The ATS is one of seven specialty societies awarded a grant by the Council of Medical Specialty Societies (CMSS) and CDC to increase COVID-19, influenza, and routine vaccination rates among high-risk adult patients in the United States.

Through this collaborative effort, the ATS partnered with and funded eight health care systems across the country to test and implement strategies to improve vaccine uptake employing a Quality Improvement (QI) approach. Specifically, health systems funded by the ATS focused on methods to improve vaccination rates for influenza, pneumococcus, and coronavirus disease (COVID-19) among high-risk individuals with chronic respiratory diseases being evaluated in pulmonary subspecialty clinics.

The ATS partner health systems are:

• Grady Health
• Meharry Medical College
• St. Luke’s Health System
• University of Arizona/Banner Health
• University of California, San Francisco/San Francisco Health Network
• University of Colorado
• Wayne Health
• West Virginia University Hospitals Inc.

“Overall, it was a very valuable experience. It provided several important gains, including improving the health outcomes of our patients, sharing strategic approaches with other organizations, and engaging in collaborative problem solving. The program also helped foster strong professional relationships among participating teams,” said Zahia Esber, MD, associate professor of medicine; associate program director, Pulmonary and Critical Care Medicine Fellowship; and medical director, respiratory therapy at Wayne State University and Wayne Health.

Through this initiative, the ATS aimed to identify member QI champions to promote immunization adoption in respiratory health and serve as advocates to the ATS community, supporting other health systems in their efforts to increase vaccine coverage. It also provided an ideal opportunity to review and update ATS immunization policy statements, clinical guidance, and member and patient educational materials, and share them with the broader Society membership.

“Rather than identifying a single area of care that should be augmented to improve vaccine uptake in pulmonary clinics, the key contribution of this initiative is the portfolio of tested strategies it generated,” explained Robert Stansbury, MD, professor, pulmonologist, and director of the Sleep Evaluation Center at West Virginia University Health. “Health systems can draw from these interventions and adapt them to their local context, allowing them to address barriers and facilitators that are unique to their clinic, hospital, or health care system. This flexibility is likely to be the most important driver to improve vaccination rates in pulmonary specialty clinics moving forward.”

Data collection for this initiative wrapped in summer 2025. The ATS is now using findings from this initiative to build a new toolkit to help other health systems raise awareness and improve adult vaccination rates. Gathered insights range from recommendations for electronic health record workflow modifications to care team training and development sessions to patient-centered care techniques that reinforce trust in the patient-provider relationship.

“What surprised us was that vaccine-hesitant patients actually wanted the conversation to continue even after an initial declination. Many expressed a desire for more information and ongoing dialogue rather than a single brief exchange. Another theme that emerged was a sense of betrayal or disappointment when patients became ill with infections they believed vaccines were supposed to fully prevent,” said Abiodun Kukoyi, MD, an assistant professor of medicine at Emory University School of Medicine, as well as a pulmonologist and critical care specialist at Grady Health. “This reinforced the importance of clearly communicating a fundamental message: vaccines are highly effective at preventing severe illness, hospitalization, and death, but they do not prevent every infection. Setting this expectation appears to be an important step in building trust, not appearing to ‘oversell’ the vaccines and improving vaccine understanding.”

The ATS will launch a campaign to disseminate these findings and encourage health systems to join the initiative and implement the successful strategies gleaned from the multi-year data collection.

To learn more about this program and other ATS QI projects or join the effort, visit the dedicated booth inside the International Conference’s Networking Super Center, located in the Orange County Convention Center Exhibit Hall.

Additional information and resources for the vaccine initiative are available on the Society’s website. If you are interested in learning more about this initiative, please contact Anna Hrovat, associate director, Evidence Dissemination & Implementation at the ATS, at [email protected].