Fargo Health Officials Deny Using Medical Records for Vaccine Mailer

Postcards sent to Cass County residents raised questions about data privacy.

Apr. 11, 2026 at 11:20am

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A minimalist design in the style of Keith Haring, where the outline of a syringe or vaccine vial is defined entirely by vibrant neon lines against a dark background, conceptually representing the public health outreach effort.A public health campaign aims to raise awareness of recommended adult vaccines, but raises questions about data privacy.Fargo Today

Fargo Cass Public Health said it did not access private medical records to send out a mailer suggesting that some older Cass County adults may be eligible for certain recommended vaccines. The postcards, which were funded by Pfizer, were created and sent by a third-party company called Televox using a list of Cass County residents over 50 years old obtained from the North Dakota Immunization Information System.

Why it matters

The mailer raised concerns among some residents about whether their private medical information was accessed and shared without their consent. Fargo Cass Public Health has sought to reassure the community that no individual medical records were used and that the mailing list was generated solely based on age demographics.

The details

The postcard advertisement sent to Cass County residents stated 'Records show you may be missing adult shots recommended by the CDC' for pneumococcal pneumonia, shingles, respiratory syncytial virus and tetanus/diphtheria/pertussis vaccines. Fargo Cass Public Health said it did not share any information with vaccine maker Pfizer, which provided financial support for the mailer. Instead, FCPH obtained a list of Cass County residents over 50 from the state's immunization database and provided that to Televox, a company that specializes in patient education and vaccination reminders. Televox then created and sent the postcards to the targeted demographic.

  • The mailers were recently sent to Cass County residents.

The players

Fargo Cass Public Health

The local public health agency in Fargo, North Dakota that commissioned the vaccine reminder postcards.

Televox

A company that works with healthcare entities to create and send patient education and vaccination reminder communications.

Pfizer Inc.

A major vaccine producer in the U.S. that provided financial support for the vaccine reminder postcards.

North Dakota Immunization Information System (NDIIS)

A confidential database that healthcare personnel can use to enter and review vaccine records for residents of North Dakota.

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What they’re saying

“Recipient information is really just based on demographics of eligibility.”

— Suzanne Schaefer, Nursing and Clinical Services Director, Fargo Cass Public Health

“It's good best practice to be able to get a little bit of information to a lot of people, which is why the postcard isn't incredibly detailed. It just talks about that this may be something that you're eligible for.”

— Suzanne Schaefer, Nursing and Clinical Services Director, Fargo Cass Public Health

What’s next

Residents who do not want to receive the vaccine reminder postcards can opt out through the North Dakota Department of Health and Human Services. Residents can also opt in to receive the mailers.

The takeaway

This case highlights the importance of data privacy and transparency around the use of personal health information, even when the intent is to promote public health. Fargo Cass Public Health has sought to reassure residents that no individual medical records were accessed, but the incident has raised questions about the appropriate use of demographic data for targeted health communications.