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When the Cat Is Out of the Bag: A Case Study in Public Health Rationing in Oregon During the 20042005 Influenza Vaccine Shortage

Skiles, Martha Priedeman MPH; Scott, Kathryn D. DrPH; Young, Collette PhD

Journal of Public Health Management & Practice: September/October 2008 - Volume 14 - Issue 5 - p 464–470
doi: 10.1097/01.PHH.0000333881.45270.97
Article

Whereas the annual influenza season in the United States is fairly predictable, the influenza vaccine supply is variable, leaving providers vulnerable to supply and demand fluctuations each season. During the 2004–2005 influenza vaccine shortage, Oregon invoked Oregon Revised Statute 433-030 to target vaccine supplies to protect persons at highest risk for complications from influenza. This case study describes Oregon's efforts to ration vaccine at the point of administration by limiting the number of individuals eligible for vaccination. An evaluation of this process found that providers responded positively to the mandatory prioritization of vaccine recipients; however, limitations in assessing and affecting redistribution of privately held vaccine supplies and challenges in enforcement of the plan were revealed.

This study describes Oregon's efforts to ration vaccine at the point of administration by limiting the number of individuals eligible for vaccination.

Martha Priedeman Skiles, MPH, is the Research and Training Manager for the Oregon Public Health Division's Immunization Program. In this position, she has provided leadership and oversight to the design and implementation of surveillance and case management systems, research and evaluation studies, health preparedness response, and community partnering through two statewide coalitions. Martha received her masters in public health from the School of Public Health, University of California, Los Angeles.

Kathryn D. Scott, DrPH, coordinates Oregon's Strategic National Stockpile Program. Before joining the Oregon Public Health Division's Immunization Program, she worked as an epidemiologist and research scientist. Kathryn received her public health doctoral degree from the School of Public Health, University of California, Los Angeles.

Collette Young, PhD, is a Research Analyst for the Oregon Immunization Program. Before joining the Immunization Program, she was self-employed as a public health evaluation consultant. Collette has a PhD and an MS from the Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.

Corresponding Author: Kathryn D. Scott, DrPH, Strategic National Stockpile Coordinator, Immunization Program, State Public Health, 800 NE Oregon St, Ste 370, Portland, OR 97232 (Kathy.D.Scott@state.or.us).

This study was supported by Grant no. H23/CCH022550 to the OPHD Immunization Program and Grant no. U90/CCU017007-05-3 to the OPHD Public Health Emergency Preparedness Program from the Centers for Disease Control and Prevention. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

© 2008 Lippincott Williams & Wilkins, Inc.