State Experiences during Different Stages of the H1N1 Pandemic

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Presentation transcript:

State Experiences during Different Stages of the H1N1 Pandemic Quite a Journey! State Experiences during Different Stages of the H1N1 Pandemic Sarah Clark Child Health Evaluation and Research (CHEAR) Unit University of Michigan April 20, 2010

Background H1N1 vaccine implementation was characterized by: Federal guidance and structure Substantial flexibility for implementation at the program level Tight timeframe for planning Overwhelming amount of information

Purpose To collect situational awareness data on H1N1 vaccine implementation Collaborative approach Real-time feedback To utilize situational awareness data in evaluating H1N1 vaccine implementation Lessons learned based on experiences

Data Collection Immunization program managers & staff and/or H1N1 vaccine implementation lead 50 state and 4 metropolitan areas Telephone and email contacts

Destination Unknown

Destination Unknown H1N1 was… different from pandemic planning scenarios but different from childhood vaccination Most programs [eventually] struck a balance between the two.

What time do we leave? Waiting for information Vaccine distribution system Provider agreement Billing guidance Information drives decision-making, facilitates implementation

ACIP Recommendation Initial target groups : Pregnant women Caregivers of infants <6 months Health care workers Children 6 months - 24 years Adults 25-64 years with high-risk conditions

ACIP Recommendation If vaccine supply is inadequate: Pregnant women Caregivers of infants <6 months Health care workers with direct patient contact Children 6 months - 4 years Children 5-18 years with high-risk conditions But even with these smaller “subpriority groups” there was not enough vaccine initially for the total population. What to do?

State Decisions Target populations for initial LAIV doses healthcare workers (42) Children 24-48 months (32) Children 5-9 years (26) Children 10-18 years (22) Caregivers of young infants (4)

Other key considerations Working with new providers registration, communication, assistance Allocation of vaccine to each site estimated need, formulations Reporting and accountability mechanisms tension between ease of use and need for accurate data Even with guidance, there were simply some decisions that had to be made with little data.

Are we there yet?

Are we there yet? New destinations built on H1N1 success: Relationships with new providers Expanded use of immunization registries New communication tools Expanded school-based vaccination

At all levels---federal, state and local---the H1N1 vaccine implementation was characterized by:

Overall impressions H1N1 vaccine implementation was characterized by: Thoughtful decision-making Innovation and flexibility Dedication At all levels---federal, state and local---the H1N1 vaccine implementation was characterized by:

Acknowledgments University of Michigan team: AIM Anne Cowan, Brian Macilvain, Gary Freed AIM Claire Hannan, Katelyn Wells State immunization officials!