TABLE 3.
Challenges faced in general and HTR populations with various approaches to vaccinating during a pandemic situationa
Objective | Challenges in the general population | Additional challenges in HTR populations |
---|---|---|
At the individual level | ||
Alert target populations to the need to be vaccinated | Identification and location of individuals at risk | |
Mobilize mass public vaccination programs quickly | Large numbers of people to be vaccinated | |
Rumors can lead to widespread fears out of proportion to actual risk | ||
At the provider level | ||
Expand the provider pool | Long wait times at peak hours | |
Need for mechanisms to manage adverse events | ||
Learning curve while programs ramp up | ||
Maintain documentation | Lack of records under crisis conditions | Low priority of documentation in crisis response situations |
Simplify vaccine administration protocols | Need for documentation and regulation | Conservative, cautious bureaucracies |
At the structural level | ||
Assure adequate vaccine supply | Annual domestic influenza vaccine capacity far below national need in a pandemic | |
Prioritize population segments | Desire of first-responders to protect family members | Resource allocation likely to favor easy-to-reach populations |
Implement an information dissemination plan | Communication under crisis conditions | By definition, hard to reach |
Plan for a Federal distribution program | Conflict of need to stockpile vs. competing seasonal needs | |
Test the plan under simulated conditions | Time lag in “ramp up” of vaccine supply | |
Select vaccine distribution points before the crisis | Hospitals resistant to lines of command external to their system | Points of distribution likely to favor easy-to-reach masses |
aChallenges outlined for the general population are not meant to be fully comprehensive and may also be applicable to HTR populations.