WASHINGTON The optimal delivery of influenza
vaccine in community settings is made less efficient
by obstacles found in purchase and distribution, logistics and reimbursement,
according to a presentation made during the 45th Annual National Immunization
Conference held here.
Between January 2009 and June 2010, researchers conducted qualitative
interviews with various stakeholders (n=65) involved in the vaccination
process, including health insurers, medical service firms, retail-based
clinics, pharmacies, schools, and state and local public health immunization
programs. The researchers sought to determine key barriers to the optimal
delivery of vaccines, now that recommendations for universal
influenza vaccination have expanded to include more
than 300 million children and adults annually.
Barriers to the purchase and distribution of influenza vaccines in
community settings included limited purchasing power, not being able to
accurately gauge public demand and the unpredictable timing of the supply.
Community vaccinators noted logistical obstacles such as the need to
manage publicly and privately purchased vaccines separately and lack of
consistent requirements by states for credentialing, physician oversight and
Barriers to reimbursement by health plans included limited willingness
to contract, the need to confirm insurance eligibility at point-of-service and
a lack of billing infrastructures at offsite clinics.
Vaccination processes in community settings could be streamlined with
the help of public health officials acting as trusted brokers,
according to presenter Grace Lee, MD, MPH, assistant professor of
population medicine and pediatrics at Harvard Medical School.
Public health partners at the federal, state and local levels are
well-positioned to facilitate the engagement of all stakeholders to overcome
barriers to influenza vaccine delivery. In addition, public-private
partnerships can augment our ability to vaccinate children and adults in
community settings, Lee told Infectious Diseases in Children.
Disclosures: Dr. Lee reported no relevant financial disclosures.
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