1189: Making Vaccination Easier and More Routine

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Wednesday, August 19, 2026. I am John Sheehan with news from the Association of State and Territorial Health Officials.

 

Declining childhood vaccination rates, rising exemptions, and growing vaccine skepticism are creating new challenges for state immunization programs. Kim Martin, Director of Immunization at ASTHO, discusses how states are responding by looking beyond traditional school vaccination requirements and taking a more holistic approach to access and trust, the focus of a recent Health Policy Update. She highlights efforts to offer vaccines at hospital discharge, expand the range of health professionals who can administer them, remove financial barriers, strengthen communication and data systems, and work with trusted community messengers. Kim Martin, welcome to the show.

 

KIM MARTIN: 

Thank you for having me.

 

SHEEHAN: 

So, Kim, the health policy update notes sort of three troubling trends: declining childhood vaccination rates, rising vaccine exemptions, and increasing vaccine skepticism. That's a big three-fer. What does that mean in terms of policy challenges?

 

MARTIN: 

Yeah, I think when we talk to states, the challenge is not just about the declining vaccination rates. I think it's also the why behind this decline, and we know that families are navigating a lot of information out there. And so, states are really working hard to make sure that they are providing the most up-to-date, evidence-based, trusted information that's easy to find, and at the same time, they're really looking at those practical barriers, like trying to make sure that appointments are easy to schedule, that school requirements are clear, and that providers have what they need to support families. So, I think a lot of the policy changes are really being addressed by both strengthening the trust, but also working to strengthen the system so that people can get vaccinated where it's convenient, where it's accessible, and where it feels routine.

 

SHEEHAN: 

You also note hospitals as a potential opportunity, or rather, as maybe a missed opportunity for healthcare professionals, to get vaccines to especially older adults. Why are some states focusing on the discharge policies at hospitals, and how is that a way to improve access?

 

MARTIN:

Yeah, hospitals are a really important touchpoint for the entire healthcare system, especially when, as you mentioned, we're thinking about older adults or people with those chronic health conditions. And so, when someone is already receiving care in a hospital, that's the perfect moment to check and see whether they're due for a vaccine. So, states like Tennessee and Pennsylvania are really looking at those discharge policies, and they know that we can make a really big difference by creating policies that make it easier for staff to offer vaccines when a person is discharged at a hospital to meet people where they're at. So, if it’s appropriate, people leaving the hospital can be offered a vaccine, and in this way, it's really about turning that moment of care into a moment of prevention and making sure that there's no one that misses an opportunity that could protect them down the road.

 

SHEEHAN: 

Another opportunity that you cite is expanding the range of providers, professionals who can actually offer to administer the vaccines. People, you know, pharmacists, pharmacy technicians, medical students, assistants, there are more people than that that could be providing the service.

 

MARTIN: 

Yeah, expanding that workforce, like you mentioned, is really important, and it's also about meeting people where they are. So, when you have that pharmacist or that pharmacy tech or the medical assistant or the nursing student that can vaccinate using the right protocols, it literally opens up more opportunities for people to get vaccinated in places where they already visit, like those pharmacies, a community clinic, or at work. So, you know, at the same time, it can help relieve some pressure from those primary care clinics. But even more importantly, a community provider, you know, usually has that strong relationship within their community, and they can be a source of trusted information. So ultimately, the vaccine becomes part of that everyday interaction, maybe in a pharmacy, and so it feels more accessible, and it feels less like you have to make that special appointment or you have to plan weeks in advance. So easier access for everybody.

 

SHEEHAN: 

Sure. And another policy proposal is, you know, reducing financial barriers. In Maine, they've eliminated a cost-sharing expense. Really, you know, that's oftentimes one of the biggest blocks to people getting a vaccine is just like, can they afford it?

 

MARTIN: 

Yeah, you're right. I mean, cost is a huge barrier and can stop someone from getting vaccinated even when they really fully intended to. So, you know, people often worry about a surprise copay or will my insurance cover the cost of the vaccine, which automatically makes someone hesitate. So, when a state removes that cost-sharing, like Maine did for pharmacy, pharmacist-administered vaccines, it sends that clear message: If you're ready to get vaccinated, we're going to make this easy, we're going to remove those concerns, which is one really big way that states can both improve the access, but also make the entire process a little bit less stressful.

 

SHEEHAN: 

And as you sort of survey all the activity around policies and state legislative actions, why is it important to keep track of all these of all these moving parts? And what should people be watching out for?

 

MARTIN: 

Yeah, I think, you know, it really stands out how broad some of these policies have become. And so for many years, a lot of immunization policies have been focused on school requirements, but now states are really looking across a lot of systems, and they're working to expand the workforce that can provide vaccines. They're working to strengthen their communication systems so that people can provide the best up-to-date information in a way that resonates. They're working with trusted messengers and providers to make sure that everyone has the information that they need so that they can communicate effectively. They're working with hospitals. They're expanding the number of health systems that offer vaccines. They're making it easier for people to get vaccines. States are working to improve data systems so that the information is all in one easy location for providers, so that they can see what immunizations people may need. And so I think there's just so much that is happening, and it's so broad. And states are really looking holistically about what does it take for vaccination to become easy and routine for people, and how can we look about this very broadly? And so I think these decisions that states are making now and what we're tracking is really, you know, about how simple states can make it for people to get a vaccine and how confident they can make it for people to feel about getting a vaccination and how prepared an entire community can be when a new vaccine-preventable outbreak happens.

 

SHEEHAN: 

Kim Martin is director of immunization at ASTHO.

 

The current public health landscape can feel daunting, uncertain, and increasingly stressful for leaders to navigate. While public health professionals have a wealth of expertise, reliance on expertise isn't enough. Collaborative leadership points the path forward. Moving away from traditional top-down approaches, effective and innovative leaders are learning to share power, practice meaningful community engagement, and create environments where partners, community, and staff feel valued and heard. In a recent blog, three scholars from ASTHO's Developing Executive Leaders in Public Health, or DELPH program, discuss how they apply these principles to strengthen collaboration within public health and build more resilient communities. Access through the link in the show notes.

 

The Public Health Hope, Equity, Resilience, and Opportunity (PH-HERO) initiative supports state and territorial health agencies in addressing workforce burnout, moral injury, and retention challenges. Grounded in trauma-informed and equity-focused approaches, PH-HERO offers curated resources to protect, support, and strengthen the public health workforce. Discover evidence-based tools, expert guidance, and research to help build resilient, thriving teams. Learn more through the link in the show notes.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.