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The Honolulu Advertiser
Posted on: Monday, November 30, 2009

Better tracking needed for vaccine doses

The state Department of Health has made a much-needed course correction in how it manages the distribution of vaccine against the H1N1 influenza virus.

The state Department of Health has made a much-needed course correction in how it manages the distribution of vaccine against the H1N1 influenza virus.
It’s about time. Up to this point, this effort to protect Hawaii from H1N1 has been marked by frustration and a lack of the basic data needed to properly manage the allocation of a vaccine that’s in short supply.
It’s clear that much more needs to happen, nationally as well as the locally, before residents can feel assured that government can meet the challenge of a future pandemic threat.
Although reports of cases are declining nationally, the danger posed by this swine flu outbreak still hovers, and officials for the Centers for Disease Control are not ready to let down their guard. Some medical experts are concerned about the possibility of multiple H1N1 waves. And because flu season can last through spring, there’s still a critical need to deliver more doses to the public.
Locally, health officials have shifted to a more targeted scheme for allocating doses among providers. Their original plan to deliver doses as widely as possible, including to freestanding pharmacies, would have worked if supplies had been adequate. But demand has far outstripped supply.
So giving higher priority to providers who have reach on multiple islands, and to practitioners who serve one of the high-priority groups, makes more sense.
However, it’s still disturbing that the state doesn’t have up-to-date numbers on how many people actually got the vaccine. The state should move ahead with plans to require providers to submit reports electronically to the health department. Officials say providers now have the option to enter data online or to submit individual paper reports that the state must then tabulate. So many have simply dumped the forms on the state that the accounting has backed up.
That’s an archaic way to deal with a fast-moving pandemic. And slow reporting can also delay dealing with questionable practices. For example, some health-care providers haven’t even inoculated all their front-line employees, stockpiling doses until enough arrive to have a one-time vaccination drive.
The only practical way to account for doses being administered in a timely way is for providers themselves to be required to do so. It’s more efficient, and in a public health emergency, every participant in the campaign has a critical role to play.
It would also help if the CDC would provide more direction on how to target priority groups, rather than leave it to the states to guess when the supply pace might pick up sufficiently. Once the delivery to vulnerable populations reaches certain benchmarks recommended by the CDC, then local authorities can broaden the outreach.
Such lessons gleaned from the H1N1 effort should help the state and the nation strengthen the public-health safety net for the next outbreak. It’s only a matter of time before one will happen.