Indicator 3.1.3.1: Local and/or state public health identified members of epidemiology investigation and surveillance teams targeted for immediate smallpox vaccination.

This indicator is unclear in several ways. First, it should be clarified whether “immediate” means “pre-event,” and whether “epidemiology investigation and surveillance teams” refers to the public health response teams commonly described in the CDC guidance. Second, the wording used implies three related tasks: the identification of teams, defining the qualifications required for teams, and the vaccination of teams. It should be made clear exactly which task(s) the indicator aims to evaluate. Because this indicator only applies to pre-event activities, it is only applicable to scenario 1; it is presumed under scenarios 2, 3, and 4.

Within the framework provided by the Ten Essential Public Health Services, this indicator corresponds to Essential Services 1 and 2.

Suggested Criteria
  • Is there an updated list or registry for each locale with smallpox public health response team members’ names, contact information, and vaccination status?

  • Does the team possess the minimum public health bioterrorism response competencies appropriate to their role(s)?

  • Is there an effective, efficient notification system for contacting team members?

Indicator 3.1.9.1: Local and/or state public health identifies members of epidemiology and investigation teams targeted for immediate smallpox vaccination following the notification of an outbreak.

The indicator wording should be clarified to explain what “notification of an outbreak” really means. Does this mean when an outbreak is officially declared? Immediately after a single case is identified? When an outbreak occurs anywhere in the world or in the United States? Also, as in 3.1.3.1, does “epidemiology investigation and surveillance teams” mean the public health response teams commonly described in the CDC guidance?

The indicator also implies three different tasks, and it is unclear which task is being evaluated, whether it is the identification of teams, the vaccination of teams, or the expansion of teams with functional role descriptions for needed expertise.

This indicator is not applicable to scenario 1, which is pre-event (i.e., before an outbreak), but it may apply to scenario 2 and is most relevant to scenarios 3 and 4 due to enhanced surveillance needs.



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