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: Federal guidance and structure Flexible implementation at the program level No existing mechanism to track implementation across states

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

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 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 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 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 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 Information systems

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