Challenges and changes: Immunization program managers share perspectives in a 2012 national survey about the US immunization system since the H1N1 pandemic response

Abstract

In mid-2012 we conducted survey of immunization program managers (IPMs) for the purpose of describing relationships between immunization programs and emergency preparedness programs, IPM's perceptions of challenges encountered and changes made or planned in programmatic budgeting, vaccine allocation and pandemic plans as a result of the H1N1 vaccination campaign. Over 95% of IPMs responded (61/64) to the survey. IPMs reported that a primary budget-related challenge faced during H1N1 included staff-related restrictions that limited the ability to hire extra help or pay regular staff overtime resulting in overworked regular staff. Other budget-related challenges related to operational budget shortfalls and vaccine procurement delays. IPMs described overcoming these challenges by increasing staff where possible, using executive order or other high-level support by officials to access emergency funds and make policy changes, as well as expedite hiring and spending processes according to their pandemic influenza plan or by direction from leadership. Changes planned for response to future pandemic vaccine allocation strategies were to "tailor the strategy to the event" taking into account disease virulence, vaccine production rates and public demand, having flexible vaccine allocation strategies, clarifying priority groups for vaccine receipt to providers and the public, and having targeted clinics such as through pharmacies or schools. Changes already made to pandemic plans were improving strategies for internal and external communication, improving vaccine allocation efficiency, and planning for specific scenarios. To prepare for future pandemics, programs should ensure well-defined roles, collaborating during non-emergency situations, sustaining continuity in preparedness funding, and improved technologies.

Influenza vaccination among workers—21 U.S. states, 2013

“…Increasing coverage among these target groups may prevent disruption in products and services in healthcare, emergency services, national security, and other sectors during a pandemic 10 . Using vaccine allocation strategies tailored to the specific event, such as factoring in the event-specific disease virulence, vaccine production rates, and public demand, would also be an important consideration during a pandemic 33 . Such tailored strategies would need to be developed.…”

“…During an actual pandemic event, this could be resolved by specifying occupational codes within the relevant industries (for example, specific occupations within the “national security and international affairs/DOD” category), although these selected occupations may vary depending on particular needs during a specific pandemic. Based on lessons learned from the 2009 H1N1 pandemic vaccination campaigns, 35% of immunization program managers stated that during a future pandemic event similar to the 2009 H1N1 influenza pandemic, they would change their vaccination allocation strategy, including specifying whether health care personnel includes fire and police personnel, school nurses, or even teachers 33 . Additionally, the BRFSS does not collect information from deployed military personnel, so estimates for this occupational group were based on a small number of military personnel sampled by BRFSS who lived in residential or college housing.…”

Using a Process Approach to Pandemic Planning: A Case Study

“…To describe the relationships between immunization programs and emergency preparedness programs, Seib et al [57] conducted a survey among immunization program (IPM) managers.…”

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

“…5 The response to the 2009 H1N1 influenza pandemic is the one of the most recent and relevant examples of largescale mass vaccination in the United States. 10,11 During this response, delays in vaccine availability reduced the number of vaccines administered and lengthened the timeframe for vaccination campaigns. Despite the role these factors played in limiting the scale of rapid mass vaccination, state and local jurisdictions experienced substantial challenges in vaccinating their populations, illustrating the need to improve mass vaccination preparedness.…”