Friday, May 18, 2007

What is Immunization Infrastructure and What Does It Have To Do With

When I tell people about my job and I let them know that my Coalition works on improving immunization infrastructure. Soon after I mention this word I see that people’s eyes kind of glaze over with a mixed sense of confusion and boredom. I find the word infrastructure is one that has this effect on people.

However, I still continue to use it because building immunization infrastructure is one of the most important things our Coalition does. But what does it mean?

It means creating a system or a structure so that vaccines can be administered correctly, timely, and optimally to the appropriate individuals in order to maximize protection from communicable diseases.

Infrastructure involves education, awareness, relationships, legislation, networks, tools, money, and reality. This all sounds very obscure. Let me give you an example.

Right now in the U.S. pertussis is a disease that is very common. It is common because the immunity from the DtaP that children receive starts to wane as they become teens and adults. So the disease has found a large reservoir of people who are not immune to pertussis. We know this is true. Pertussis is no fun to get as an adult but it can be deadly for a newborn.

Since 2004 in California we have had 13 newborns die because they contracted pertussis from an adult who was infected. How do we stop this? Simple – a safe and effective booster shot called Tdap given to teens and adults which will most likely reduce the amount of cases of pertussis in the general population reducing the amount of cases transmitted to newborns and basically saving babies' lives.

Unfortunately there does not exist an infrastructure to immunize teens or even adults. This immunization infrastructure has to be built. This means making providers and the public aware that they need to get a Tdap booster to fully protect them from pertussis which is quite common. And it means creating places where they can get these vaccines.

Working with providers, school clinics, pharmacies, teen clinics, and emergency rooms to make sure they can get the vaccine, store it safely, administer it properly, and get paid for administering it. This means helping establish relationships between providers, the general public, vaccine makers, and State and local health departments. Immunization Coalitions can help do all this.

And this is what creating immunization infrastructure is all about. Immunization Coalitions identify barriers or gaps in the infrastructure and work on ways to fill them. Single entities like hospitals, health departments, or school districts can not build infrastructure alone – they need organizations that stretch across all of these sectors bringing diverse partners together for the common cause of protecting people from disease.

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