Learn from Matthew Bobo, MPH, the Immunization Program Manager in Alaska, about the unique challenges of his state’s landscape. From making vaccines accessible in remote locations to building meaningful relationships with the Tribal system, Matt shares what it takes to keep his state safe from vaccine-preventable diseases. Make sure to tune in for this a-MOOSE-ing episode for tips on navigating a demanding vaccine environment and advice to keep you motivated as a new immunization manager.
This episode was recorded in July 2022. In August 2022, Matt resigned from the Immunization Program in Alaska. We’re grateful to have Matt’s wisdom and insight and wish him the best of luck!
Matthew Bobo, MPH, has worked in public health for over 15 years. Matt has been the Alaska Immunization Program Manager for five years and was the Deputy Program Manager for three years. Before working in immunizations, Matt was an epidemiologist for Alaska’s Tobacco Prevention and Control Program. In addition, Matt has worked in Indonesia (mental health research) and rural China (HIV research). Matt received his MPH from Boston University in Global Health and has a BA in pre-medicine/English Literature from Auburn University.
Brent Ewig 0:03
Welcome to AIMing to inform. I’m Brent Ewig, your host for this limited series podcast produced by the Association of Immunization Managers. We started this podcast so we could talk to immunization managers across the US to understand how they have overcome challenges and become a champion for vaccines. Before we’re done today, we hope you’ll experience at least one a-ha moment, enjoy a few dad jokes, and leave the episode feeling motivated to carry on your work as a public health leader. Let’s get started.
So welcome to the latest episode of AIMing to Inform. I’m your host, Brent Ewig, and with me today is Alaska immunization program manager, Matt Bobo. So if you’re ready, Matt, we just jump into some questions.
Matt Bobo 0:51
Let’s do it.
Brent Ewig 0:53
All right, then anchorage away. My first dad joke of the day. First of all, Matt, can you share a little bit about your career path into public health and immunization specifically?
Matt Bobo 1:05
Sure, I’d be happy to. I got my MPH from Boston University and that was in global health. I did some research in Indonesia, and then rural China went back to Boston, had a job at BU, and then 2008 recession hit. And so it took me a while to find another one. And so the state of Alaska offered me a position as an epidemiologist in the tobacco prevention and control program. They offered to move me up. So I thought why not? So I was there for about three and a half years went to a senior consulting position at a little research firm, I ended up getting a contract to stand up the Alaska Vaccine Assessment Program. The higher-ups at the Division of Public Health really liked me. And they say, hey, there was a deputy program manager position – you should apply. So I said, Sure. I will. I did. They hired me. And then after the program manager, Gerri Yett retired, I took her position as a program manager.
Brent Ewig 2:10
You kind of touched on this, but can you talk a little bit, encapsulate kind of what motivates you to do this work?
Matt Bobo 2:17
What I’m finding about immunization work that’s fascinating is it is constantly changing. And it moves really fast. I found in the tobacco prevention and control world, that really the subject matter didn’t change as fast as I wanted it to. And so it really brings me great joy for every day to be a new challenge. And really the importance of getting all Alaskans vaccinated against all vaccine-preventable diseases and not spreading diseases around. So, I have found this work challenging and very motivating.
Brent Ewig 2:52
And that’s excellent. And you touched on this. The challenge is, obviously, Alaska has some unique challenges and opportunities. Can you to share a little bit more about your program? How you how you address those challenges?
Matt Bobo 3:02
Yeah, so Alaska, as any Alaskans will say, we are unique. And so we do not have any counties. So there’s not county health departments. We’re structured a little differently. We have a very large tribal population. And so tribes are structured differently here in Alaska. They’re structured as tribal health organizations. So, we really work with those tribal health organizations one on one, and we have relationships with them across the state. The Tribal Health Organization’s kind of come together through the Alaska Native Tribal Health Consortium and THC. So we work a lot with ANTHC as well. Just because of the size of Alaska, it takes a lot of effort to get vaccines to some places. And some places are much more complex than others. There are two islands off the coast of Alaska, St. George, St. Paul, historically, they’re just really challenging to get to due to weather. Also the Aleutians, you have the eastern and western Aleutian chain, and getting flights out to those locations are also really difficult. So often planes are delayed, weather delays, and so really just always being on your toes to not knowing what the day is gonna hold.
Brent Ewig 4:27
Well, you open the door to this one, Matt, but did you hear about the guy who he thought he saw a palm tree off the coast of Alaska on an island?
Matt Bobo 4:36
Brent Ewig 4:37
Yeah, it turns out it was an optical Aleutian.
Matt Bobo 4:43
That is a great joke.
Brent Ewig 4:45
Can you talk on so you have just how big of a team there do you have to do this work?
Matt Bobo 4:50
Yeah, so traditionally, we are a staff of 18 with a public health advisor from the CDC. So we have recently we gotten two new permanent positions, which is really exciting. And then during the COVID-19 pandemic, we kind of exploded to a staff of around 50. We’ve kind of stood down a little bit, so we don’t need that much staffing. But we’ve really had to grow in terms of really all the work that we have
Brent Ewig 5:21
You began to talk about in the last response, but that kind of urban/rural, what is the rural-urban mix in Alaska? I would imagine it’s pretty, pretty stark divide.
Matt Bobo 5:31
So it’s, it’s interesting. So, you have urban areas, urban areas, for the most part, are on the road system. So that would be Anchorage. Then you would have kind of the Mat-Su area and then going up to Fairbanks. And those are kind of the main hub areas that are on the road system. But you also have an urban area in Juneau, that’s on the panhandle, southeast Alaska. There are no roads that go to Juneau and a lot of the southeast. And then basically, you have some communities that are on the road system, but most are off. And so really you work within those areas, you work a combination with tribal health organizations, as well as with the section of public health nursing. So we have a group of public health nurses that have public health centers across the state. And to get to these rural remote areas, a lot of those nurses will itinerant out to those locations to vaccinate or do child well visits. So there’s kind of a hybrid of a lot of kind of systems going on, that all kind of link up together.
Brent Ewig 6:42
And I would imagine in many of those rural areas, there’s a lot of moose and other wildlife. Which reminds me of the joke. Do you know why dad jokes are so much better in Alaska?
Matt Bobo 6:54
Brent Ewig 6:56
Because they’re so a-Moosing.
Matt Bobo 7:01
Love it. My favorite Alaskan animal is a muskox. They’re very cool. And they seem just otherworldly, because they’re just really, really short, like short little bulls.
Brent Ewig 7:13
I have seen those. That’s pretty cool. So let’s talk a little bit about the policy landscape, and particularly around funding, what do you find is kind of the challenges and opportunities to get funding for your program in Alaska?
Matt Bobo 7:25
So I think in terms of funding, we have gotten a lot of supplemental funds, as has everyone else that have been helpful with really hiring long-term non-perms and getting other staff. I will say, as the pandemic continues on, I think the political-ness of things have gotten a little heightened. To be quite frank, everyone’s done with COVID. They want to be done with it. We don’t want to talk about it anymore. We don’t want to mention it anymore. And so as we get closer to November, which is an election year here in the state of Alaska, and there will be a new governor, things are a little bit more heated than usual. And so I’ve noticed as I’ve just done my first RFP for a communications grant, or communications contract, rather it was $3 million, and it got a lot of attention. Once it was posted on State of Alaska open notices, I have gotten media requests, I have gotten questions about why are using terms like health equity, misinformation. And so it’s a hot button issue. And so I think as I am trying to spend all of these funds, it’s increasingly getting harder to do.
Brent Ewig 8:51
Any advice you’d have for colleagues on how to how to navigate that?
Matt Bobo 8:56
I would say talk to your leadership, know what their perspective is, and really have frank conversations about what you can and cannot say in this kind of political hot world that we live in, especially as immunizations are so focused right now. And so I think it’s just being aware of your surroundings.
Brent Ewig 9:19
Good. Good insight. Good advice. You had alluded to this also upfront about the success, substantial success, in working with your tribal populations. Can you delve into that a little more and talk about how that consortium works and where you’ve had the success?
Matt Bobo 9:34
Yeah, so the Alaska Native Tribal Health Consortium they have an immunization program that we work really closely with. And then as well as we work very closely with our tribal health organizations. Really one of the big successes of the immunization program that obviously we didn’t know a pandemic was coming. But in 2018, we took a step back, and we decided that we want to do an assessment on all of the distribution channels within the state of Alaska. So really how this works, there will be a vaccine that either comes from McKesson or it will come from the state. And that will go to a tribal health organization. And then once it goes to a tribal health organization that’s in a hub, then it will be redistributed to a rural remote village. And so that’s kind of how the system is set up. And so what we did is we decided to buy VeriCor coolers, we provided continuous recording thermometers, and we made sure that they had enough equipment to get vaccine from the tribal hub to the remote village. And then we also made sure that we trained in the remote village, who works there is a CHAP, it’s a community health aid. And they go through a training that has been family certified. But they’re kind of a lower level, they’re not even kind of the standard of a nurse. And there are different levels, and you have to be up to a level four to vaccinate. So really also working strongly with that community to make sure that they are aware of how to properly send vaccine around as well. And so it was a lot of educating, a lot of really training folks and getting systems in place that work for their unique environment and unique geography. And so really having projects like that, this that really work hand in hand with a tribal health organization. It’s really a great way to build a relationship that lasts, a lot of these individuals turn over a lot. So you’ll have a lot of turnover. But as long as you kind of have a people that know you and know of you, then that kind of continues along that relationship with those organizations.
Brent Ewig 11:57
Excellent. Relationships and trust and two key things you mentioned there. And we should probably clarify, you mentioned PHAPs stands, that’s the CDC Public Health Advisor Program. That same…
Matt Bobo 12:08
Yeah. So they come up every two years, they’re kind of a fresh MPHer or masters who have public health or a little public health experience. They’re very usually go-getters. And so they’re great individuals, they can send off into the field and go collect a lot of data and bring it back and then synthesize it. So they’re a great asset.
Brent Ewig 12:30
Yeah, I agree. We’ve had some terrific ones come through AIM headquarters that have been just invaluable. They’re, they’re some of the finest folks out there. Let’s talk, you’ve been in vaccine policy for some time now. What would be your top advice to other immunization managers?
Matt Bobo 12:46
I think, top advice in terms of policy, know who are your representatives. I will say that I am super lucky that I have a partner who was a legislative staffer. So I kind of had the inside scoop on everyone and everything that was going on. I would say that that was super beneficial in terms of me, kind of navigating the landscape of what to say and what not to say. So I think really know the policies that are coming out, know the key players. If you’re part of the opportunity to do the bill analyses, definitely do them so you know the bills that are coming out and you know the language that’s being used. Also, make sure that you’re using AIM and other organizations. A lot of bills that are introduced each year are copy bills from other states. And so making sure that you work on talking points and really know the landscape. And then in terms of internal policies that are outside the legislature, write everything down. It’s really simple. But just take the time to write it down. If you don’t, five years will go by, literally five years will go by, and you’re like, oh, I should have run done that policy or what what was that policy we decided? And so shifting your brain from COVID back to normal immunizations, I’ve forgotten a lot of things. So definitely either task someone, task a contractor, but write down all of your policies and procedures.
Brent Ewig 14:22
Excellent, excellent ideas. Thank you. So there’s three questions we’re asking every guest. Are you ready for these last three?
Matt Bobo 14:30
Brent Ewig 14:31
Okay. What is one thing you wish you could tell your younger professional self?
Matt Bobo 14:35
I think I would tell my younger professional self to stop being such a stresser, I am a stresser and COVID-19 did not help. So, I am taking steps to remember go on bike rides, go for long walks, go for runs. Life is too short to stress about every everything. So I think as an immunization program manager, it’s so, so easy to stress about so many different things so sometimes you really just have to take time for yourself. Also, remember to eat lunch, it’s really important.
Brent Ewig 15:11
What are you looking forward to professionally in the next year,
Matt Bobo 15:15
I am super excited and pumped about what the future of vaccines and immunizations look like. I am someone who, reading the science and reading the literature. I’m super excited about the mRNA technology, if you can, with you know, with flu, we’re limited to a Quadrivalent vaccine, pulling four different strains. If you had an infinite number of strains that you could pull, that that’s quite amazing. I think that things are going to start to change and hopefully the realms like HIV and other areas that are decimating certain populations. So for me, that’s really exciting.
Brent Ewig 15:59
Yeah, it really seems like we’re on the cusp of something that it’s it’s in our hands to shape the future. So last of the three, the trio, is what’s the greatest value you get from the AIM community?
Matt Bobo 16:12
I think the greatest value that I get from the AIM community is having an opportunity to share the day-to-day. It’s, it’s, it’s difficult, even as I’m getting older in my MPH, you know, my friends from grad school, they’ve often done different things. And so really to talk to an immunization program manager, it’s it’s like, they get it, they get it’s hard, they get stressful, they get leadership don’t understand certain things. They get that you’ve gotten a ton of money that is political. They get that every time a legislative session happens, well, school requirements are going to be a thing. And you need to be prepared for that. And so I think it is an opportunity for me to share and to grow from, and more importantly, to learn. And so I think there’s a great opportunity to really just share our stories. And I think that’s, that’s really important. And I think that further helps the community as a whole and our country against vaccine-preventable diseases, learning the history at an AIM meeting of immunization programs and the Carter administration. And really the history of Measles and really learning about there’s there’s a long history, there’s a long legacy. And I want others to know, and Alaska happens to be a universal program, where we have an assessment program and where we have all ACIP recommended vaccines for children and adults. And that’s a really cool spot to be in. And I, I want to help other other leaders and others grow. And so I think AIM has a great forum for that.
Brent Ewig 18:02
Thanks. Well, we’ve, we’ve had a good dialogue today. We learned a lot about Alaska. We we slipped in a few Alaska dad jokes. But I before we close, I’ve mentioned for our listeners, I actually am from Wisconsin, which is America’s Dairyland. You may know but did you hear that they found a cow in Wisconsin that didn’t give any milk. It turns out it was a milk dud. The utterly terrible joke but I thought that’d be a good one to close on.
So Matt Bobo, Alaska immunization program manager, thank you for sharing some time and insights, and wisdom with us today. And thank you for joining us on this episode of AIMing to Inform.
Matt Bobo 18:42
It was a pleasure. Thank you.
Brent Ewig 18:43
Thank you for listening. If you want to get all the episodes as we release them, please subscribe on your favorite podcast app, or visit the AIM website to join our mailing list. The Association of Immunization Managers, AIM, is dedicated to establishing a nation free of vaccine-preventable diseases. Visit our website at immunizationmanagers.org to get resources and attend events to keep you aiming to inform.
This podcast series was made possible through the independent financial support from Merck. AIM controls all content on this podcast. All episodes were recorded and produced in 2022.
Transcribed by https://otter.ai