In this episode of AIMing to Inform, Utah Department of Health and Human Services Immunization Director Rich Lakin shares his unique perspective on immunization work in his home state. Hear about his strategy to confront misinformation and increase COVID-19 vaccination in low-uptake areas. Rich also shares his perspective on developing compelling messages for all age groups. Make time to listen to this seasoned immunization advocate!
Rich Lakin has worked in public health for 26 years. He has held positions at the local health department in injury prevention, tobacco prevention, emergency preparedness, and as a public information officer. Rich currently works the as the Immunization Director at the Utah Department of Health and Human Services. In addition, he has held several positions, from Disease Investigation and Management Manager to Epidemiologist. Rich holds a Master’s degree in public administration and a Master of Science degree in public health.
Brent Ewig 0:37
So, welcome back to the latest episode of Aiming to Inform. My name is Brent Ewig your host and excited to be joined today by Rich Lakin from the Immunization Program at the Utah Department of Health.
Now, Rich, I wanted to let you know I did a little research on Utah before our chat. And I found out you all have a, a state insect, that’s the bee and you’re known as the beehive state. Um, I found out that’s, uh, because of your industry and perseverance, which, uh, both I’m sure have had play out in your covid vaccination campaign.
It was a really believe, bee-lievable story for me with my first dad joke. Um, I also found out that you have a state dinosaur there. The Allosaurus did you know that?
Rich Lakin 1:59
No, I didn’t know that.
Brent Ewig 2:00
I didn’t know that one either, but I knew what, uh, you call a dinosaur. Do you know what you call a dinosaur that’s been vaccinated?
Rich Lakin 2:06
Brent Ewig 2:07
That’s an oh my arm-is-saurus two dad jokes right at the bat. Um, but we should get to talk. We’re gonna talk covid today. We’re gonna talk about your experience in the, the Utah department. Um, and, uh, once, as they say in Utah, once talk the talk. You better walk the walk. So why don’t we just, Get right to it. So brace yourself. Here’s the first question.
Uh, Rich, you’ve been in government for a fair amount of time. Can you tell us, uh, how you, you know, just describe your career, what brought you to your current position?
Rich Lakin 2:40
Well, I’ve been in government for, um, about 27 years. Um, I’ve worked at the city level. I’ve worked at the county level, um, and then at the state, um, so I’ve worked for a local health department. Um, I did an, uh, early when I graduated, I, I worked at a city, um, doing some recreation kind of stuff and that was actually a fun job, but it didn’t pay enough. So I went to the local health department, and I held nu number of positions from health education to communications, um, PIO officer, emergency preparedness, and then I went to, um, the state health department and was the, uh, manager over, um, disease investigation and management program. Um, I was at for a little while. Um, I was an epidemiologist and then, uh, executive director asked me to go to Medicaid. I went to there for a little while and ran a program for a couple years, and then, uh, this position opened up and I, um, came down into program manager in the immunization program. So that’s kind of how I ended up here. And I’ve been here for about six years, and I’ll probably stay here until I decide to retire.
Brent Ewig 3:57
That sounds good. Can you talk to us a little bit about what motivates you to do this work in immunization?
Rich Lakin 4:03
I would say probably the main thing, um, that motivates me is it’s, it’s really ever-changing. It’s a challenge. Um, whether it’s, you know, at the, at the national level or whether it’s the state level or whether it’s the local level. It’s just, you know, it’s just ever-changing. There’s, um, things have always seem to evolve and, and, uh, go up and down and I think that’s what I like about this position. Um, where some of the other manager positions that I’ve been in have kind of been, you know, the same thing over and over, and this one is, has nothing. Like, and over and over type position. So, um, I’ve really enjoyed it.
Brent Ewig 4:45
That’s great. Can you tell us a little more about your program in Utah? How big is your team?
Rich Lakin 4:49
Sure. So we have about 50 people. Um, and we’re broken down into several programs. So we have the vaccine management program, which is, they control, like it says, all the vaccine management, ordering, um, et cetera. And then we have the VFC vaccine for children’s program. And then we have our, um, COVID, uh, 19 program. And then we also have our registry program, um, within there. And I basically manage, um, like I said, 50 people and then, uh, the managers there, manager staff, and then I have some that are directly underneath me. But for the most part, that’s about, uh, what I do is manage, uh, about 50 people.
Brent Ewig 5:32
And can you talk to us a little bit, what are some of your biggest opportunities and challenges out there?
Rich Lakin 5:37
Um, I think some of the biggest opportunities are that, um, as we kinda, well I would say the, one of the biggest opportunities is our registry is a homegrown registry. And, um, with the COVID money, we’re able to really beef up that system and do it what it really needs to do. Tracking. Data analysis, um, work with providers. You know, there’s a lot of things that go into a registry, and in the past, we haven’t had the funding. We haven’t really been able to do what we wanted to. So I would say that that’s probably one of the biggest opportunities. And then also being able to hire for the COVID program and for them to manage that. So that’s been, um, probably opportunities and.
I would say some of the challenges probably fall within the same line. Um, you know, as we, as we grew, we also had a challenge to, to fill those positions. Programmers, you know, are hard to find, uh, business analysts, um, epidemiologists. Uh, and so those were some of the challenges and I think other challenges really to combat the, the misinformation that people have readily available to them on their phone. Um, and that, you know, when they get the information, it needs to be, um, reputable places, um, where they get it, not, uh, some places that look like it’s a valid source. So I, I would say that’s probably some of the best opportunities and challenges that we’ve faced.
Brent Ewig 7:08
Good. And, um, I’ve had the chance to drive across particularly southern Utah, and I know you have a very bea-UTE-iful landscape there see what there you. But I wanted ask you a little bit about the policy landscape in your state, particularly when it comes to supporting immunizations. What’s your outlook been?
Rich Lakin 7:27
So I actually live in the southern part that you probably drove through. I live down in the St. George area, Zion’s area. Um, so from the policy standpoint, um, you know, we have, we have great support. Um, from leadership at the Utah Department of Health and Human Services. Um, matter of fact, they’ve made immunizations one of their top priorities, um, here in the state, and there’s only three of ’em, so that’s really good to hear. Um, I would say from the legislator standpoint, we, it’s, uh, hit and miss. Uh, we have many legislators that, um, support public health and immunizations, and then there are some that don’t Um, so from a policy standpoint, they can, you know, uh, do legislation that can either support immunizations or they can make it very difficult, um, for policy if they don’t support it and, and don’t support a bill or they write a bill. That would be, um, detrimental, I guess, to the current policies that we have in Utah. And so, um, I think from a policy standpoint, what I just kind of mentioned is probably some of the. The key points. Um, the governor highly, highly supports immunizations, which is good. Um, and then, like I said, leadership, et cetera. From a legislative standpoint, there’s uh, still some work need to be done.
Brent Ewig 8:50
Yeah. I wanna, um, delve specifically into some, some of the questions around, COVID but since you mentioned policymakers and legislatures there, I was gonna ask you, did, did you hear about this movie starring a, a handsome senator from Utah’s it’s kind of sappy movie?
Rich Lakin 9:06
Um, no. Are there handsome senators from Utah?
Brent Ewig 9:09
Yeah, this one’s a Mitt Romney-com. We’ll see in, I’m not sure. Let’s talk more about COVID, particularly Utah, how your state, both the leadership and population at large, how did they responded to the vaccine rollout there.
Rich Lakin 9:26
So I, I think it’s pretty similar to what’s happening across the country. Um, the older population’s getting vaccinated to see the importance of it. Younger population, um, not as much. And then the, um, six-month, uh, five-year, uh, five-year-olds are even less. So you, you kind of see that curve, that bell curve. I, I guess ask based on age of, of how covid vaccinations are going, um, you know, we, we have a, um, not necessarily a huge anti-vax kind of population here. Um, but you know, there are a lot of people that, that do question, um, vaccinations. Um, and especially for a, for COVID for many of the others, like school vaccinations and that there’s, there seems to be quite a, a, a good support for that and uh, that’s moving along strongly. But I think with a new disease, COVID, it’s gonna take a while for people to, to support it. But I think it actually, in Utah, it will probably turn around and we’ll, we’ll probably have higher than. Uh, you know, those will gradually increase as years go by.
Brent Ewig 10:37
Yeah. Good to hear. But you, you mentioned that people are seeing covid vaccine differently from routine. Do you have, do you have any thoughts on how that, why that is and that makes it a different issue tackle?
Rich Lakin 10:51
Um, I think it’s, you know, I, I, I don’t quite know how to answer that other than, um, the school rule. Makes vaccinations important. Um, however, you know, we’re, we’re starting to see maybe a slight decrease in some of these, like, uh, measles, you know, the MMR vaccine. Um, but again, you know that that population is pretty small. Mm-hmm. , that, that’s against, you know, we’re on the 90 up in the mid-nineties and vaccination for TDAP MMR, polio, etc.
Um, it’s just the ones that are annual, like flu and covid that seem to be, uh, smaller than other vaccinations. So I think it’s just people recognizing what they feel is less important to be vaccinated against as compared to the more important, um, vaccine-preventable diseases, um, that they’ve been routinely getting vaccinated for.
Brent Ewig 11:53
Yeah, it’s a unique position to be in. Um, can you talk a little about how you handled the increased visibility due to covid with the attention from media governors, office legislators, and so forth?
Rich Lakin 12:05
So we work very close with, uh, our health disparities program. We work very close with our public information officer, um, their, their whole program. And, and we actually just put out a big campaign that separated, um, about people don’t forget about your routine vaccinations. And then also adults don’t forget that there are vaccinations that you need to receive as adults. And we’ve tied COVID into that. So, um, that campaign is currently running now and, um, it’s a, it’s a large campaign. Um, very creative. They were, they used an advertising agency to assist and they’ve come up with some great, uh, messaging through, uh, through social media, et cetera. And it’s just moving along, um, really strong. So that’s kind of one of the way we do it. The other, the other way we do it is we kind of work with our providers and, um, doctors, et cetera, and just, you know, encourage them to get their patients in, um, and give them the, the correct information, et cetera, uh, to help them, you know, reach out to their patient population and, and get them vaccinated.
Brent Ewig 13:22
So I understand that you’ve taken some time to understand, um, how to specifically motivate Utah residents to accept the COVID vaccine. Can you talk about some of the ways you gathered some of that messaging research?
Rich Lakin 13:34
Yeah, so we, um, we used the survey and, um, our epidemiologist, uh, works with other programs within the department. The BRFSS survey, which is the behavioral factor risk survey. And, um, we put a number of questions in there and basically that’s how we gather our information is, is through the survey. Um, and those questions give us information about, um, populations, age, gender, um, also, uh, certain areas within. Utah, that, that may have lower rates, areas that may have higher, uh, helps us identify health disparities. Um, and we use that data. And then, um, our have a couple epidemiologists that gather that data and then we work with our partners, um, based on that data to try to reach those specific areas or maybe misinformation that’s kind of going to that area. So it really helps us dive in, you know, why, why is this particular spot, um, in Utah or spots in Utah have a less vaccination, and, and that, that survey really helps us identify those areas. And then there are also other programs that have different types of surveys and we collaborate with them and gather information and that helps us identify in Utah.
Brent Ewig 15:01
That’s fascinating. It sounds like you’re, you’re definitely getting the, where there’s pockets of under vaccination. Are you getting any insights into the why people seem to be?
Rich Lakin 15:1
Yeah, so, um, there are, there are a lot of whys when it comes to COVID. Um, some are just waiting to see what happens, um, which was, is a big question. Uh, quite a large population or just, we just wanna see what happens. Um, many are, they just don’t feel that it’s significant. Um, others that, uh, for example, some parents will say they just don’t feel it’s a risk to their child. Um, and, you know, kind of get questions around that, that realm. Yeah. Yeah.
Brent Ewig 15:45
So, um, the last data I saw had yet at about 65.7% of, of Utahns uh, up to date. On completion of COVID vaccine, that’s about the middle of the packs. Do do you see much more public interest in, in the vaccine or how, how would you describe kind of the current state of play?
Rich Lakin 16:04
Well, I would say as a conservative state, middle of the packs, probably not too bad. Um, of course, you know, we would, we would definitely like to be higher. Um, I think this is, just like flu, we’re kind of in the middle of the pack. And this is, I think COVID is just one of those where many Utahns believe that it’s, it’s not a, not a concern. Um, but you know, there are those that, that want the vaccine very early.
Um, and then there are some that have been waiting, and then there’s, we’re actually having a large group right now that are getting their first doses. Approximately about 5,000 a week. So there are some people that maybe according to that survey have said, you know, I’ve, I’ve watched, um, and learned and, and now it’s time for me to get my first dose. And so if you just got a whole range of a population, I say, to be in the middle of the pack, I, I would think that we’ll gradually increase as we just continue to try to, um, motivate Utahns of the importance. Yeah.
Brent Ewig 17:12
And I, I wonder, but I mean, we’re at about nationally about 500 deaths a day right now from, COVID and on a weekly basis that that’s more than one 9/11 a week. But because it’s so spread out rather than in one dramatic instant that makes harder, harder to message the seriousness. We’ve got work to do there. Uh, but do you have some thoughts on kind of where we go from here, what the next steps.
Rich Lakin 17:36
Well, I think in regards to that, I think, um, we, we, we probably did a poor job in and, um, I think across the country in messaging how important it is for all age groups. Um, you know, in the, in the beginning we, we had said this is from the national level. They said This is, could be very harmful. Now hospitalized deaths in the older population, and that’s what the public heard in the beginning, and then try to come back and combat that with your child’s at risk at five years old is very difficult. Or school age. And so what parents heard or adults have heard is that this is a disease that affects the old. And what we’re trying to do now is combat that, that this is important across all life, uh, all age groups. And it’s gonna be difficult to do that. We’ll, we’ll keep pushing. Our current campaign does that, so hopefully it, it does have some impact.
Brent Ewig 18:38
Yeah. So I wanted to ask about the, the campaign, and I understand you’ve, you’ve got some good partnerships and in relationships that they, how, how would you kind of describe the current state of play around the partnerships that you’ve utilized to get this done?
Rich Lakin 18:52
Um, we’ve got some great partners. Um, we’ve, we’ve got, uh, several contractors that do, um, some jobs for us. They, they go to vulnerable populations that we’ve identified and they vaccinated in those areas. Um, they, uh, they have mobile vans. They’re able to move around the state and, and vaccinate in certain areas. They work with their local health departments. They work with their community health centers. They work with, uh, a particular group, communities of color within the area. And, and we try to reach those groups, for example, African Americans and Hispanics in this area that, uh, tend to have a lower vaccination. Um, we’re able to work with their leaders and, and get into those areas. So we’ve got some great partners. Uh, we’ll continue to work with those. We work directly with the health Disparities program kind of assist and, and because they know the areas better than we do in our local health departments. And that’s kind of how we, uh, how we move in this, in this stage where everybody that would like to receive a vaccine can they can go to their pharmacy, local health department, their physician community health center. Um, if there are some areas that we’ve identified that are a little bit difficult, uh, for them to travel and get to places or, um, they don’t have insurance, then um, we have other opportunities where, uh, Utahns can go and get vaccinated. Yeah.
Brent Ewig 20:18
So we talked about, um, challenges across the state. We talked about the beauty of Southern Utah. We didn’t mention we have that you have that area of the state where, where you, you border four, four states coming together. And I’d actually just heard about this that, did you hear this man that tragically died right at that, at that spot where Arizona, Utah, Colorado, and New Mexico come together?
Rich Lakin 20:42
I haven’t heard them.
Brent Ewig 20:43
Yeah. Turns out he needed four corners. Foreigners.
Rich Lakin 20:49
I got it. I got it. I’ve been there, and there’s four corners there.
Brent Ewig 20:54
Probably the last dad joke of the episode. In every episode, we ask three questions of all our guests to kind of wrap things up. Are you ready?
Rich Lakin 21:04
Brent Ewig 21:05
Good. The first one is, what is one thing you wish you could tell your younger professional self?
Rich Lakin 21:13
Um, I would say that, um, you know, don’t worry about the, the, the small things and just, just continue working as the, the best you can. Um, I think we, you know, I have a tendency to, um, very detail oriented, very goal driven. If I could tell my younger self something that, you know, you can still do that, but there are things that are outta your control and, um, don’t sweat it. Just keep moving forward.
Brent Ewig 21:47
I like that. What are some of the things you’re looking forward to professionally in the next year?
Rich Lakin 21:54
Um, I’m looking forward. I, and I mentioned this at the AIM Conference in Philadelphia. Um, I’m looking forward to the continued, continued battle that, uh, immunization program managers face every day when we’re, we’re trying to increase rates. Um, and, you know, whether it’s from a policy standpoint, whether it’s partnerships, you know, all those things that, that’s, that’s enjoyable. That’s, you know, that’s, that’s fun to do to, to, to get those groups together. And we’re all kind of working on the same page and I’m looking forward to doing that again this year. Um, it’s, it, you know, it’s a, it’s a stressful time, but, um, you know, we, I made it through COVID. I can make it through anything now. Um, I can’t imagine what the next year’s gonna bring, but, um, it can’t be any worse that we had to go through 10 years ago or the last two years. So, looking forward to it. And again, the battles of, of just trying to get, uh, rates increased. It’s a challenge. You know, I like a challenge.
Brent Ewig 22:59
That sounds great. And you mentioned AIM so that’s the last question. If you could talk a little about the greatest value you get from the AIM community.
Rich Lakin 23:07
So, my greatest value from AIM is probably the national perspective. Um, when I first became program manager, um, six years ago, you know, I’m, I’m very focused on Utah and um, I think a lot of program managers become very focused on their state but, and say, you know what, I’m, you know, I’m here in the state. I’m the program manager here in the state. I’m gonna increase rates. I’m gonna, you know, do all these things. I think the thing that we forget about is the national perspective and how that, how that applies, um, to our own states. And so I think AIM provides that national perspective, which is, which is very, very important because a lot of those national perspectives, you can apply it to state level. Um, and then you can also coordinate with your, um, other states that are, let’s say, you know, Wyoming and Colorado and Arizona, Nevada, those that kind of border, Utah. You know, we can work together, um, because we may be very similar. Um, uh, because we’re here in the West. So, so I think that’s what AIM provides is a, is a good national perspective. And, and, uh, that’s why I got involved a little bit later on. Cause I actually realized that it actually kinda like the light bulb turned on one day, that, you know what, it, I’m working so hard for just Utah that, you know, uh, a national perspective is very important. I can’t forget, I can’t forget about that.
Brent Ewig 24:42
That sounds terrific. Well, Rich Lakin in the Utah Department of Health, wanna thank you for joining us today on the episode of Aiming to Inform. It’s been a pleasure talking with you. Thanks for being here. Thanks. Thank you. I found out that’s because of your industry and perseverance, which both I’m sure have had play out in your COVID vaccination campaign.