During the first week of February, thirty big thinkers from the world of immunization gathered in a converted warehouse in Phoenix to dream about the future and ask the question, How could public/private partnerships increase vaccination rates? Said another way, they asked themselves, How could we change the world?

The Big Brain:

The Surprising Results of the First
Innovation in Immunization Summit

By Dale Dauten

I was nervous.”

That’s the first thing Mike Popovich said when asked how he felt going into the first Innovation in Immunization Summit.

It was late last year that he’d started asking, “What if we could bring together some of the bright people in the immunization world to discuss how to really move the needle in increasing vaccination rates?” He got others involved and the idea evolved: The planning team decided to tie it to the Healthy People 2030 goals, and, if we were talking about the year 2030, why not try to get 30 big thinkers to join in?  And let’s try to get them from every part of the immunization ecosystem.

Mike described what happened next: “So we created a wish list of people I thought could contribute and might be willing to come to a conference in Phoenix. I sent out an email and that’s when I started getting nervous – would anyone come? I soon got my first surprise: everybody said yes, or just about everybody. So we sent out a formal invitation. Again, just about everybody said yes. Now I was really nervous.”

That’s because it meant that 30 people were willing to come to Phoenix at their own expense and that meant we had to come up with something worthwhile for thirty busy, overworked, influential professionals to devote a couple of days of their time. We knew this much:  we didn’t want it to be a list of speakers preaching at our group; no, we wanted them to meet and bond, and to start to merge their knowledge in a way that would create an elite team of innovators, a SEAL team in the battle against vaccine-preventable disease. We needed a big group brain that would be smarter and faster than any one person or group.


We decided to include a couple of short presentations, like one on the Healthy People 2030 process, but the focus was on idea generation. And Mike could relax: It worked! We broke into teams and generated ideas, then focused on a few that might make good pilot projects, then picked the initial ones to undertake. Along the way, we learned a lot about who did what and saw the walls between organization types start to fall away.


When you put folks from all sorts of disciplines in one room, you learn a lot, big and small. To give you a sense of the discussions, below is a summary one of our attendees shared with us about the ideas popping up during the discussion, ideas that had him saying “Who knew?”…

One of the teams was looking at ideas for increasing pertussis/ Tdap vaccinations. We looked at how pregnant women and new mothers might help get everyone around the new baby to get vaccinated. That’s when I learned that there’s a Southern tradition called “Sip & See” — you invite everyone over to meet the new baby and to have champagne while doing so. That means dozens of people are going to be passing around the baby, and, of course they should all be vaccinated. Why not make that a part of the invitation? And why not do the same for baby shower invitations? That eventually led us to consider babysitters. There are sites/apps for babysitters, like, and why not ask those sites to have vaccinations as part of the list of babysitter qualifications? And one of the team members told of a local doctor who gave new mothers signs for the front door announcing that only vaccinated people were allowed in. We had dozens of such facts/ideas that we then rolled into fresh proposal for a pertussis campaign.

We had so many of these individual ideas – we stopped counting when we got over a hundred – that we decided to create a list of the ones we liked best and to release it. We ended up calling it The Idea Orphanage and we’re hoping you’ll take a look (there’s a link at the end) and see if you’d like to take one on and give it a try.


We settled on three finalists for our first pilot project. We won’t go into all three here, but let’s take a quick look at one that demonstrated how bringing together people from different organizations created the synergy we’d hoped for.

What follows is a summary from Dr. Scott Hamstra, who’s had a thirty-year career with the Indian Health Service, and is now STC’s Medical Director:

Three things our team agreed upon:

  1. The key to herd immunity is the smartphone – that’s what just about everybody in the herd carries with them. (There are estimated to be 230 million smartphones in the U.S.)
  2. Pharmacists are the logical place for adult vaccinations. (The reporting and the stocking of inventory are too much for many doctors’ offices, while pharmacies are perfectly set up to handle consumer/patients vaccines.)
  3. Everybody agrees having access to an up-to-date, accurate record of their vaccinations and their meds is a good thing.

Given those assumptions, we also knew…

A pilot project already exists that checks the state vax registry when patients come in to pick up prescriptions.

And, one of our summit participants noted, they are technically ready TODAY to provide the medication list.

Simply put — by merging vaccine and medication data and making it readily available in a user-friendly display, we could test the effects…

  • Would this lead to a significant increase in the rate of vaccinations?
  • Would users come to see pharmacies as the central place for their meds and their vaccinations?

We can hardly wait to see if the project team can get the pilot going, and if the results are as powerful as we hope they will be.


In sum, it’s time. We have data that is underutilized. If we can create partnerships to break down barriers, we can embrace the challenge of those 2030 goals and we can know we have an elite team standing by to take them on.

We hope to have a second meeting of the Summit team this summer. We may have a few spots open to replace people who can’t attend. Let me know if you’d like to be considered.

For a list of ideas we hope someone will adopt, click on THE IDEA ORPHANAGE.

PDF Version of Article>>


Keep Your Eye on Density!

By Bill Davenhall, Geomedicine Analyst

That’s right – population density, not destiny.

Recent Census updates (January 2019) paint an interesting picture of where the population will be growing across the US over the next 5 years. While you have probably already learned what’s in store for your State, population density will probably not be a statistic you thought a lot about. Population density has a great deal to do with the transmission of infectious diseases; increasing density of people raises the risk of disease transmission, perhaps creating disease “hot spots” in what otherwise appears as desirable community growth.

Little more than half (57%) of all counties in the US will be experiencing a gain in total household population by 2023. This group of counties will be absorbing over 13.2 million new residents over the next 60 months, that’s about 7,200 people per day, every day for the next 5 years. Packed into those numbers however is something else you should be watching – population density – especially in smaller geographical areas, like Zip Codes, Block Groups and Census Tracts. While this analysis only focuses on the county, similar data is available at smaller geographical levels for those interested in looking into smaller geographical areas within their markets.

A preliminary look at the new population projections at the county level reveal that there will only be 11 counties where more than 500 new people will move into the county each month for the next 5 years. Many of these counties will also see significant increases in the densities of their populations, most 3 to 6 times greater than most other counties across the US.

Here are the 11 counties (6 in Texas) that will see more than 500 new residents each week for the foreseeable future, their respective population density growth, and the number of new residents expected over the next 5 years.



County and State


Weekly Population



% Population

Density Growth


Expected Additions


Population By


Denton, TX




Collin, TX




Clark, NV




Hillsboro, FL




Maricopa, AZ




Bexar, TX




Tarrant, TX




Riverside, CA




King, WA




Dallas, TX




Harris, TX




Source: US Census Bureau and ScanUS and STC – 2019


The map below shows where expected population growth over the next 5 years will be distributed and where the ”super gainers” are located. As you can see, most of the gainers will see very modest growth, while a smaller number will experience excessive growth. Knowing about population growth is important but identifying counties that will see a significant increase in population density is equaling important. If you would like a PDF of the list of the 1,787 growth counties, with estimates of population growth and density increases, you may request it here.

Top 100 Counties