Number of Eligible Clients Receiving Services through our Immunization Program


In this measure, ‘Number of Eligible Clients’ represents the total number of clients who received vaccinations through Austin Public Health (APH) ‘Shots for Tots/Big Shots’ clinics at the St John and Far South locations. Vaccines administered at APH ‘Shots for Tots/Big Shots’ clinics are received via the federally funded Vaccines for Children (VFC) program and the state funded Adult Safety Net (ASN) program. To provide comprehensive immunization services to our target population, the clinics also offer seasonal Flu vaccine for uninsured adults and Shingrix for uninsured adults over 50. City funds are used to purchase these additional vaccines not available through the Adult Safety Net program. In 2021, ‘Shots for Tots/Big Shots’ clinics began offering COVID-19 vaccine. This data set includes clients of any age who received COVID-19 vaccine at ‘Shots for Tots/Big Shots,’ but not those who received the vaccine from APH in another setting. Data for this measure is reported in May and October of each year. Data is extracted and compiled from eClinicalWorks (eCW).


The number of eligible clients receiving services from our Immunization Program via Shots for Tots/Big Shots clinics increased in 2021 with the introduction of COVID-19 vaccines. The total number of clients the Shots for Tots/Big Shots program can serve remains limited at its upper value by the number of available nursing resources. As a safety net provider, our capacity for routine vaccination is also affected by the make-up of the eligible client population: children with Medicaid, children who are American Indian or Alaskan Native, children who are uninsured, children whose health insurance does not cover vaccines, and uninsured adults.
Our clinics continue to see increasing numbers from the immigrant population, requiring the need to translate foreign Immunization Records. In March 2022, our clinics instituted a new process to allow clients to upload their foreign records using a HIPAA-compliant digital interface before their scheduled appointments eliminating significant in-clinic translation time and increasing clinic capacity. Traditionally, Children have made up about 75-80% of Shots for Tots/Big Shots clientele. As of this April 2023 update, children make up about 50% of clinic clients; the other half are adult clients receiving vaccines to meet immigration requirements. Both clinics are still fully booked, but fewer children are able to obtain appointments. To meet community need, APH has conducted clinics in schools to vaccinate students moving from one grade to another where new vaccines are required, i.e. 6th graders going to 7th grade where Meningococcal vaccine (MCV4) and the Tetanus booster (Tdap) are required and graduating seniors where MCV4 and Meningitis B are needed for college attendance.

Note: to see the underlying data for this chart, please select the "View Source Data" link to the left.

Additional Measure Insights

  • Austin Public Health received its first shipments of COVID-19 vaccine in December 2020; the current data set includes eligible clients who received their COVID-19 vaccines in Shots for Tots/Big Shots clinics through September 30, 2022. This data does not include clients vaccinated for COVID-19 by APH in other settings such as mass clinics, pop-up clinics, and mobile outreach. Since December 2020, APH has administered over 400,000 COVID-19 vaccines to 240,000+ unique clients.
To improve equity of vaccine uptake, Shots for Tots/Big Shots partnered with our Neighborhood Centers to provide COVID-19 vaccination to their vulnerable populations, the elderly and disabled who had no access to a computer and/or mobility impairment.  Our Call Center referred many clients to CapMetro’s Free Ride program.  This collaboration between multiple programs multiplied the benefits to our community.
In addition to vaccinating children and adults through Shots for Tots/Big Shots clinics, the APH Immunization Program also serves as Austin/Travis County’s Responsible Entity for the Texas Vaccines for Children and Adult Safety Net programs.  In this role, APH Immunization Program staff support the distribution and administration of vaccines through 75+ community providers (shown in the map below).  Through their work with this diverse and widespread network of providers, we support the vaccination of an additional 130,000+ eligible pediatric and adult clients each year.
This dataset only includes the number of persons vaccinated.  In addition to vaccinations, Shots for Tots/Big Shots clinics provide comprehensive immunization services to the public, including:
  • Immunization Record Screening – This includes reviewing immunization records and providing vaccine recommendations based on the record.
  • Foreign Immunization Record translation – This includes transferring all vaccines appropriately documented as administered in another country or US state and creating a Texas record with all valid doses.  APH provide vaccine recommendations based on the translated record.
  • Certified Immunization Records – Staff provide certified replacement of Immunization Records, including corrections, i.e. name changes.  If needed based on the record, staff will provide vaccine recommendations.
  • Social Services Referrals – Staff maintain a current list of community resources and provide these to clients upon request.

Measure Details and Definition

1) Definition: 'Number of Eligible Clients' represents the total number of clients who received vaccinations through Austin Public Health ‘Shots for Tots’ and ‘Big Shots’ programs at the St. John's and Far South clinics as well as clients who received Vaccines for Children (VFC) and Adult Safety Net (ASN) vaccinations from Shots for Tots nurses via community outreach programs. 
2) Calculation method: We calculated this measure by adding the total number of clinic and outreach clients who received vaccinations through our Shots for Tots and Big Shots programs.  
3) Data Collection Process: Until December 2017, Austin Public Health Immunization Program staff used the Texas-Wide Integrated Client Encounter System (TWICES) program, a Texas Department of State Health Services (DSHS) immunization record system, to run a report for each clinic. Beginning in December 2017, Austin Public Health (APH) implemented an electronic health record system, eClinical Works (eCW). Shots for Tots/Big Shots staff now run a clinic-client report each month from eCW. The monthly reports are then compiled to reach a yearly total. 
4) Measure Target Calculation:  The total number of eligible client visits is limited at its uppermost value by the total number of appointments available for either vaccinations or immunization record translation (for which a double appointment is often required). Total number of available appointments is pegged to throughput time for each client and the number of Full-time employees. The measure target of 12,000 represents the maximum number of clients that could be served (prior to reduction in capacity to accommodate pandemic-safe social distancing) with the current number of Full-time employees.
5) Frequency Measure is Reported: Annually (Fiscal Year)
Date page was last updated: April 2023