Tracking State-Level Implementation of H1N1 Vaccination Grantees

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Tracking State-Level Implementation of H1N1
Vaccination Grantees

• Sarah Clark
• Child Health Evaluation and Research Unit (CHEAR)
• University of Michigan
• National Immunization Conference
• April 21, 2010

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Background

• H1N1 vaccine implementation was characterized by
• Federal guidance and structure
• Flexible implementation at the program level
• No existing mechanism to track implementation
  across states

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Background

• UM team collected situational awareness data on
  H1N1 vaccine implementation
• September 2009 February 2010
• Collaborative approach
• Short-term feedback
• Lessons learned based on experiences

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Purpose

• To describe some of the key influences on state
  implementation of H1N1 vaccination

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Key Influences

• States had varying goals for their H1N1 vaccine
  campaigns
• Make vaccine available to whoever wants it.
• Vaccinate as many people as possible.
• Vaccinate high-risk individuals first.
• Goals established the perspective for key
  decisions

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Key Influences

• State immunization officials had varying
  relationships with other key agencies prior to
  H1N1
• Preparedness
• Epidemiology
• Education
• Medical licensure

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Key Influences

• States have varying public health capacity
• Almost no public health departments
• City/county/regional health departments that are
  agents of the state
• City/county/regional health departments that are
  autonomous
• Range of LPH 1 to 350
• Variety of service delivery across LPH

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Key Influences

• States began the campaign with variable
  information infrastructure
• Immunization information systems
• Databases of providers
• Communication systems
• States had variable IT support
• New mechanisms needed for registration,
  allocation, doses administered reporting

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Key Influences

• States were highly variable in their existing
  relationships with other immunization providers
  and settings
• Hospitals
• Adult immunization providers
• Pharmacies and community vaccinators
• Schools

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Lessons Learned

• Flexibility in implementation of H1N1 vaccination
  was essential to
• accommodate existing state differences
• allow for different choices
• States should build on their H1N1 efforts
• New relationships with providers and other state
  agencies
• Information systems

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Acknowledgments

• University of Michigan team Anne Cowan, Brian
  Macilvain, Gary Freed
• AIM Claire Hannan, Katelyn Wells
• Immunization program officials

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