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Evaluating CDC’s Approaches to Enhancing Adult Immunization Uptake

A culturally responsive evaluation of CDC’s efforts to boost adult immunization uptake and advance equity
  • Client
    Centers for Disease Control and Prevention
  • Dates
    June 2022 - Present


Vaccination coverage is low among U.S. adults, with deepening disparities.

Adults typically receive preventive care less frequently and can be hard to reach with vaccination messages and services. As of 2019, four of every five adults ages 19 and older were missing at least one recommended routine vaccination. Stark racial and ethnic disparities persist, with lower coverage for most vaccines among non-White adults compared to non-Hispanic White adults. Lower vaccination coverage also poses a threat to the health of rural populations, pregnant women, older adults, adults with chronic underlying conditions, and other disproportionately affected adult populations—and the COVID-19 pandemic has further lowered adult vaccination levels.

Through a multisectoral partner network, CDC/NCIRD works at multiple levels of the health system to improve adult vaccination uptake and advance vaccine equity. Understanding the successes, areas of unmet need, impact, and sustainability of these efforts is critical to achieving CDC/NCIRD’s adult immunization objectives. 


An innovative, inclusive evaluation of national immunization efforts. 

NORC is applying its expertise in equitable evaluation to lead a comprehensive mixed-methods evaluation of CDC/NCIRD’s adult immunization strategies, with an emphasis on COVID-19 and influenza vaccine rollouts. 

Using a participatory and culturally responsive approach, the evaluation encompasses formative, process, outcome, and impact evaluation methods. This evaluation will: engage partners across sectors and levels of the health system to understand factors that facilitated COVID-19 vaccine rollout; identify best practices and opportunities for improvement in implementing adult vaccination interventions, with a focus on health equity; and support CDC to strengthen its collaborations and ultimately, vaccine uptake. 


Evaluation findings will help CDC/NCIRD enhance adult immunization and improve health equity.

NORC will lead the development and implementation of a dissemination strategy to raise awareness and encourage use of the results. Findings will enable CDC/NCIRD to strengthen its adult immunization activities towards greater impact and health equity, build the evidence base, and lay the groundwork for future evaluations. 

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