11
Final Remarks

The IOM Preparedness Forum’s regional workshop series was one of several efforts to examine the 2009 H1N1 vaccination campaign, discuss lessons learned, and identify promising practices (e.g., ASTHO, 2010; NACCHO, 2010b). A particular contribution of these workshops was the special emphasis placed on including partners from across the vaccine distribution and administration system in all the workshops. The workshops provided an opportunity for federal, state, tribal, and local public health officials, healthcare providers, EMS providers, healthcare administrators, representatives from the private sector (including pharmacies and healthcare organizations), journalists, and community leaders, among others, to learn about each other’s roles and experiences during the campaign. Most importantly, it was a venue for them to join together to discuss strategies to sustain and leverage progress made during the past year, identify opportunities and areas for further work, and continue to improve the nation’s ability to respond to future public health threats. The challenge now, participants said, is to take the lessons that have been learned through this experience and move forward, improving the nation’s emergency response system. One of the major themes that arose during the workshops is the ideal of flexible standardization or nimble uniformity—creating systems that find the sweet spot between consistent, standardized processes and highly fluid, reactive ones. As Georgia’s Blackwell put it, “Public health agencies have to adapt and evolve quickly. We have to be much more nimble than we have ever been in the past to respond to an emerging situation.”

Several participants emphasized that the annual seasonal flu vaccination campaign presents an excellent opportunity to integrate many of the lessons learned from the 2009 H1N1 response, continue to enhance vac-



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11 Final Remarks The IOM Preparedness Forum’s regional workshop series was one of several efforts to examine the 2009 H1N1 vaccination campaign, discuss lessons learned, and identify promising practices (e.g., ASTHO, 2010; NACCHO, 2010b). A particular contribution of these workshops was the special emphasis placed on including partners from across the vaccine distribution and administration system in all the workshops. The work- shops provided an opportunity for federal, state, tribal, and local public health officials, healthcare providers, EMS providers, healthcare admin- istrators, representatives from the private sector (including pharmacies and healthcare organizations), journalists, and community leaders, among others, to learn about each other’s roles and experiences during the campaign. Most importantly, it was a venue for them to join together to discuss strategies to sustain and leverage progress made during the past year, identify opportunities and areas for further work, and continue to improve the nation’s ability to respond to future public health threats. The challenge now, participants said, is to take the lessons that have been learned through this experience and move forward, improving the na- tion’s emergency response system. One of the major themes that arose during the workshops is the ideal of flexible standardization or nimble uniformity—creating systems that find the sweet spot between consis- tent, standardized processes and highly fluid, reactive ones. As Georgia’s Blackwell put it, “Public health agencies have to adapt and evolve quickly. We have to be much more nimble than we have ever been in the past to respond to an emerging situation.” Several participants emphasized that the annual seasonal flu vaccina- tion campaign presents an excellent opportunity to integrate many of the lessons learned from the 2009 H1N1 response, continue to enhance vac- 97

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98 THE 2009 H1N1 INFLUENZA VACCINATION CAMPAIGN cination systems and activities, strengthen relationships, obtain feedback on what works and what does not, and continue to refine practices from year to year. They suggested that providing additional attention and re- sources to the seasonal vaccination campaign would also be highly bene- ficial to future emergency vaccination campaigns. To improve their ability to respond effectively to the next public health emergency, workshop participants spoke of the need to evaluate what worked and what did not, then systematize what worked and change what did not. They spoke of the need to capitalize on the momen- tum that had started and to reinforce the plans, policies, and procedures that worked, rather than letting time erode the collective memory of the event. Many participants emphasized that the partnerships that were so valuable in the response need to be nurtured and further developed so that they can be relied on in the future. Communication strategies need to be refined, and work needs to be done at the community level to ensure that those who need to hear the messages have relationships with those who will be the messengers. Processes, from manufacturing to distribution and administration, should be looked at with a critical eye to see how they can be simplified and made more transparent to improve the delivery not only of vaccine, but other countermeasures as well. As the CDC’s Merlin said, “The les- sons that we learn from stepping back and looking at this entire process and how time can be carved off of the process from detection to manu- facturer to distribution to administration—that [saved] time actually translates into saved lives.”