1. University of Michigan Health System 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. University of Michigan Health System 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. University of Michigan Health System 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. University of Michigan Health System Purpose To describe some of the key influences on state implementation of H1N1 vaccination

5. University of Michigan Health System 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. University of Michigan Health System Key Influences State immunization officials had varying relationships with other key agencies prior to H1N1: –Preparedness –Epidemiology –Education –Medical licensure

7. University of Michigan Health System 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

8. University of Michigan Health System 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

9. University of Michigan Health System 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

10. University of Michigan Health System 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 and other state agencies –Information systems

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

12. University of Michigan Health System