The 2009 H1N1 Influenza Vaccination Campaign Summary of a Workshop Series (2010) / Chapter Skim
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5 Vaccine Administration Methods and Partners
5 Vaccine Administration Methods and Partners
Pages 37-54
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From page 37... ...
BOX 5-1 Stakeholders Involved in the 2009 H1N1 Vaccination Campaign • Public health authorities− • National and local disease organi federal, state, tribal, territorial, zations or support groups and local • Other government agencies • Association of State and Territorial and offices, including De- Health Officials partment of Defense, Veter ans Administration, De- • National Association of County partment of Homeland Secu- and City Health Officials rity, and Indian Health Service • Hospitals and large health • Emergency medical service systems providers 37
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From page 38... ...
Although mass clinics are an efficient way to vaccinate large numbers of people, in the case of 2009 H1N1, there were also some challenges, particularly about the use of ACIP recommendations to prioritize vaccine for the target groups. In most places, people were asked to self-assert their eligibility for priority vaccination; public health officials did not ask for verification of a person's high-risk status.
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From page 39... ...
If plans call for their use, alternate backups should be investigated in case those vaccinators are not available. Emergency Medical Service Providers To ease the staffing shortage, Ohio activated rules from 2004 that allowed EMS personnel to function as vaccinators so long as the governor had declared a public health emergency, the personnel had been trained, and all vaccinators were under the direction of a physician.
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From page 40... ...
The Baltimore program relied on an immunization team that had been meeting monthly for more than 10 years, said Anne Bailowitz, acting chief medical officer for the Baltimore City Health Department. To prepare for the 2009 H1N1 vaccination campaign, the team started planning 4 months in advance and continued to meet with the city school system for 4 months after clinics began.
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From page 41... ...
The 2009 H1N1 vaccine was free, which helped in running the school clinics. Slemp wondered if pilot programs could be chartered to look at how to sustain school vaccination programs.
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From page 42... ...
Students may or may not have received vaccinations during the winter holiday break, but student health offices had no way to gather that information. Healthcare Providers Healthcare providers played an integral role in the distribution and administration plans, particularly for vaccination of pregnant women and other high-risk adults, as well as children.
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From page 43... ...
Administering Vaccine Once they had registered and received vaccine, healthcare providers faced more logistical challenges: vaccine storage, staff training and time for data entry and/or registry requirements, and decisions on who would administer vaccinations. Even pediatricians accustomed to providing routine and seasonal vaccinations to their patients had to develop plans for administering the 2009 H1N1 vaccine.
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From page 44... ...
Pharmacies Independent and large chain pharmacies and retail clinics are involved extensively in seasonal influenza vaccination campaigns, and many were ready to assist in the 2009 H1N1 vaccination effort. The extent to which pharmacies were used to administer 2009 H1N1 varied widely across the nation.
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From page 45... ...
Participants discussed various scenarios based on vaccine supply levels. When ample supply of vaccine is available, participants seemed to generally acknowledge that using retail pharmacies is appropriate to increase vaccine accessibility, as in the case for the administration of seasonal influenza vaccine.
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From page 46... ...
In North Carolina, there was a misperception that pharmacies were vaccinating anyone who came in if supplies were available, but public health was able to distribute the pharmacies' screening criteria to counteract the misinformation. As discussed above, large chain pharmacies with locations in multiple jurisdictions encountered challenges because of cross-jurisdictional variations in vaccine distribution plans and differences in the implementation of priority groups.
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From page 47... ...
It was challenging for pharmacy chains to deal directly with a large number of state and local public health departments, as well as with state variations in vaccination scope of practice laws and pharmacist regulations. Participants suggested that it would be useful to examine whether a national standardized age should be set.
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From page 48... ...
Health plans can communicate with their covered patients, physicians, and other healthcare providers as well as employer groups they serve, providing a way to dispense information and education where needed. They can also provide data and other information to health departments.
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From page 49... ...
Opportunities for Improving Vaccine Administration and Enhancing Partners' Roles in Future Campaigns Numerous individual suggestions were made about opportunities to improve vaccine administration methods and to further enhance the role of partners in future emergency vaccination campaigns. These suggestions are compiled here as part of the factual summary of the workshops and should not be construed as reflecting consensus or endorsement by the workshops, the Preparedness Forum, or The National Academies.
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From page 50... ...
Work with school systems in ad vance to increase the likelihood that they might allow the use of instructional time. • Consider college censuses when distributing vaccine rather than treating student health centers as regular provider offices.
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From page 51... ...
Participants noted disparities in how private healthcare providers engaged with public health, de pending on their relationship prior to the 2009 H1N1 vaccination campaign. Public health officials have knowledge and skills that may help private-provider offices plan for mass vaccinations and maintain business continuity during a public health emergency.
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From page 52... ...
• Consider engaging wholesale pharmacy distributors to reach independent and chain pharmacies. Health Plans There were several individual suggestions related to health plans for public health authorities to consider.
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From page 53... ...
As discussed above, many representatives from multijurisdictional healthcare systems, large chain pharmacies, large companies with occupational health programs, and tribal authorities whose reservations crossed multiple state boundaries said that having different strategies in different jurisdictions was problematic for them. Several participants suggested that stricter national guidelines for vaccine distribution and administration would be useful, although as was also noted above, many of the public health authorities emphasized the value of flexibility to tailor plans to their specific populations.
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