State, Local and Territorial Immunization Programs and Emergency Preparedness Programs Collaboration During the H1N1 Vaccination Initiative

Background: We conducted a survey of Immunization Program Managers (IPMs) aimed at learning how state, city, and territorial immunization programs (IP) and emergency preparedness programs (EPP) collaborated to implement the H1N1 influenza vaccination initiative. The survey is part of a larger project aimed at improving public health preparedness against future emergencies in which leveraging the vaccine system may be useful.

Objectives: Examine collaborations between IPs and EPPs during the H1N1 vaccination response focusing on successes, challenges, and lessons learned.

Methods: The survey was administered via email to 64 state/city/territorial IPMs in June 2010. Data were analyzed using SAS, version 9.2 (Cary, NC).

Results: Eighty-four percent (54/64) of IPMs responded to the survey.  Thirty percent (19/64) of IPMs indicated sharing the lead role with EPP for their public health agencies’ HN1N vaccination campaign. Equivalent numbers of IPs and EPPs led the response (23% each). There was no association between who IPMs reported doing the bulk of the work with who they reported leading the response.  On average 47% of IPMs indicated EPP were effective in supporting H1N1 management tasks (i.e. allocating vaccine, facilitating allocation decisions, developing risk communications for providers and the public, supplementing IP staff, facilitating overall response and educating new providers). IPMs qualitatively reported successes in collaborations with EPP in communication, coordination, and resource management. Communication was also cited the number one challenge, along with differences in work cultures between the two groups.

Conclusions: During the H1N1 influenza vaccination campaign, there were national variations in how health agencies structured who was the lead for response activities. Overall, about half of IPs indicated EPP were effective in supporting response activities. To improve collaborative efforts in future pandemics, it may be useful to further investigate ways to continue enhancing “peace-time” relationships between IPs and EPPs .