1. 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

2. 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

3. 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

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

5. 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

6. 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

7. 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

8. 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

9. 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

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