Improving Immunization Rates Among Seniors using the CANImmunize Digital Application

Although immunizations are important for reducing negative health outcomes related to pneumococcal disease, influenza, and herpes zoster (shingles), vaccination rates for older adults are well below the Public Health Agency of Canada’s target rates (e.g., 80 percent target rate for pneumococcal immunizations in adults over 65 versus 42 percent actual rate). A lack of awareness about which vaccines are needed and when, as well as confusion around the role of healthcare providers in recommending vaccinations, contribute to low vaccination rates among older adults. While monitoring and tracking vaccinations through a digital reminder system has been shown to improve immunization rates for children, there has been less focus from researchers on tracking and increasing the immunization rates of older adults. This program implemented an existing Canadian digital immunization platform, known as CANImmunize, to help improve immunization rates for older adults in assisted, independent, and retirement living facilities.

• The platform allowed older adults and their caregivers to access immunization records, view recommended vaccination schedules, and receive vaccination reminders on a secure website adapted for older adult use.
• The platform also shared the immunization status of residents with care staff, who could prompt them to receive overdue vaccines. 

The primary goal of the project was to evaluate changes in older adults’ pneumococcal immunization rates. The project also assessed changes in influenza, shingles, and COVID-19 immunization rates. The platform was implemented at three assisted/independent living facilities in Fredericton. Ten older adults (7 women and 3 men, aged 63 to 86 years) were recruited to participate. Data was also collected from a staff member at one of the assisted living facilities.

• Project outcomes provide insight into the immunization rates of older adults in a small sample, but generalizability of the findings is limited due to the project’s small sample size.
• More research is still needed on the immunization rates of older adults.
• The COVID-19 pandemic significantly impacted the project.
  • Recruitment was impacted by COVID-19 fatigue and vaccine hesitance.
  • Much of the immunization data collected relates to COVID-19, rather than pneumococcal, immunization habits and experiences.
• Older adults’ access to and relationship with technology impacted their engagement with the digital immunization platform, with some participants lacking regular access to internet-enabled technology and other participants wary of spam email communications (e.g., when they received digital reminders from the project team).
• Many of the older adults in the sample still desired paper immunization records instead of, or in addition to, digital records.

• Decision-makers at assisted living facilities should consider implementing policies for communal access to technology, such as shared computers for resident use.
• Experiment with different methods to engage older adults through technology (e.g., include the researcher’s full name and credentials in email communications and send text messages in addition to email reminders).
• Include the option for users to print their digital records in future digital immunization platforms.

To learn more read the complete project findings (PDF 144 KB)