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Arkansas State Health Improvement Plan (SHIP), 3rd Annual Meeting

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Wyndham Grand Executive Center, Little Rock,

August 27, 2026

Presenters:

Dr. Sarah Labuda, MD, MPH, CTropMed, Arkansas Department of Health

Dr. Allie Staton, PharmD, ImmunizeAR

Focus Area: Infectious Disease Transmission & Immunization

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Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. Shattock, Andrew J et al. The Lancet, Volume 403, Issue 10441, 2307 – 2316.

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization

Andrew J Shattock, Helen C Johnson, So Yoon Sim, Austin Carter, Philipp Lambach, Raymond C W Hutubessy, Kimberly M Thompson, Kamran Badizadegan, Brian Lambert, Matthew J Ferrari, Mark Jit, Han Fu, Sheetal P Silal, Rachel A Hounsell, Richard G White, Jonathan F Mosser, Katy A M Gaythorpe, Caroline L Trotter, Ann Lindstrand, Katherine L O'Brien, Naor Bar-Zeev.

Findings: Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10.2 billion years of full health gained. We estimate that vaccination has accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

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Improve Access to Adult Immunizations

Influenza Virus Vaccination Rate

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Strategy 1: Targeted approach to take vaccinations to the hard-to-reach population.

Partners: ImmunizeAR, Arkansas Department of Health (ADH), nursing homes, Arkansas Pharmacy Association (APA)

Activities: Leverage resources of ADH’s VFC and immunizations programs, and resources of ImmunizeAR and APA to

      • Support pharmacies in low-access counties to enroll as VFC providers
      • Provides flu vaccine to uninsured nursing home residents
      • Provide flu vaccine to uninsured nursing home employees
      • pneumococcal vaccine to uninsured nursing home residents.

Focus Area: Infectious Disease & Immunizations

Improve Access to Adult Immunizations

(Indicator: Influenza Vaccine coverage)

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Vaccine for Children (VFC) Immunizations Providers by County, Arkansas, 2025

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Influenza Vaccination Coverage by Age Groups, Arkansas, 2012-2024

Source: National Immunization Survey

(NIS) and Behavioral Risk Factor Surveillance System

(BRFSS)

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Influenza Vaccination Coverage by Race, Arkansas

Source: National Immunization Survey

(NIS) and Behavioral Risk Factor Surveillance System

(BRFSS)

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Influenza Vaccination Coverage For Persons ≥6 Months of Age

Source: National Immunization Survey

(NIS) and Behavioral Risk Factor Surveillance System

(BRFSS)

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Strategy 2: Work with partners to incentivize vaccination, by offering e.g., gifts, free services, recognitions etc. to patients and family members, children, elderly, college/university students, congregate facilities, shelters.

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Partner(s): ImmunizeAR

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Activities:

    • Host college competition to increase flu immunizations.

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Focus Area: Infectious Disease & Immunizations

Improve Access to Adult Immunizations

(Indicator: Influenza Vaccine coverage)

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Strategy 3: Help leverage state partnerships and their work to improve vaccination rates.

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Partner(s): ImmunizeAR

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Activities:

    • ImmunizeAR Respiratory Virus Working Group meetings
    • Adult Immunizations Working Group meetings
    • Stakeholders’ meetings to help develop strategies to improve vaccine rates in Arkansas

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Focus Area: Infectious Disease & Immunizations

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Improve Access to Adult Immunizations.

Indicator: Influenza Vaccine coverage

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Improve Human Papilloma Virus (HPV) Vaccination Rate

Focus Area: Infectious Disease & Immunizations

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Strategy 1: Educate dental providers to better counsel patients on importance of HPV vaccine in preventing oropharyngeal cancers.

Strategy 2: Engage providers and provider support organizations to train pediatricians on motivational interviewing or HPV roundtable strategies to improve vaccination rates.

Partners: Nursing organizations, AAP, ADH, and ADE.

Activities: Organized 2025 HPV Summit

  • A total of 114 nurses, physicians, dentists, pharmacists, and students attended the 2025 Summit.

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Focus Area: Infectious Disease & Immunizations Improve HPV Vaccination Rate

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Strategy 3: Leverage resources of statewide AR-SHIP partners to promote vaccinations among clients and through their respective networks.

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Partners: ImmunizeAR, St. Jude HPV Cancer Prevention Program

Activities:

  • Collaborate with St Jude HPV Cancer Prevention Program for potentially utilizing its education and outreach activities for HPV, including online webinar series and working group activities.

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Focus Area: Infectious Disease & Immunizations Improve HPV Vaccination Rate

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Initiative for a broader impact:

Building Vaccine Confidence in Arkansas

Dr. Labuda and Dr. Staton

Focus Area: Infectious Disease & Immunizations

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Factors Contributing to Vaccine Hesitancy

    • Mistrust of institutions, including
      • Public health
      • Healthcare
      • Pharmaceutical companies
    • Misinformation and disinformation – “Infodemic”
    • Cost
    • Geographic barriers

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World health Organization: https://www.who.int/news/item/18-08-2015-vaccine-hesitancy-a-growing-challenge-for-immunization-programmes

Initiative for a broader impact

Vaccine Hesitancy

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Source: PEDIATRICS: https://publications.aap.org/pediatrics/article/153/3/e2023065483/196695/Strategies-for-Improving-Vaccine-Communication-and?autologincheck=redirected

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Prevalence of Vaccine Hesitancy:

    • Among high income communities irrespective of geographic locations
    • Rural minorities in remote communities
    • Wealthy urban residents
    • Those who do not accept due to religious reasons
    • Those who do not accept due to philosophical reasons

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World health Organization: https://www.who.int/news/item/18-08-2015-vaccine-hesitancy-a-growing-challenge-for-immunization-programmes

Initiative for a broader impact

Vaccine Hesitancy

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States With Medical, Religious and Philosophical Exemptions for Childcare and K-12 From School Immunization Requirements, May 2025

  • All 50 states and DC school immunization laws grant exemptions to children for medical reasons. 
  • There are 45 states and D.C. that grant religious exemptions for people who have religious objections to immunizations.
  • 20 states and D.C. allow some philosophical exemptions from few or all vaccines, or to certain age groups for those who object to immunizations because of personal beliefs.

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Source: https://www.immunize.org/official-guidance/state-policies/vaccine-requirements/exemptions-child-school-2025/

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Immunization Exemption by Type, Arkansas 2001-25

Source: Arkansas Department of Health

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Immunization Exemption Rates per 1,000 Students by Grade Groups, 2001-2025

Source: Arkansas Department of Health

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Medical, Philosophical, and Religious Exemption Rate per 1000 K-12 Students, Arkansas Public Schools, 2024-2025

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Strategies for Improving Vaccine Communication and Uptake

  1. Educate healthcare providers so that they are comfortable with giving a strong recommendation to their patients
  2. Support providers in knowing how to address concerns raised by vaccine hesitant patients and families
  3. Pre-bunk and share scientific, evidence-based support for routine vaccination for the public via trusted messengers

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Initiative for a broader impact

Vaccine Hesitancy

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Strategies for Improving Vaccine Communication and Uptake

Source: PEDIATRICS: https://publications.aap.org/pediatrics/article/153/3/e2023065483/196695/Strategies-for-Improving-Vaccine-Communication-and?autologincheck=redirected

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Strategies for Improving Vaccine Communication and Uptake

Source: PEDIATRICS: https://publications.aap.org/pediatrics/article/153/3/e2023065483/196695/Strategies-for-Improving-Vaccine-Communication-and?autologincheck=redirected

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How are we improving vaccine confidence in Arkansas?

    • Monthly Vaccine Confidence Collaborative meetings among thought leaders in healthcare and public health
    • Annual Immunizations Summit
    • Collaborations with AR AAP, UAMS/ACH Pediatric Residency Program, AR AAFP, and other prof. groups for provider education opportunities
    • Amplifying voices of advocates and evidence-based recommendations via partner social media platforms

Initiative for a broader impact

Vaccine Hesitancy

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Contact information�Dr. Labuda: sarah.Labuda@arkansas.gov�Dr. Staton: allie@immunizear.org

Thank you!

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Arkansas State Health Improvement Plan

Update

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Creshelle R. Nash, MD, MPH, CHIE

August 28, 2025

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Briefly……

  • Whole Population Health
  • Update of Activities
    • Infectious Disease
  • What is the Impact
  • What’s next: Call to More Action

SHIP update

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Whole Population Health

Title of the Presentation Here

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Infectious Disease and Vaccination

  • Influenza Vaccination Rate
    • Strategy 1: Address vaccination needs of homebound residents
    • Strategy 2: Incentivize vaccination
    • Strategy 3: Capitalize on the resources of state partners to promote vaccination

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Arkansas Pharmacy Association Partnership

  • Pharmacists as Providers
    • Test and Treat COVID, Flu, Strep
    • Oral Contraceptives Counseling and Prescribing
    • Naloxone Prescribing
    • Smoking Cessation Services
    • HIV testing and Prep and PEP

SHIP Update

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Impact- Vaccinations

SHIP Update

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Creshelle R. Nash

Crnash@arkbluecross.com

Thank You

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