title: Changes in immunization program managers' perceptions of programs' functional capabilities during and after vaccine shortages and pH1N1.
abstract: OBJECTIVE
  We surveyed U.S. immunization program managers (IPMs) as part of a project to improve public health preparedness against future emergencies by leveraging the immunization system. We examined immunization program policy and Immunization Information System (IIS) functionality changes as a result of the Haemophilus influenzae type B (Hib) vaccine shortage and pandemic influenza A(H1N1) (pH1N1). Evaluating changes in immunization program functionalities and policies following emergency response situations will assist in planning for future vaccine-related emergencies.
  
  
  METHODS
  We administered three consecutive surveys to IPMs from 64 state, city, and territorial jurisdictions in 2009, 2010, and 2012. We compared IPMs' responses across either two or three years (e.g., changes in response or consistent responses across years) using McNemar's test.
  
  
  RESULTS
  Immunization programs maintained increases in functionality related to communication systems with health-care providers during this period. Immunization programs often did not maintain changes to IIS functionalities made from 2009 to 2010 (e.g., identifying high-risk and priority populations, tracking adverse events, and mapping disease risk) in the post-pandemic period (2010-2012). About half of IPMs reporting additional IIS functionality in identifying high-risk populations from 2009 to 2010 reported no longer having this function in 2012. There was an 18% decline in respondents reporting geographic information systems risk-mapping capability in IIS from 2010 to 2012.
  
  
  CONCLUSIONS
  Because of the Hib vaccine shortage and pH1N1, immunization program needs and efforts changed to address evolving situations. The lack of sustained increases in resources or system functions after the pandemic highlights the need for comprehensive, sustainable public health emergency preparedness systems and related resources.
authors.affiliation: Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA.
authors.forename: Leah F
authors.initials: LF
authors.lastname: Moriarty
authors.affiliation: Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA ; Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA ; Emory University, School of Medicine, Department of Pediatrics, Atlanta, GA ; Emory University, Emory Vaccine Center, Atlanta, GA.
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.affiliation: Emory University, School of Medicine, Division of Infectious Diseases, Atlanta, GA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Seib
authors.affiliation: Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA.
authors.forename: Allison
authors.initials: A
authors.lastname: Chamberlain
authors.affiliation: Association of Immunization Managers, Rockville, MD.
authors.forename: Katelyn
authors.initials: K
authors.lastname: Wells
authors.affiliation: Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Whitney
authors.affiliation: Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Berkelman
authors.affiliation: Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bednarczyk
mesh_terms: D006192:Haemophilus Infections / Q000453:epidemiology / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000600:supply & distribution; D019741:Haemophilus influenzae type b; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007115:Immunization Schedule; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000600:supply & distribution*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D015980:Public Health Practice / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D018073:Haemophilus Vaccines; D007252:Influenza Vaccines