2025 NCICP Award Nominations

2025 National Conference for Immunization Coalitions and Partnerships (NCICP) Award Nominations:

NCICP is excited to host the immunization recognition awards. Please complete the nomination form below to nominate an immunization champion passionate about vaccines and who has worked to increase immunization rates in their community! Please be thorough in your nomination; the recognition committee will use your information to determine the winner. Assume the committee knows nothing about the nominee.

There are five (5) categories (Immunization Leadership, Equity in Immunization, Excellence in Immunization Advocacy, Excellence in Immunization Collaboration, and Emerging Leader).

Please send only one nomination per email address. Scores are not tabulated on the number of nominations.

Nominations will be accepted through June 6, 2025.

2024 immunization award winners are not eligible for the same award. These award winners are eligible for a different award. The 2024 award winners are listed below:

Immunization Leadership - Andrea Polkinghorn
Equity in Immunization - Geovannie Gone
Excellence in Immunization Advocacy - Allie Alvine
Excellence in Immunization Collaboration - Catherine Flores
Emerging Leader - Nicole Cope

If you have any questions about the nomination form or the awards, please email: heather@immunizear.org

Question Title

* 1. Who are you nominating?

Name

Organization/Agency

Role/Title

What state coalition is nominee affiliated?

Address

Address 2

City

Zip

State

Email Address

Phone Number

Question Title

* 2. Category for Nominee (only choose one)

Immunization Leadership Award - Nominee is considered an immunization expert in their community. An individual who goes above and beyond or does an exemplary job to promote or foster immunizations. · Activities may include acting as a spokesperson, trainer, mentor, or educator.

Scoring information for immunization leadership award: Considered expert on immunizations in their community. The individual promotes or fosters immunizations. Activities include but are not limited to acting as spokesperson, trainer, mentor, or educator.

Equity in Immunization Award - Nominee uses creative or innovative strategies to promote immunization equity or addresses challenges to immunization. Activities may include both new strategies and adapting existing strategies in new ways to reach the under-immunized population.

Scoring information for equity award:The individual uses creative or innovative strategies to promote immunization equity or address challenges to immunization. The individual has used new or existing strategies in new ways to reach under-immunized populations.

Excellence in Immunization Advocacy · Nominee is advancing policies to support immunization in their community, state, or region. Activities may include but are not limited to providing legislative testimony, building and/or coordinating the development of a group of grassroots advocates, submitting press releases, utilizing social media to educate on bills and deliver a call to action, providing advocacy training, etc.

Scoring information for advocacy award: The individual is active in advancing policies to support immunization in their community, state, or region. Activities of the individual may include but are not limited to providing legislative testimony, building and/or coordinating the development of a group of grassroots advocates, submitting press releases, utilizing social media to educate on bills and deliver call to action, providing advocacy training etc.

Excellence in Immunization Collaboration - Nominee is recognized as a collaborator who dedicates their time and talent to build partnerships with community members, organizations, and institutions to build a common agenda to solve complex problems that make a collective impact.

Scoring information for collaboration award: The individual is recognized as a collaborator who dedicates their time and talent to build partnerships with community members, organizations, and institutions. Activities of the individual include creating a common agenda to solve complex problems that make a collective impact.

Emerging Leader Award - The nominee is an individual or organization with five (5) years or less experience working in the immunization field who has demonstrated their potential through outstanding service and contributions and has made innovative contributions to their field.

Scoring information for emerging leader award: Individual or organization with five (5) years or less experience working in the immunization field. The individual has demonstrated their potential through outstanding service and contributions and has made innovative contributions to their field.

Question Title

* 3. Will the nominee attend the NCICP Conference? (not a requirement to win)

Yes

Unsure

Question Title

* 4. Describe how the nominee fits the criteria for this award. Please include as much information as possible in 250 words or less (no CVs/resumes)

Question Title

* 5. How is the nominee engaged with their state/local immunization coalition? *worth 10 points(Limit to 250 words)

Question Title

* 6. Nominator (Your) Information

Name

Organization/Agency

Role/Title

Address

Address 2

City

Zip Code

State

Email Address

Phone Number

Relationship to Nominee

2025 NCICP Award Nominations

Question Title

* 1. Who are you nominating?

Question Title

* 2. Category for Nominee (only choose one)

Question Title

* 3. Will the nominee attend the NCICP Conference? (not a requirement to win)

Question Title

* 4. Describe how the nominee fits the criteria for this award. Please include as much information as possible in 250 words or less (no CVs/resumes)

Question Title

* 5. How is the nominee engaged with their state/local immunization coalition? *worth 10 points(Limit to 250 words)

Question Title

* 6. Nominator (Your) Information

Question Title

* 7. Any additional information you would like to add? (Limit 100 words)

Question Title

* 8. If you would like more information about the NCICP Conference, the link is here: NCICP Conference