Hawaii Department of HealthHawaii Department of Health
Prevent childhood illnessPrevent childhood illness Indirectly decrease community transmissionIndirectly decrease community transmission ACIP RecommendationsACIP Recommendations Prepare for possible mass vaccinations of school Prepare for possible mass vaccinations of school
children in the event of an influenza pandemicchildren in the event of an influenza pandemic
Planning/ProposalPlanning/Proposal Collaborating PartnersCollaborating Partners LogisticsLogistics Budget/ExpendituresBudget/Expenditures Media/CommunicationsMedia/Communications
Feasibility of providing choice of TIV or LAIVFeasibility of providing choice of TIV or LAIV 3 elementary schools3 elementary schools Overall vaccination rate: 35%Overall vaccination rate: 35%
Grades K – 8Grades K – 8 All Hawaii public and private schools invited All Hawaii public and private schools invited
to participateto participate Voluntary written consent of Voluntary written consent of
parent/guardian requiredparent/guardian required Offered TIV and LAIVOffered TIV and LAIV Two clinics held for schools with children Two clinics held for schools with children
aged less than 9 years in first year (2007-aged less than 9 years in first year (2007-08); only 1 clinic in subsequent years08); only 1 clinic in subsequent years
95% participation rate for all public and 95% participation rate for all public and private K-8 schoolsprivate K-8 schools
50% influenza vaccination uptake for 50% influenza vaccination uptake for Hawaii school children grades K-8 in Hawaii school children grades K-8 in participating schoolsparticipating schools
Formation of an Executive Advisory CommitteeFormation of an Executive Advisory CommitteeNeighbor Island District Health OfficesNeighbor Island District Health Offices
Hawai`i Department of EducationHawai`i Department of Education Hawai`i Association of Independent SchoolsHawai`i Association of Independent Schools Hawai`i Catholic SchoolsHawai`i Catholic Schools Hawai`i Pacific University, School of NursingHawai`i Pacific University, School of Nursing Kauai Community College, School of NursingKauai Community College, School of Nursing Maui Community College, School of NursingMaui Community College, School of Nursing University of Hawai`i at Manoa, School of NursingUniversity of Hawai`i at Manoa, School of Nursing American Academy of Pediatrics – Hawai`i ChapterAmerican Academy of Pediatrics – Hawai`i Chapter American Academy of Family Physicians - Hawai`i ChapterAmerican Academy of Family Physicians - Hawai`i Chapter Hawai`i Medical Services Association Hawai`i Medical Services Association Hawai`i County Fire Department Hawai`i County Fire Department Kaiser Foundation Health PlanKaiser Foundation Health Plan Kahu MalamaKahu Malama MedImmune, Inc.MedImmune, Inc. Medical Reserve Corps – Oahu, Maui, Hawaii, and Kauai countiesMedical Reserve Corps – Oahu, Maui, Hawaii, and Kauai counties Sanofi PasteurSanofi Pasteur U.S. Military’s Joint Public Health Emergency Working GroupU.S. Military’s Joint Public Health Emergency Working Group West Kauai Lions ClubWest Kauai Lions Club Etc.Etc.
School, student, and vaccine projectionsSchool, student, and vaccine projections Staffing projectionsStaffing projections IT supportIT support Budget analysisBudget analysis TimelinesTimelines Printed materials and communicationsPrinted materials and communications
Feas
ible
?
JanJan Feb Feb MarMar AprApr MayMay JunJun JulJul AugAug SepSep OctOct NovNov DecDec Jan*Jan*
Order VaccinesOrder Vaccines
Staffing Staffing ArrangedArranged
Consents Consents Due/ReviewDue/Review
SchoolsSchoolsScheduledScheduled
ClinicsClinics
Consents Consents SentSent
SchoolsSchoolsAskedAsked
Promotion Promotion
*2007-08 only
Subsequent years
Separate (color-coded) consent forms
for LAIV and TIV
2007-2008(Printed in triplicate)
20072007(1(1stst year) year)
20082008
VaccineVaccine $1,858,995$1,858,995 $1,289,441$1,289,441
StaffingStaffing $266,345$266,345 $233,884$233,884
OtherOther†† $782,134$782,134 $311,911$311,911
TOTALTOTAL $2,907,474$2,907,474 $1,835,236$1,835,236
**Note that expenditure figures for 2009 still being finalized.Note that expenditure figures for 2009 still being finalized.††Medical Supplies, Print Materials, Data Entry, Staff, Curriculum & Training, Public Relations, Medical Supplies, Print Materials, Data Entry, Staff, Curriculum & Training, Public Relations, Courier, Promotion & IncentivesCourier, Promotion & Incentives
Develop Public Service Announcements (PSA)Develop Public Service Announcements (PSA) TV commercialsTV commercials Radio spotsRadio spots Newspaper advertisementsNewspaper advertisements Flyers Flyers
Morning show interviews (TV and radio)Morning show interviews (TV and radio) Governor’s announcementGovernor’s announcement Call centersCall centers
Public inquiriesPublic inquiries Physician inquiries and reporting of adverse eventsPhysician inquiries and reporting of adverse events
Translation servicesTranslation services Coordinate media events at school clinicsCoordinate media events at school clinics
2007 2008 2009*Participating Schools 340/377 (90%) 337/379 (89%) 342/375 (91%)
Student enrollment 146,777 142,603 152,623
Students Vaccinated
TIV 38,231 36,981 44,188
LAIV 24,922 25,375 26,581
TOTAL 63,153 (43%) 62,355 (43.7%) 70,769 (46.4%)
Total Faculty/Staff 21,625 21,102 22,471
Faculty/Staff Vaccinated
TIV 8,318 8988 9,400
LAIV 988 533 648
TOTAL 9,306 (43%) 9,521 (45.1%) 10,048 (44.7%)*Preliminary Data*Preliminary Data
Consent FormConsent Form Separate TIV and LAIVSeparate TIV and LAIV SimplifySimplify
22ndnd dose clinics for children under age 9 years dose clinics for children under age 9 years 45% of all clinics were 245% of all clinics were 2ndnd dose clinics dose clinics Diminishing returnsDiminishing returns
StaffingStaffing Student nursesStudent nurses Medical Reserve CorpMedical Reserve Corp Contract nursesContract nurses
Established relationships with partnersEstablished relationships with partners Existing forms and proceduresExisting forms and procedures Existing suppliesExisting supplies Staffing sourcesStaffing sources Parental/community supportParental/community support
H1N1 clinics followed seasonal clinics, beginning H1N1 clinics followed seasonal clinics, beginning November 2009November 2009
Limited staff available to run additional clinicsLimited staff available to run additional clinics Uncertainty regarding timing of availability of 2009 Uncertainty regarding timing of availability of 2009
Influenza A H1N1 vaccineInfluenza A H1N1 vaccine Short lead-timeShort lead-time School furlough daysSchool furlough days
School-based influenza vaccination clinics are School-based influenza vaccination clinics are feasiblefeasible Provide infrastructure for pandemic preparationProvide infrastructure for pandemic preparation Require extensive planningRequire extensive planning Close collaboration with partners, especially schoolsClose collaboration with partners, especially schools Funding – constant challengeFunding – constant challenge
Once established, public expectation (and support) Once established, public expectation (and support) for clinics to continuefor clinics to continue
Assessment of impactAssessment of impact
Recommended
