Strengthening Vaccine-Preventable Disease Prevention and Response - The purpose of this project is to address low vaccination coverage areas, low vaccination access and low vaccine confidence in Iowa. The Iowa Immunization Program falls within the Health Protection Unit, Division of Public Health within the Iowa Department of Health and Human Services. The Immunization Program is comprised of 17 full-time staff with extensive history implementing statewide vaccines programs, including the Vaccines for Children and Vaccines for Adults Programs and managing the state’s immunization registry information system. The Iowa Immunization Program will conduct activities to increase vaccine coverage, access and confidence. Expected outcomes include increased vaccine access, increased vaccine confidence, enhanced data and evaluation, strengthened program support for partners, improved vaccination coverage and enhanced vaccination response readiness. Addressing these problems requires a multifaceted approach involving collaboration between public health officials, healthcare providers, and community organizations to develop targeted interventions that improve access, education, and overall vaccination rates in Iowa.