July 19-Children living in Flint homeless shelters can now receive free immunizations, thanks to a $3,000 CATCH grant awarded by the American Academy of Physicians. Poonam Mahajan MD and her colleague, Sneha Rao MD, submitted the proposal for the grant. Both are physicians in their first year of training in Hurley Medical Center's Pediatric Residency Training Program and are on assignment at Hurley Children's Clinic at Mott Children's Health Center in Flint.

Poonam Mahajan MD (left) and Sneha Rao MD (right) with a patient at Hurley Children’s Clinic

Of the 68 applications submitted nationwide, Mahajan and Rao's proposal was one of 19 projects funded by the 2012 Cycle 2 Community Access to Child Health (CATCH) Resident Funds grant and the only residents funded in the entire State of Michigan. Mahajan, the primary applicant, stated that the money will be put to good use in the Flint community, where the immunization rate for Genesee County is significantly below national and state averages.[1]

Give It A Shot

Mahajan's project, called “Give it a Shot,” aims to do the following:

1. Assess the immunization status of displaced children living in homeless and crisis centers.
2. Educate parents about immunizations and address barriers to delivery.
3. Redirect families to their pre-existing medical home or identify a new and accessible medical home for immunization delivery.
4. Develop protocols within the shelter admission process to continually assess and ensure immunization delivery.

Mahajan's Personal Experience In India Helped Win Grant For Hurley

In her grant application, Mahajan described how her personal experience led her to address the crucial pediatric health need in the Flint community.

“During the early period of my medical training in India, I came across several children suffering from vaccine-preventable diseases such as tetanus, diphtheria, hemophilia influenza, and tubercular meningitis,” Mahajan wrote. “These illnesses accounted for severe population-wide morbidity and mortality, as well as profound family grief. These cases significantly impacted my thinking during the initial years of my pediatric training. I wished that those children had received that one shot; one shot of prevention would have eliminated all that suffering.”

As part of World Polio Day, Mahajan later conducted home-to-home surveys to search for children who had not been vaccinated against polio. That is where she saw, first-hand, the value of community health efforts.

“The success of that initiative has inspired me to continue reaching outside of the hospital walls to solve these community-based problems. After beginning my residency in the Unites States, I realized that even at the other end of the globe, similar problems exist,” she wrote.

Low Immunization Rates in Genesee County

When Mahajan learned about national and local health disparities, she was struck by the lower-than-average immunization rates in Genesee County. Among 19- to 35-month-olds in Michigan, 79% are up to date on their vaccinations. In Genesee County, the immunization rate for that age group is 73%.[2]

“Significant socioeconomic issues – poverty, unemployment, personal and cultural beliefs, poor transportation and lack of access to a medical home – contribute to our low immunization rates,” said Mahajan. “This low level of immunization coverage is taking its toll in the form of disease outbreaks like pertussis in Michigan. Children who opt out or are left out of this immunization shield are still at risk for those preventable diseases.”

But it doesn't have to be that way, according to Mahajan. “It just takes a shot. Or rather, we need to ‘Give It A Shot,’ to improve the immunization rates of the underserved children in the City of Flint.”

Grant Will Significantly Improve The Lives Of Children Living In Flint Shelters

Poonam Mahajan MD with an sample vaccination, the focus of her “Give It A Shot” initiative

Annually in Flint, approximately 2300 children come into contact with homeless shelters, with 60-65% actually living in the shelters, stated Mahajan. She added that most of these children are younger than 10 years old and are predominantly African American. The health status of children seeking shelter in crisis situations is unknown. “They don't submit health data at the point of entry into shelter homes,” said Mahajan.

1 Centers for Disease Control and Prevention and the State of Michigan
2 Michigan Care Improvement Registry