The skills needed to carry-out the ABC Immunization Calendar program are minimal and can be easily learned by existing health care personnel working at the health clinic. As of 2004, there were already 18 public health centers in St. Louis, Mo, East St. Louis, Ill, and Harlem, New York City that had adopted the program and were running it with existing staff members.
There is somewhat of a initial investment in terms of the cost of the software required to upload and print the calendars ($4500-$3700). And while the taking the picture and printing out a new calendar takes minimal time (<5 mins), staffing changes could potentially be needed in order to initially enroll families. Beyond those initial investments, the maintenance requirements would mostly be in materials (i.e. paper and ink) which are already part of the clinic’s overhead costs.