National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

The 2009 H1N1 Influenza Vaccination Campaign

Summary of a Workshop Series

Clare Stroud, Lori Nadig, and Bruce M. Altevogt, Rapporteurs

Forum on Medical and Public Health Preparedness for Catastrophic Events

Board on Health Sciences Policy

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W.
Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This project was supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians, the American Hospital Association, the American Medical Association, the American Nurses Association, the Association of State and Territorial Health Officials, the Centers for Disease Control and Prevention (Contract No. 200-2005-13434 TO #6), the Department of Health and Human Services’ Agency for Healthcare Research and Quality (Contract No. HHSP233200800498P), the Department of Health and Human Services’ National Institutes of Health (Contract No. N01-OD-4-2139 TO #240), the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract Nos. HHSP233200900680P and HHSP23320042509X1), the Department of Homeland Security, Federal Emergency Management Agency (Contract No. HSFEHQ-08-P-1800), the Department of Homeland Security’s Office of Health Affairs (Contract No. HSHQDC-07-C-00097), the Department of the Army (Contract No. W81XWH-08-P-0934), the Department of Transportation’s National Highway Traffic Safety Administration (DTNH22-10-H-00287), the Department of Veterans Affairs (Contract No. 101-G09041), the Emergency Nurses Association, the National Association of Chain Drug Stores, the National Association of County and City Health Officials, the National Association of Emergency Medical Technicians, the Pharmaceutical Research and Manufacturers of America, The Robert Wood Johnson Foundation, and the United Health Foundation. The views presented in this publication are those of the editors and attributing authors and do not necessarily reflect the views of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-16021-6

International Standard Book Number-10: 0-309-16021-9

Additional copies of this report are available from

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Suggested citation: IOM (Institute of Medicine). 2010. The 2009 H1N1 influenza vaccination campaign: Summary of a workshop series. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Geothe

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES


Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.


The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.


The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.


www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

Workshop Planning Committee*

JAY BUTLER (Co-Chair),

(then) Centers for Disease Control and Prevention, Atlanta, GA, (currently) Alaska Native Tribal Health Consortium, Anchorage, AK

JEFFREY S. DUCHIN (Co-Chair),

Public Health–Seattle & King County and University of Washington, Seattle, WA

TERESA BATES,

Tarrant County Public Health, Fort Worth, TX

BETH P. BELL,

Centers for Disease Control and Prevention, Atlanta, GA

PAMELA BLACKWELL,

Cobb & Douglas Public Health, Marietta, GA

JAMES S. BLUMENSTOCK,

Association of State and Territorial Health Officials, Arlington, VA

BROOKE COURTNEY,

Center for Biosecurity of UPMC, Baltimore, MD

JACK HERRMANN,

National Association of County and City Health Officials, Washington, DC

B. TILMAN JOLLY,

Department of Homeland Security, Washington, DC

LISA KOONIN,

Centers for Disease Control and Prevention, Atlanta, GA

DAVID L. LAKEY,

Texas Department of State Health Services, Austin, TX

CATHY SLEMP,

West Virginia Department of Health and Human Resources, Charleston, WV

IOM Staff

BRUCE ALTEVOGT, Preparedness Forum Director

CLARE STROUD, Program Officer

ANDREW POPE, Director,

Board on Health Sciences Policy

ALEX REPACE, Senior Program Assistant

*

Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

Forum on Medical and Public Health Preparedness for Catastrophic Events*

LEWIS GOLDFRANK (Chair until September 2010),

New York University Medical Center, New York

ROBERT KADLEC (Co-Chair from September 2010),

PRTM Management Consultants, Washington, DC

LYNNE KIDDER (Co-Chair from September 2010),

Center for Excellence in Disaster Management and Humanitarian Assistance, Tripler AMC, Hawaii

ALEX ADAMS,

National Association of Chain Drug Stores Foundation, Alexandria, VA (from September 2010)

DAMON ARNOLD,

Association of State and Territorial Health Officials, Arlington, VA

GEORGES BENJAMIN,

American Public Health Association, Washington, DC

D. W. CHEN,

Office of the Assistant Secretary of Defense for Health Affairs, Department of Defense, Washington, DC

ROBERT DARLING,

Uniformed Services University, Bethesda, MD (until September 2010)

VICTORIA DAVEY,

Department of Veterans Affairs, Washington, DC

JEFFREY DUCHIN,

Public HealthSeattle & King County and University of Washington, Seattle, WA

ALEXANDER GARZA,

Department of Homeland Security, Washington, DC

JULIE GERBERDING,

Merck Vaccines, West Point, PA (from September 2010)

LYNN GOLDMAN,

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (until September 2010)

DAN HANFLING,

Inova Health System, Falls Church, VA (from September 2010)

DAVID HENRY,

National Governors Association, Washington, DC (until September 2010)

JACK HERRMANN,

National Association of County and City Health Officials, Washington, DC

*

Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

KEITH HOLTERMANN,

Federal Emergency Management Agency, Washington, DC (until September 2010)

JAMES JAMES,

American Medical Association, Chicago, IL

JERRY JOHNSTON,

National Association of Emergency Medical Technicians, Mt. Pleasant, IA

BRIAN KAMOIE,

The White House, Washington, DC

LISA KAPLOWITZ,

Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC (from September 2010)

ALI KHAN,

Centers for Disease Control and Prevention, Atlanta, GA (from September 2010)

MICHAEL KURILLA,

National Institute of Allergy and Infectious Diseases, Bethesda, MD

JAYNE LUX,

National Business Group on Health, Washington, DC

ANTHONY MACINTYRE,

American College of Emergency Physicians, Washington, DC

ANGELA MCGOWAN,

Robert Wood Johnson Foundation, Princeton, NJ

MARGARET MCMAHON,

Emergency Nurses Association, Williamstown, NJ

MATTHEW MINSON,

Texas A&M University, College Station, TX (from September 2010)

ERIN MULLEN,

Pharmaceutical Research and Manufacturers of America, Washington, DC

GERALD PARKER,

Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC (until September 2010)

CHERYL PETERSON,

American Nurses Association, Silver Spring, MD

SALLY PHILLIPS,

Agency for Healthcare Research and Quality, Rockville, MD (until September 2010)

STEVEN PHILLIPS,

National Library of Medicine, Bethesda, MD

EDITH ROSATO,

National Association of Chain Drug Stores Foundation, Alexandria, VA (until September 2010)

ROSLYNE SCHULMAN,

American Hospital Association, Washington, DC

RICHARD SERINO,

Federal Emergency Management Agency, Washington, DC (from September 2010)

DANIEL SOSIN,

Centers for Disease Control and Prevention, Atlanta, GA (until September 2010)

SHARON STANLEY,

American Red Cross, Washington, DC

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

ERIC TONER,

University of Pittsburgh Medical Center, Pittsburgh, PA

REED TUCKSON,

UnitedHealth Group, Minneapolis, MN

MARGARET VANAMRINGE,

The Joint Commission, Washington, DC

GAMUNU WIEJETUNGE,

National Highway Traffic Safety Administration, Washington, DC

IOM Staff

BRUCE ALTEVOGT, Project Director

CLARE STROUD, Program Officer

ANDREW POPE, Director,

Board on Health Sciences Policy

ALEX REPACE, Senior Program Assistant

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
×

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

Kristen R. Ehresmann, Minnesota Department of Health

Christine G. Hahn, Idaho Department of Health & Welfare

Scott Needle, Collier Health Services, Inc.

Eduardo Sanchez, Blue Cross and Blue Shield of Texas

Jeanne Sheffield, University of Texas Southwestern Medical Center

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by Kristine M. Gebbie, City University of New York. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
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Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
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Suggested Citation:"Front Matter." Institute of Medicine. 2010. The 2009 H1N1 Influenza Vaccination Campaign: Summary of a Workshop Series. Washington, DC: The National Academies Press. doi: 10.17226/12992.
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4

 

IMPLEMENTATION OF ACIP RECOMMENDATIONS

 

25

   

 Implementation of the Initial Target Group Recommendations,

 

25

   

 Expanding to the General Public,

 

29

   

 Flexibility and Consistency,

 

31

   

 Vaccine Formulations and Target Groups,

 

33

   

 Opportunities in Using Priority Groups,

 

35

5

 

VACCINE ADMINISTRATION METHODS AND PARTNERS

 

37

   

 Mass Vaccination Clinics,

 

38

   

 School Vaccination Programs,

 

40

   

 Healthcare Providers,

 

42

   

 Pharmacies,

 

44

   

 Health Plans,

 

48

   

 Occupational Health Clinics,

 

48

   

 Opportunities for Improving Vaccine Administration and Enhancing Partners’ Roles in Future Campaigns,

 

49

6

 

VACCINATION RATES IN CERTAIN POPULATIONS

 

55

   

 Pregnant Women,

 

56

   

 Healthcare Workers,

 

57

   

 Racial Disparities in Vaccine Uptake,

 

58

   

 Opportunities for Improving Vaccination Rates in Certain Populations,

 

59

7

 

DATA COLLECTION, MONITORING, EVALUATION, AND USE

 

63

   

 State and Local Public Health Data Collection Models,

 

65

   

 Data Collection Challenges,

 

69

   

 Opportunities for Improving Data Collection, Monitoring, Evaluation, and Use,

 

71

8

 

COMMUNICATIONS AND MEDIA

 

73

   

 Communication Challenges During the 2009 H1N1 Vaccination Campaign,

 

73

   

 Communication Among Public Health Authorities,

 

74

   

 Communicating with Healthcare Providers,

 

75

   

 Communicating with the Public,

 

77

   

 Media Relations,

 

80

   

 Opportunities for Improving Communications During Future Emergency Vaccination Programs,

 

82

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The 2009 H1N1 vaccination campaign was one of the largest public health campaigns in U.S. history, vaccinating one-quarter of the population in the first three months. The Institute of Medicine held three workshops in Raleigh, NC; Austin, TX; and Seattle, WA to learn from participants' experiences during the campaign and improve future emergency vaccination programs.

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