Vaccine Preventable Disease Reference Laboratories: Piloting Public Health Laboratory Shared Services

Brief Summary:
Despite widespread vaccination, morbidity from vaccine preventable diseases (VPDs) remains significant in the US. Concomitantly, competing priorities and limited funding has led many public health laboratories (PHLs) to discontinue or reduce diagnostic testing capacity for VPDs. The Association of Public Health Laboratories (APHL), in conjunction with the U.S. Centers for Disease Control and Prevention (CDC) launched the VPD Reference Laboratory Project in November 2012. The main goal of this project is to establish 4 PHLs as VPD Reference Laboratories to maximize testing efficiencies for low incidence VPDs in a strained fiscal environment. VPD Reference Laboratories will provide reference services for molecular, genotyping and serologic testing to support other PHLs and CDC in a shared service model for measles, mumps, rubella, varicella-zoster virus, B. pertussis, S. pneumoniae, N. meningitidis, and H. influenzae. Additionally, VPD Reference Laboratories will improve informatics capability and data capture of VPD information by creating standard 2.5.1 HL7 messages across all VPD Reference Laboratories.  Secondarily, epidemiologically important meta-data elements may be added to the Enhanced Electronic Laboratory Surveillance Message to better inform disease surveillance trends. Submitting sites will be enrolled in the project by mid-March 2013 and will submit specimens to an assigned VPD Reference Laboratory for diagnostics and further characterization. Submitting laboratories are expected to communicate with their epidemiologists before submitting the specimen. Results will be reported to the submitting laboratory through fax or over the phone, and through a printed or electronic report. It will be the responsibility of the submitting laboratories to communicate the results to their epidemiologists and submitting providers. The impact of this project on laboratory efficiencies and theVPD Reference Laboratory’s ability to assist PHLs and CDC with routine and specialized testing has yet to be seen.  The objectives of this project and impacts on the epidemiology community will be discussed, as well as the clinical and surveillance significance of electronic messaging on disease trending.