H1N1 After-Action Review

When H1N1 became a serious public health threat in April of 2009, many public health departments found their emergency response mechanisms put to the test. Local health departments played a significant role through disease surveillance, vaccine administration and distribution, and communications with the public, the media and schools.


The unusual intensity of these events prompted the Northern Illinois Public Health Consortium to conduct a formal evaluation of its member health departments to identify best practices and areas for improvement. The review process began in January 2010 with the formation of a steering committee from a variety of expertise areas. The steering committee selected eleven issues for examination in the following categories: emergency response, infectious disease, public information and legal. Feedback was collected from each health department through focus groups, interviews and surveys. Regional challenges, strengths and recommendations are outlined below.



  • Modification of guidelines by state and federal agencies required local strategies to be constantly amended.
  • Variability of school closure criteria across counties. 
  • Uncertainty surrounding when vaccines would arrive and how much would be provided, leading to increased media scrutiny and challenges with distributing to community partners.
  • Health departments across the region adhered to the designation of priority group differently, causing confusion.
  • Health departments were unable to quickly utilize medical volunteers due to limited time for required training and challenges with lending across counties.


  • One local health department developed a web-based system that was utilized by all school districts to track absences. 
  • One local health department organized a public information campaign with schools and hospitals that tied countywide H1N1 information together.
  • One local health department coordinated a regular conference call with hospitals and other healthcare providers to exchange information and provide updates.
  • One local health department conducted phone surveys to find out why residents were not getting vaccinated, helping identify target populations and improve outreach efforts.


  • The region should standardize vaccination and demographic forms to collect uniform data.
  • NIPHC should explore the development of a regional health information system to collect and analyze data to anticipate disease outbreaks and understand the level of illness across the region. 
  • Health departments across the region should release more consistent messages through advanced sharing of plans and press releases. 
  • Regional criteria for school closures should be created.
  • The Illinois Department of Public Health should take the lead in establishing contracts and training for additional health professionals utilized during vaccination campaigns.

While the H1N1 pandemic is formally over, this After-Action Review provides a better understanding of how events unfolded and the need to regionalize strategies to share resources and capitalize on individual strengths. The Northern Illinois Public Health Consortium has already begun to address these challenges and will take the lead in carrying out these recommendations.

About the Northern Illinois Public Health Consortium

The mission of NIPHC is to promote and protect the health of the region through networking and collaborative action that raises public awareness, builds capacity, and influences legislation and policies concerning public health issues affecting northern Illinois.


Certified health departments represented: Counties of Cook, DuPage, Grundy, Kane, Kendall, Lake, McHenry, Will, Winnebago, the City of Chicago and the Village of Skokie

Additional Documents


 full after-action review 

provides additional context and analysis of key areas where greater regional collaboration can yield tangible benefits, along with recommendations for enhancing the role of the state. 

Any feedback or questions can be sent to Heather Drummond, NIPHC Intern, at