EXCITE – Extension Foundation

The Extension Collaborative on Immunization Teaching and Engagement (EXCITE) is a nationwide initiative led by U.S. Cooperative Extension to provide adult immunization education. EXCITE is made possible through an interagency agreement between the United States Department of Agriculture – National Institute of Food and Agriculture (USDA-NIFA) and the Centers for Disease Control and Prevention (CDC), with a cooperative agreement with the Extension Foundation in partnership with the ECOP Health Program Action Team.

Unique Reach and Trust

EXCITE is uniquely positioned to deliver trusted, locally delivered education at a national scale through the Cooperative Extension System (CES).

CES spans 112 land-grant, tribal, and 1890 institutions and more than 3,000 local offices.
The network includes 32,000 employees and 2 million volunteers, reaching every county and parish in the U.S

Since 2021, EXCITE has reached over 51 million people and enabled the delivery of nearly 53,000 adult vaccinations against several diseases.

EXCITE at a Glance

updated June 2025

51,611,354

Reach

194,764

Engagement
Activities

1,214

Vaccination
Clinics

52,875

Immunizations

Become a Partner

EXCITE values partnerships that are rooted in community needs.

Partner

Addressing the Critical Need of Vaccine Education

Adult vaccination rates in the United States remain below recommended levels, especially among rural and underserved populations. Barriers such as access, trust, health literacy, and misinformation continue to affect vaccine confidence and uptake.

EXCITE began during the COVID-19 pandemic when the CDC recognized Cooperative Extension as a vital national education resource to address vaccine hesitancy. Since then, the initiative has expanded to provide plain-language information about adult vaccines within the broader context of health and wellness.

EXCITE works with Extension professionals and community partners to help adults make informed health decisions and strengthen connections to trusted health resources.

Our Core Goals:

Support informed decision-making
Help rural and other key audiences access plain-language information about adult immunizations.
Strengthen community-health connections
Build stronger connections between communities, Extension, and healthcare systems.
Improve health outcomes through local programs
Support local partners in implementing programs that increase knowledge, confidence, and access to health education.

Our Strategic Approach and Future Growth

Responding to Emerging Public Health Needs

H5N1: EXCITE is also supporting Cooperative Extension professionals with education and outreach related to H5N1. These efforts focus on raising awareness among dairy farmers, workers, and agricultural communities about animal and human health considerations related to H5N1.
H5N1 website

Measles: EXCITE has created several resources, hosted webinars and provided information in response to the CDC’s call to action on Measles outbreaks in certain states and in the migrant farm community.
Measles resources website

Innovative Vaccine and Health Education Strategies

Getting to the Heart and Mind of the Matter – A Toolkit designed to increase vaccine confidence using evidence based and brain science based strategies. The purpose of this toolkit is to better equip and empower all Extension professionals to participate as active agents in vaccine education and any other health education initiatives in their communities.
View Toolkit.

Misinformation campaign?

Integrating Vaccine Education Into Whole-Person Health

EXCITE’s path forward is focused on integrating adult immunization education into existing and new Extension curricula related to health and wellness. This approach places vaccine education within trusted programs that already support chronic disease prevention, health literacy, nutrition, diabetes management, and community wellness.

Expanding Capacity Through Regional Health Agents

In 2025, Cooperative Extension regions began hiring EXCITE Health Agents to support vaccine education across multiple states. These agents serve as regional multipliers by conducting direct education, training Extension professionals, and helping local teams integrate immunization education into existing programs.

Looking Ahead: Chronic Disease and Vaccination Education

In 2026, EXCITE will expand immunization education into one or more chronic disease curricula, recognizing that individuals with underlying health conditions may face increased risks from vaccine-preventable complications.

Our Current Curriculum:

Balanced Living with Diabetes: A set of educational materials on the value of vaccines that can be incorporated into diabetes lifestyle management programs and diabetes support programs
Diabetes Prevention Program: A series of one-page educational supplements on the value of vaccines to be integrated into the CDC’s National Diabetes Prevention Program Prevent T2 Facilitator Guide
Health Workers: Online training program for health workers to become efficient messengers providing adult immunization education
How to Talk to Your Doctor: A program to integrate adult immunization education into an existing health literacy program
Increasing HPV Vaccination among University Students: A collaboration between Extension professionals and their land-grant university student health professionals aimed at increasing HPV vaccine awareness and Vaccination

Full Curriculum

Partner with EXCITE

Because Extension professionals live and work in the communities they serve, EXCITE is well positioned to align health education with local priorities, trusted relationships, and real-world challenges.

Together, we can:

Provide health and wellness education on a variety of topics
Offer free, online, and self-paced immunization education modules
Support community members as they learn, understand, and make informed decisions about their health
Connect Extension programs with healthcare and community partners
Expand trusted adult immunization education across rural and underserved communities

Quick Links

Find Extension in Your State
Search Extension
Impact Collaborative
Connect Extension

About
Team & Board
Annual Report
Contact Us

Membership
Campus
Ask Extension
Tools

Our mission is to empower a national network of community-based educators, volunteers, and partners to turn knowledge into real-world solutions for stronger communities and people.

The Extension Foundation is a nonprofit established in 2006 by Extension Directors and Administrators nationwide. Extension Foundation is embedded in the U.S. Cooperative Extension System and serves on Extension Committee on Organization and Policy (ECOP).

This website is supported in part by New Technologies for Ag Extension (funding opportunity no. USDA-NIFA-OP-010186), grant no. 2023-41595-41325 from the USDA National Institute of Food and Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture or the Extension Foundation.

Sign up for our Newsletter

Stay up to date with the Extension Foundation.