Learning Objectives for this Presentation:
Describe the need for developing a novel prioritization process
Identify components of a comprehensive prioritization process
Apply the DAST methodology and develop a rank-ordered prioritization list
Identify components of an optimal vaccine implementation strategy


Background:
Pandemic influenza threatens to cause mass illness and death in California as well as significant economic and social disruption. Vaccine is a key prevention strategy for controlling pandemic influenza and will aid in decreasing the health consequences of a pandemic. Given the initial anticipated supply shortage during a pandemic, the California Department of Health Services (CDHS) developed a comprehensive prioritization planning tool to allocate vaccine to specified target groups.

Objectives:
Develop a prioritization method that was systematic, justifiable, flexible, adaptable, and transparent, and produce a rank-ordered prioritization list and a multi-dimensional implementation strategy.

Methods:
CDHS developed the Decision Analysis Scoring Tool (DAST), a survey tool that simultaneously analyzes multiple goals, criteria, and alternatives to develop an optimal prioritization scheme. The DAST evaluates target groups along competing vaccination criteria and assigns a numerical score based on how well each group matches a given criterion. A prioritized rank ordered list of target groups were developed and evaluated on multiple implementation criteria to develop an optimal pandemic vaccination strategy.

Results:
Prioritization scores were arranged into a rank-ordered list. Medical care and emergency response professionals dominate the top third of the priority list. Medical care support workers, essential workers, and individuals with high-risk medical needs comprise the middle third of the priority list, while remaining essential workers, individuals with medical needs, and healthy adult populations dominate the bottom third of the list.

Conclusions:
The DAST methodology produced a rank-ordered prioritization list and a multi-dimensional implementation strategy. This strategy was recommended to the CDHS Executive Policy Council for review and approval for implementation during a pandemic influenza emergency.