Conservative Care Occupational Health (CCOH): A Focus on Minimizing Vaccine Hesitancy among Industrial Workers in Arkansas

At the Conservative Care Occupational Health (CCOH), the team aims to serve the occupational health and wellness needs of many businesses and industries in Northwest Arkansas and beyond. Konstantin Berestnev, MD, MPH, Gregg Smith, Melissa Page, LPN, Veronika Berestneva, MIT, and Victoria Smith strive to improve access to tetanus, COVID-19, and influenza immunizations among poultry workers, municipal workers, and firefighters.  The community encounters many challenges when it comes to misinformation about immunizations and the team aims to strengthen partnerships, improve documentation through their EHR (Systoc) and the Arkansas IIS, WedIZ, and provide educational materials on the importance of immunizations.

Focus Group Findings

CCOH hosted in-person focus groups to gain a better understanding of the community’s point of view on immunizations. The majority of the focus group participants were white males, some participants were of Hispanic, African American, and Pacific Islander backgrounds. Many factors influenced an individual’s decision to receive a vaccine, which included family/friends, requirements for occupation, culture, fear, physician recommendation, and education. Several participants commented that they received vaccines because it was part of their upbringing. As they got older, they either started to question vaccines or took them to protect their children and parents when visiting them.

The participants commented that culture and lack of trust in the medical field play a role in an individual’s opinions on vaccines. African Americans are more resistant to medical professionals. There is hesitation due to stigma and fear as to what the physician will administer to them compared to individuals of other races. In addition, within the Pacific Islander community, some elders are intimidated to ask questions about medical conditions because they are part of a minority group and may not have medical insurance. They feel like if they ask questions, they will not get treated. Finally, most of the hesitation was noted around receiving the COVID-19 vaccine for a variety of reasons including:

·       Mandatory vaccination for work,

·       Speed at which the vaccine was developed,

·       Still catching COVID-19 after receiving the vaccine,

·       Adverse events from the vaccine, and

·       Lack of trust in the government agencies.

CCOH is exploring ways to improve their educational materials for their employees to try to address this hesitancy.

Trustt Medical Partnership

One of the major barriers CCOH encounters is the inability to administer vaccines that are not work-related. CCOH sought out the opportunity to mitigate this issue by partnering with Trustt Medical which offers mobile vaccine clinics utilizing community paramedics. Trustt Medical will help facilitate employees’ access to vaccinations when insurance coverage is required, which helps close the gap in care for their patients and provides convenience for the employees.

Connecting to the IIS

CCOH began the project with no access to Arkansas’ IIS (WebIZ). The patients’ records needed to be manually extracted the data from WebIZ and manually submitted documentation of each vaccination administered to the WebIZ. Due to the staff time involved with manual documentation, their goal was to fix this by coordinating an “iron bridge” between their EHR (Systoc) and WebIZ. They encountered several roadblocks along the way, such as a waiting list with Arkansas’ Department of Public Health, and incomplete tetanus forms/reporting in Systoc. However, after 15 months, they successfully received approval to implement the connection between Systoc and WebIZ in two of their clinics. The team now can automatically transmit vaccinations administered at these clinics to WebIZ.

Tetanus immunization program development

CCOH expanded its immunization quality improvement efforts to tetanus. As a supervising physician, Dr. Berestnev, through chart reviews and direct feedback to the mid-level providers, is educating providers on the assessment of tetanus vaccine eligibility and documentation of the tetanus immunization status in the clinical records. Melissa Page, LPN is training nursing staff to reduce errors in vaccine administration documentation and reporting to the Arkansas State immunization registry.  CCOH's initial internal data analysis shows a significant effect of these interventions on the assessment of tetanus vaccination status and eligibility, a decrease in missed opportunities, and a>30% reduction in documentation errors.  CCOH is currently at >95% error-free mark in documenting tetanus vaccinations.

ACOEM Resources for Adult Immunizations

The Centers for Disease Control and Prevention (CDC) Standards for Adult Immunization Practice calls for healthcare professionals to help ensure that their adult patients are fully immunized. Learn more about the Standards for Adult Immunization Practice (SAIP) here. 

Published on September 30, 2024