially need to be excluded from school for up to 21 days in the case of a measles outbreak because they’ve either claimed a vaccine exemption (26,830 students) or have an incomplete or missing MMR vaccination record on file (17,834). With the decline in routine vaccination rates, it’s likely the number of potential exclusions jumped even higher during the 2020-21 school year.

As preparation for the next school year begins, getting Colorado’s kids back on track with vaccinations will be critical—especially as they return to in-person learning. Any progress made to bring rates back up could be further delayed if COVID-19 vaccine(s) get approved for children and teens and they’re unable to receive other recommended vaccines like meningococcal and Tdap before heading back to school. Currently, CDC recommends that other vaccines shouldn’t be given within 2 weeks of the COVID-19 vaccine.

“That’s why it’s critical for health care providers to create opportunities for vaccination catch-up now and help get kids back on track,” said Dr. Cataldi. “We can’t risk additional disease outbreaks.”

To mitigate this risk in 2021 and beyond, child health care providers can prioritize scheduling well-child visits and vaccine appointments for their patients – and parents can call their child’s provider to schedule them – this spring, before the inevitable back-to-school rush.