H1N1 Vaccine Allocation In New York State

Background: When H1N1 influenza vaccine first became available during the 2009-2010 pandemic, it was in limited supply relative to the number of high risk individuals during the peak of disease.  To ensure that vaccine was distributed equitably, the New York State Department of Health allocated vaccine on a per capita basis by county.    

Objectives: To determine if per capita allocation resulted in equitable access to vaccine during the 2009-2010 H1N1 influenza pandemic and to identify the benefits and challenges to using a per capita allocation methodology.

Methods:  An analysis of the data collected during the H1N1 influenza vaccination campaign was completed, including the number of providers who registered for vaccine and the number of doses ordered, distributed, redistributed, administered, and wasted.    

Results: Preliminary results demonstrate that the population size of a county is not always directly associated with the providers’ vaccination burden.  Also, the number of providers registered for H1N1 influenza vaccine in each county and the amount of vaccine they ordered severely limit the ability to maintain a per capita allocation strategy.  

Conclusions: Planning for the future allocation of limited resources is very difficult given the uncertainties surrounding the epidemiology of novel diseases and the demand for and availability of medical counter measures.   Per capita allocation is an equitable way to allocate vaccine.  However, it is also important to consider the number of providers willing and able to administer vaccine in a given county and the movement of individuals from one county to another for vaccination services.   Utilizing pre-pandemic resources to assist in estimating where people seek vaccination services could increase the ability to provide equitable access to vaccination.