Story from the Field

Name of Health Department/Agency:	Oklahoma State Department of Health
State:	OK
Date Added:	03/10/2010
Themes:	Vaccine Planning and Administration
Issue Summary:	Expanding H1N1 Vaccination Beyond ACIP Target Groups
Description of Issue(s):	Oklahoma expanded its vaccination program the week of November 15 after a great deal of internal discussion. Overall, the decision to expand has been a positive one for the state. Four factors led to the decision: (1) the number of doses administered to ACIP target group members was on the decline, (2) ILI had peaked in mid-September/October, (3) demand for vaccine among all groups was starting to wane, and (4) providers were reaching storage capacity in their refrigerators.
Actions taken to address the issue(s):	The health department started its vaccination program by targeting predominantly school sites, and expanded week by week. The week prior to official expansion, the state was targeting all ACIP groups. The state organized a vaccine blitz on a Saturday to target members of all five ACIP target groups at several clinics across the state. Despite being very well publicized, these clinics did not generate high attendance. Providers were getting pressure from senior groups (65+) who heard that providers were sitting on vaccine in their offices. State health officials decided to expand the program to the entire population in mid-November because they were seeing a decrease in ILI among school-aged children and an increase of ILI among adult populations. The first week of the expansion (11/15/2009) saw a surge in demand (70 percent increase from the previous week). During the first week, 40,000 doses were administered over the previous week?s high and uptake was high among the elderly. Demand trends normalized the next week (first week of December) as numbers returned to pre-expansion levels (approx 36,000 doses).
Outcomes that resulted from actions taken:	Jurisdictions should expect a surge in demand during the first week after expanding the vaccination program. Health departments and providers need to plan and make sure they have enough supply to meet this surge in demand. Communication is very important and jurisdictions need to maintain good relationships with the local media. Oklahoma did this by publicizing the expanded program through local television, radio, and newspaper outlets.

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