“Shots in arms” is the goal for every public health official vaccination provider, and as the SARS-CoV-2 Delta variant floods hospitals, the demand for COVID-19 vaccines is on the rise again.
But before doctors and nurses can inject individuals, immunization managers must deal with logistics of supply, scheduling and delivery, according to Claire Hannan, MPH. She is executive director of the Association of Immunization Managers (AIM) in Rockville, Maryland.
Hannan discussed the evolving demands of immunization management with AMA chief experience officer, Todd Unger, on a recent episode of the “AMA COVID-19 Update.”
The highly transmissible Delta variant of the novel coronavirus has led to new demands for immunization programs that have expanded beyond previous limits to include teenagers, pre-teens, students and school staff. These programs pose special problems that are not just logistical. Politics, sadly, also play a role as immunization spreads to schools, she said.
AIM members usually operate at the state public health or metropolitan government levels, she said. The association has 64 members, funded by Congress as part of Centers for Disease Control and Prevention to manage the immunization and vaccine programs in the country.
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Implementing school vaccine programs
“They're responsible for sort of implementing strategies like school requirements, looking into outbreaks, really immunization across the board, and, of course, with the COVID campaign, planning and implementing that,” she explained.
The first week of August was a serious challenge for immunization managers as hospitalizations rose and colleges, universities and schools prepared to reopen for face-to-face education, creating new demand for vaccinations, she said.
“This has been the toughest week, just because we worked so hard, tirelessly for more than a year in this pandemic and we really thought we'd be at herd immunity by now,” Hannan said.
“We really thought we would push this vaccine out, people would get vaccinated, we'd reduce the virus circulation. And we're hitting that point where we're realizing the virus is back on the upswing. We've got a variant that is protected by the vaccine, but it's much more easily transmitted. And we have this unvaccinated population that's at risk and plus we have children that can't get the vaccine yet who are at risk,” she said.
Many colleges and universities taught remotely last year, but most are planning to be open to on-site education in the fall, she noted.
“There are a whole host of universities requiring the vaccine, so many people going back to college will be required to get it,” Hannan said. “But public schools, high schools, daycares, those school requirements are state responsibility, so they're state laws. And what we're seeing actually is a trend with states saying that you are not going to be able to require COVID vaccine.”
States vote against vaccination requirements
AIM reports that 12 states have passed laws preventing required vaccination of students, supplemented by an additional nine executive orders from governors.
“So that trend is there. I think with school requirements, you really need to have that time period of acceptance of the vaccine, trust in the vaccine in place and get to the point where you want to get just that last hump of the population—those kids—vaccinated.
“The school requirements are an incredible tool and an incredible protection to keep our kids safe while at school, but we have to make sure we've got things in place before we require the COVID vaccine,” she said.
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