Here’s the challenge traditional healthcare datasets leave unaddressed. Anonymized claims and pharmacy records show where individual shots have already been administered, but they offer little visibility into who remains open to getting vaccinated. Retrospective records show where shots occurred, while community-level intent maps where outreach should go next, revealing the actionable delta between intent and actual coverage.

The Washington State Benchmark: 133,000 Willing Seniors

Let’s look at Washington State to see what happens when you combine the two. It’s one of the only states that publicly publishes RSV vaccination rates down to the county level. Overlay those county records on intent estimates, and a highly actionable number surfaces: about 133,000 Washington seniors 75 and older want the RSV vaccine and haven’t yet gotten it. This is the state’s immediate addressable 75-and-older market.

The largest pools, as expected, sit where the most people are: King County holds roughly 27,500 willing and unvaccinated seniors, followed by Pierce at 14,900, Snohomish at 12,300, Spokane at 10,000, and Clark at 9,900.

From County Budgets to Census Tracts: Eliminating Media Waste

Campaign budgets are often set at broad administrative levels, while outreach often targets individual patient lists. But neither approach reveals neighborhood dynamics. Zooming into Pierce County, home to Tacoma, reveals that intent is anything but uniform across its 193 census tracts. Willing seniors cluster in specific neighborhoods, and a county-wide ad buy would waste most of its money reaching people who will never convert. The tract view puts trusted activation messengers exactly where the most receptive seniors are clustered.

Neighborhood-level audience data also shows which media properties seniors use the most, so a campaign can match message, messenger, and mode to the audience instead of guessing. More than three-quarters of Pierce County’s seniors are on Facebook and half are on YouTube, but they’re also highly reachable through traditional media: network news broadcasts reach a third or more of them, and local news and local radio still pull real audiences. The winning plan meets them across the whole mix, digital and analog, not one channel or the other.

Source: Fraym data (June 2026) for adults aged 60+ and analysis. Figures display self-reported use in the past week.

The “One-and-Done” Vaccination Advantage

Why does this approach matter so much for a disease like RSV? Because RSV is a one-and-done vaccine. A single dose delivers durable protection, so every willing senior you convert is a permanent addition to cumulative coverage, not a patient you have to win back next season. That changes the strategy completely. “Protecting last year’s footprint” is a seasonal-vaccine approach. For a one-and-done shot, the only efficient way to raise coverage is to find the willing but unvaccinated and go get them as efficiently as possible.

None of this requires abandoning the data health systems already use. It simply requires adding the critical element that’s been missing. By combining administrative uptake records with precise intent data mapped to the neighborhood level, we stop hiding willing-but-unreached seniors inside a statewide average. This might just be the biggest, lowest-hanging fruit for expanding immunization coverage.

The RSV vaccine is safe and available, millions of seniors already want it, and we now know where they live. The only question left is whether we’ll start leveraging healthcare intent and preference data to move the needle nationwide.