Evaluating Local Efforts to Assure Equitable Access to 2009 H1N1 Vaccine in Oregon

Background: The Oregon Immunization Program (OIP) gave local agencies (counties, tribal centers, and state institutions) the authority to distribute H1N1 vaccine within their jurisdiction. Additionally, each agency submitted a mass vaccination plan prior to initiating 2009 pandemic influenza A (H1N1)  vaccination efforts. OIP evaluated local efforts to reach priority groups and underserved populations in order to understand how best to assist agencies in their vaccination efforts during this and future pandemic situations.

Setting: Each of the 44 local agencies were responsible for developing mass vaccination plans. Plans included agencies outreach strategies for traditionally underserved populations.

Population: Immunization and Preparedness coordinators from local agencies involved with the implementation of 2009 H1N1 vaccination efforts.

Project Description: Semi-structured interviews were conducted with Immunization, 2009 H1N1, and Preparedness coordinators to assess local agency efforts to reach out to target populations during the H1N1 pandemic. Discussion topics included a review of the original county mass vaccination plans, barriers encountered to providing access to certain populations, and changes made to vaccination plans over the course of 2009 H1N1 vaccination implementation.

Results/Lessons Learned:Due to limited vaccine supply, most participants reported difficulties implementing their original 2009 H1N1 vaccination plans.  Large mass vaccination clinics were no longer appropriate modes of delivery, resulting in concentrating efforts to target priority groups and traditionally underserved populations through SafetyNet clinics, such as WIC sites and FQHCs, hospitals, OB/GYN practices, oncology clinics, pediatric heart centers, juvenile detention centers, and socioeconmically diverse school districts. The barrier most commonly identified was a lack of staff familiar with immunization processes. These findings suggest future mass vaccination plans and prioritization policies should be developed for both adequate and limited vaccine supply scenarios. Additionally, consistent and timely guidance at state and national levels are critical to facilitate efficient and equitable delivery of vaccine.