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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. Background. H1N1 vaccine implementation was characterized by:

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Tracking state level implementation of h1n1 vaccination grantees

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


Background
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


Background1
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


Purpose
Purpose

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


Key influences
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


Key influences1
Key Influences

  • State immunization officials had varying relationships with other key agencies prior to H1N1:

    • Preparedness

    • Epidemiology

    • Education

    • Medical licensure


Key influences2
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


Key influences3
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


Key influences4
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


Lessons learned
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


Acknowledgments
Acknowledgments

  • University of Michigan team: Anne Cowan, Brian Macilvain, Gary Freed

  • AIM: Claire Hannan, Katelyn Wells

  • Immunization program officials