The Navigators Recommend Enhancing and Expanding Publicly Funded Vaccine Programs

The Navigators are announcing their efforts to offer recommendations to modernize, enhance, and expand publicly funded vaccine programs such as the Vaccines for Children (VFC) program. These recommendations are focused on learning from the COVID-19 experiences, optimizing VFC use and access, and providing accurate documentation.

A cross section of health professionals from across the nation have worked to share information and overcome barriers for COVID-19 vaccination. This group, “The Navigators” is now advocating for expanding and modernizing federal vaccine programs. Increasing access to vaccines will reduce the health disparities spotlighted during the pandemic.

The Navigators have achieved several outcomes over the past 18 months. These include advocating for CDC policy changes early on in the pandemic; improving access to COVID-19 and other vaccines by promoting pharmacies as a critical public health partner; strengthening relationships and interoperability between pharmacies and public health immunization programs; and playing a supporting role in underwriting and promoting  a documentary entitled “Vaccination from the Misinformation Virus” (www.themisinformationvirus.com) to address vaccine confidence concerns by the public.

According to Todd Watkins, President of STChealth and co-founder of The Navigators, “In spite of these achievements, there are still many opportunities The Navigators are pursuing in our quest to expand access, advocacy and infrastructure initiatives to improve immunization coverage rates for all ACIP recommended vaccines across all cohorts. The Navigators are united in their belief that enhancing and expanding publicly funded vaccine programs to pharmacies is a critical issue that, when addressed, opens up a wide array of solutions to pursue these opportunities in earnest.”

Additional vaccine providers who receive public stock vaccine and can report accurate vaccination information are needed for emergencies as well as to maintain and increase routine immunization rates, which have fallen during the pandemic. The Navigators are therefore suggesting that HHS convene partners to overcome barriers to VFC modernization based on these recommendations.   In its advocacy work on increasing vaccination rates, The Navigators has identified the following areas for stakeholder attention:

1. Learn from COVID-19 experiences:  COVID-19 vaccination response and the recent decline of routine immunization rates demonstrates the need for evaluation and expansion.

• According to the CDC, more than 70% of COVID-19 vaccinations provided through a public supply chain have been administered within community pharmacies demonstrating the abilities and reach of these accessible providers who can expand access to populations where routine vaccination rates have decreased across all cohorts.

• Currently about half of American children receive vaccines through VFC at no charge, an existing mechanism to address health equity. Since the PREP Act extends vaccination administration to pharmacists down to the age of 3, it is crucial that pharmacies can provide immunizations to children who are VFC eligible.

• Programmatic components of VFC requires further assessment within current practice experiences and available processes, and consideration of requirements that are barriers to VFC expansion.  This includes process efficiency and simplification.

• Federally funded disease prevention initiatives such as VFC are fiscally sound and the best way to mitigate the impact of vaccine preventable diseases.

2. Optimization of VFC Use and Access:  The VFC program was created in response to low immunization coverage and the 1989–1991 measles outbreak in the U.S.

• COVID-19 vaccine response requires traditional and additional vaccinators, hence the need for VFC expansion.

• This pandemic highlighted significant health disparities thereby highlighting the need to integrate vaccine surveillance and analytics into the infrastructure of publicly funded vaccine programs such as VFC.

• Access to vaccines must be available in all communities with a variety of options for individuals to address the challenges due to social determinants of health.

• HHS can increase routine vaccination rates and enhance preparedness to prevent disease outbreaks by expanding the VFC program.

3. Accurate Documentation: Maintaining vaccine effectiveness and accurate documentation of vaccinations and vaccine inventory is critical to the administration of the VFC program.

• A complete and thorough vaccine record must be available to vaccination providers and maintained as accurate, although the current process should be simplified to focus on only what’s essential to maintain vaccine efficacy.

Publicly funded programs like the highly successful VFC program must be modernized to be more inclusive of pharmacies. According to Stacy Hall, retired Immunization Program Director for the Louisiana Department of Health, and co-founder of The Navigators, “There are over 44,000 registered VFC providers across 61 public health jurisdictions, and fewer than 100 are pharmacies. Pharmacies proved during the 2008-2009 H1N1 pandemic and then again during the current COVID pandemic that they are a substantial partner in protecting the public’s health. Pharmacies have proved invaluable in vaccine administration during the pandemic. This engagement is needed for all vaccine preventable diseases. Traditional vaccinators will continue to provide service, yet families need more opportunities to access disease prevention by vaccination.”

About The Navigators

The Navigators is an all-volunteer public/private partnership group formed in March of 2020 at the start of the COVID pandemic to overcome the long-standing barriers in the vaccine delivery process. This group has been instrumental in major changes adopted by CDC, state public health and pharmacies. The Navigators continue to meet each week to discuss solutions that can be implemented and scaled specific to the problems we face today to include how to increase vaccine access to all Americans, advocating for the further expansion of administering point of care testing and immunizations in pharmacies, overcoming the challenges with vaccine hesitancy, and bolstering the infrastructure between pharmacies, public health, and the consumer.

Through collaboration and coordination, and a focus on addressing patient and public health needs we can make a difference. The Navigators welcomes interested entities representing stakeholders across the immunization ecosystem to participate in our weekly meetings, which are held via zoom every Tuesday at 11am EDT. If you would like to join, please contact Ryan Watkins at ryan_watkins@stchome.com.