NACCHO Advocates for Seasonal and Pandemic Flu Preparedness

By Eli Briggs, Senior Director of Government Affairs

On November 14, NACCHO and a coalition of public health and healthcare partners met with staff from the House Energy and Commerce Oversight and Investigations Subcommittee in preparation for a hearing on Flu Preparedness and Response.

NACCHO government affairs staff highlighted the role of local health departments in monitoring, preventing, and controlling disease to reduce the health risks and financial burden of seasonal flu. We know that most local health departments provide direct immunization services (adult: 90% and childhood: 88%, according to NACCHO’s National Profile of Local Health Departments) and promote the importance of annual flu vaccination through education and policy.

NACCHO government affairs staff also discussed the vital role of local health departments in preparing for a pandemic flu outbreak, and the need for more federal support to ensure that they have the capacity in place to respond if pandemic strikes. Many local health departments  are operating at a diminished capacity due to budget pressures on federal, state, and local governments. Local health departments have lost 23% of their workforce since 2008, shedding over 40,000 jobs across the country.1 This deficiency is compounded by the aging of the LHD workforce—55% are over age 45,2 and almost a quarter of health department staff are eligible  for retirement. Between those who plan to retire or pursue jobs in the private sector, projections suggest that over a third of the local workforce might leave in coming years.3

When it comes to flu, pandemic, and immunization, there are fewer epidemiologists to track the spread of diseases and identify pockets of underserved areas within the community at disproportionate risk. There are also fewer nurses to staff immunization clinics and conduct outreach to healthcare providers and community groups.

Data interoperability also remains a challenge. Sharing information across state lines is necessary to have a full picture of vaccination rates and remaining gaps. NACCHO has supported the Data: Elemental to Health Campaign, a D.C. coalition-based effort to secure $1 billion in federal funding over the next decade to modernize the public health surveillance enterprise at the Centers for Disease Control and Prevention and, importantly, at state, local, tribal, and territorial health departments. This year, the House of Representatives approved $100 million for the first year of this effort, but actual funding in FY2020 is expected to be lower after negotiations with the Senate, which are still on going as of press time.

NACCHO remains committed to advocating for strong capacity for local health departments to tackle both seasonal and pandemic flu. If you have a story to share that can bolster our efforts, please reach out. To read NACCHO’s policy statements on immunization and infectious disease, visit


  1. Robin N, Leep CJ. NACCHO’s National Profile of Local Health Departments Study: Looking at Trends in Local Public Health Departments. J Public Health Manag Pract. 2017;23(2):198-201.
  2. Robin N, Castrucci BC, McGinty M, Edmiston A, Bogaert K. Local Public Health Workforce Interests and Needs in 2017: A Nationally Representative Benchmark of the Local Governmental Public Health Workforce. JPHMP. 2019; 25:S16-S25.
  3. Leider JP, Coronado F, Beck AJ, Harper E. Reconciling Supply and Demand for State and Local Public Health Staff in an Era of Retiring Baby Boomers. Am J Prev Med. 2018;54(3):334-340.