Vaccine Preventable Disease Laboratory Reference Centers - Use and Sustainability - CHANGE, presenting author (June 17)

Brief Summary
     Recently, four Reference Centers (RCs) for viral vaccine preventable diseases (VPDs) with two of these also serving as RCs for bacterial VPDs were established for molecular testing and advanced diagnostics by CDC in conjunction with the Association of Public Health Laboratories and state public health department laboratories.  The primary intent of this project was to provide access to molecular and serologic testing for selected VPDs to all public health laboratories and to evaluate the long term utility and sustainability of shared service models. The VPD Reference Centers were established to provide testing for states where molecular methods are not available and where it would be impractical to implement testing due to low test volumes.Although this project is in its infancy, substantive strides have been made in standardizing and validating protocols for all molecular and serologic testing and the RCs began accepting specimens for testing in April 2013.  Since that time 32 state health department laboratories and 9 local health departments have set up agreements with the RCs. Twenty-five of these have submitted specimens that as of January 2014 numbered in excess of 220 viral and bacterial specimens. Turnaround times for test completion have been excellent and the RCs have supported investigations of three viral disease outbreaks including providing genotyping results in a complete and timely fashion. Most  initial molecular diagnostics were completed in less than 24 hours and genotyping results were available within 48 hours.The RCs have been most successful in attracting submission of specimens for suspected cases of VPDs of low incidence that many public health laboratories find too costly to provide validated testing for in-house. However, many laboratories are uncomfortable with abandoning testing for those agents, since the sustainability of the RCs is on a year-to-year basis with no commitment to long-term funding. This far, federal funding has paid for all aspects of the RCs from personnel, reagents, to shipping of specimens and even evaluation panels for test validation. We would like to have discussions centered around increasing enrollment of submitting laboratories, alternative shared service agreements that might include fee for service, and ideas for sustaining the RCs on a more long-term basis.