Episode 3: AIMing to Inform Guest Heather Burris

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.

I’m Brent Ewig, your host, and joining me today is Heather Burris of the DC Department of Health. And Heather, if I have this correct, you were recently promoted to permanent chief of immunization. Is that correct?

Heather Burris 0:48
That’s correct.

Brent Ewig 0:49
Yes. Wonderful. Congratulations. I know you’ve been interim for some time, so that’s great news. Congratulations. And as you know, the purpose of the webcast is, or the podcast, is to try to share the stories of AIM members, inspire our folks to help them feel supported, and share a few dad jokes along the way. So first things first, we know you’re of course from our nation’s capitol. We’ve got monuments, we’ve got Congress, we got memorials…you have baseball, the Washington Nationals, which I understand they’re not doing so well, this year. Is that right?

Heather Burris 1:22
Oh, no.

Brent Ewig 1:24
I think they’re in last place. It’s…it’s gotten so bad I heard that the team just hired a baker. They wanted to try a new batter. Dad joke number one. So well, let’s just jump right in if you’re ready to go. Can you first just kind of tell us a little bit about your career path and how you found yourself in the immunization field?

Heather Burris 1:51
Yeah, sure. So I grew up in Seattle, Washington, came to Washington, DC, by way of Howard University to attend undergrad, and then put some time in Atlanta – I did my MPH at Emory University. But I had a really robust network here in the DC area, and so after after that, I spent nine years in clinical research. Even after having gotten my MPH, I was really interested in kind of closing the, I guess, the gap between like epidemiology, clinical medicine, and public health. And so it led me to a DOD contractor. So, I spent nine years in the military world, and after that, I just really wanted to, not to be so investigative and be in a space of more direct applied public health work. And I kind of liken it to becoming, you know, a doctor of the, of the city, so to speak, because at one point I was pre-med. But that journey, you know, went several different ways after taking the MCAT a few times. So yeah, so I ended up at DC Health in 2017. And really have just been here for the last five years, always in immunization, starting out as the Vaccines for Children program manager, so really looking at our pediatric providers in the city. And then once COVID hit, I joke that that kind of uniquely prepared me for all of the things related to vaccine distribution for COVID because it was just really on a larger scale. We had already done provider enrollment, we were already doing vaccine distribution around the city. So we, our team really had those skills that were required to expand this program pretty quickly. And so I was voluntold to be the COVID vaccine team lead. And then, you know, through a series of leadership transitions and the experience that I gained along the way, here I am.

Brent Ewig 3:57
That’s terrific. So I want to ask you, what motivates you to do this work? But first, you mentioned you’re from Washington State. And that just reminded me of why you can’t compare Washington and Florida. Because it’d be like comparing apples and oranges.

Heather Burris 4:17
That is…that’s a good one.

Brent Ewig 4:23
But, but back to the issue at hand. So you kind of touched on this, but can you tell us a little bit more about what motivates you to do this work?

Heather Burris 4:31
Yeah. So I think after spending so long and clinical research, and like answering your research question, it was very theoretical and, like, trying to find a solution to a problem, but it took a really long time. One thing I really enjoyed and been able to see in our immediate results of our work, and so what’s really motivating to continue to do this work is the impact that we make. It doesn’t seem so theoretical. You can literally plan a program, putting into action, you know, and yes, government, sometimes funding does move slow, but you’re not writing, like, grants and you know, things that are taking, like, years to come to fruition or things that might not work, because it is an experiment. That is really what’s motivating. It’s like being able to design programs and see immediate impacts in our community, and also just the makeup of our community, you know, as people who look like me, and really being able to partner and understand their needs, and be able to meet their needs, and DC Health as an organization, you know, has a lens of equity. Our director has always pushed that as, as a, one of her mission and values. And so to be able to talk about that in our work has been really motivating and challenging and fulfilling at the same time.

Brent Ewig 5:59
Let’s talk about that a little bit more. You mentioned the community. So DC, unique situation, you’re you’re not just a city, you’re not a state, you’re a district. So you had some unique challenges and opportunities. Can you tell us a little bit about what that’s like, working in that that sort of environment?

Heather Burris 6:14
Oh, yeah, absolutely. So in a lot of ways, we represent all three aspects. We are a city, we are a state, and we are the Feds all in one. Sometimes we have that. Because we are in the District of Columbia, we have times when we have to respond to like, as a federal support an exterior kind of thing. So many things happen in the city. So maybe not immunizations, per se, but like DC health as a whole, you know, emergency response, oftentimes takes on the activities that happen because of the federal seat that lives in and works here. Even when we did get vaccines actually, we were asked initially to support our federal because we had a policy in place that we were vaccinating anyone who worked in DC. And so being the seat of Congress, and a lot of, you know, federal positions, we were asked, ‘Well, does that include federal workers?’ It…so we actually had to dial that back a little bit and like, no, there’s actually federal allocation for that workforce. But that that’s kind of sometimes…we have to respond federally. We’re often as as a district, you know, put in with other states, although sometimes we get the short end of the stick on that because our population oftentimes is bigger than, you know, many states in sometimes the way our, our density works, we have a lot more needs and impacts. And we don’t always receive the same type of state allocations that other places would. And then as a city, you know, we’re really accessible. So our touch points, our Congress, our leadership, are our other governmental agencies, like they’re all a handshake away, really. So in a lot of ways, you know, we have very close proximity to our leadership, and sometimes that’s, you know, challenging, and sometimes it really works in our favor. So yeah, we do have unique opportunities. And then just the makeup of the city as well. You know, I’ve lived here, I’m having gone to Howard University, I’ve lived here for over 20 years, I’ve been here longer than I’ve actually was, you know, born and raised in Seattle, and just watching the city change and meeting the different demographics and different age populations of our city is really fascinating as well. I’m a district resident, my husband and I we live in Ward Seven, which is east of the river. There’s a lot of needs in our community. Our children are being raised in, you know, our, our public school system here. And so we are, we’re very much ingrained, and it’s, it’s been interesting, and I’ve enjoyed actually living working. And you know, raising a family here in the district with all of these different opportunities and challenges.

Brent Ewig 9:13
I lived in DC myself for about ten years in my younger days. And that reminds me of a story. That’s when I, when I started dating, and it wasn’t going very well for me in DC but then my mother, she was very encouraging. She told me don’t worry, there’s plenty of fish in DC.

That’s a groaner. Thanks for the struggle to read more about your program. How big is your team?

Heather Burris 9:44
Yeah, so it’s fluctuating. So yeah, and probably because I’ve worn several different hats. So you know a couple years ago, pre-COVID, I only oversaw about four staff. At the height of the pandemic, and shortly thereafter with contractors and different assignees to our team, I was overseeing, in an interim role, close to 40 people. So we are currently kind of restructuring our organization right now, adding in some additional layers of supervision so that that does not happen, because that was…that was quite challenging times. So now, I oversee just about ten staff, couple of managers, and we have some vacancies that will take us up to about 15 for my direct team, but our division will still be around about 40 or so people.

Brent Ewig 10:39
And what are some of the biggest challenges you’re facing? And what’s, kind of, the funding outlook of city support in addition to your federal grants?

Heather Burris 10:47
Yeah, so some of our challenges are really around that proximity that I was mentioning about, you know, being very close to our leadership in city jurisdictions. We have, you know, our mayor’s office, our state superintendent, our city council, all of these people are like, at our fingertips. And that work’s, you know, like I said, challenging and, but also creates opportunity at the same time, because there’s room for like, scope creep, and, you know, making sure that our missions are clear and divided so that we’re not on top of one another. But at the same time, I think, getting our needs met locally. So I think that right now, we do have some federal funding that as most agencies and administrations across DC Health have received, by way of COVID in the pandemic, to support some infrastructure. And there’s additional opportunities coming federally. I think locally, though, because our city is pro-vaccine in many ways. Our city council has passed the COVID vaccine mandate, they’re supportive of minor consent for vaccination, you know, these are there. For no shots, no school, which is an immunization attendance policy we have for our student population, I think that, you know, if there was a budget need that we cannot support, infrastructure wise, beyond our, you know, time-lapse of our government funding, I think that we would be able to, you know, go before our counselor or lobby for our directors and our leaderships to get the infrastructure support that we would need to be able to continue to accomplish the things that we’ve already accomplished along the way. I think federal funding, you know, there’s some time limits associated that we are concerned about that and the future of that funding. But I’m optimistic that, you know, we will still be in a position to support our infrastructure and our growing team, um, to accomplish the work that we need to get done.

Brent Ewig 12:55
Yeah, so let’s, let’s talk about those accomplishments. You’ve certainly had some real successes there. So how would you kind of frame that success? And do you have any secrets that you could share? What’s been the policy of the tools that you’ve utilized to get the achievements that you’ve had?

Heather Burris 13:11
Well, you know, I think we’ve had great leadership. First off, I would always be remiss if I didn’t acknowledge our director, Dr. LaQuandra Nesbitt, who is a great leader and role model to me and the work that I’ve done, and just how she’s led with excellence and just really sharp vision, I would say, and always with a lens on equity, and she has a clear sense of direction that she has passed down through several of my, my leadership team or those who I report to. And so I think being able to connect with her, and you know, the deputies, former and current that are between us, it’s always been very clear, like what our intent should be. And being able to carry that out. I think another one of our secrets is we have very dedicated staff and team members. We have a few people who have been around for over a decade, maybe longer, who have a lot of institutional knowledge. So there’s always some experience in the room, people who have been there before, some people who were here during H1N1. So they had some, some history about how this happened, how this could be successful in DC. And then we have a lot of new staff, too, that bring a lot of innovation and fresh ideas. But I think one thing that has been really key, that I’ve experienced, and I’ve been able to grow with and watch others along the way is really relationship building, always presenting DC Health as a partner, taking initiative to keep people informed, being transparent, lots of meetings and touchpoints, and then just you know, showing kindness along the way and so, you know, being able to reach across the aisle. I think whether it’s a private organization, you know, a university, a hospital system, one of our associations in the community, that has gone a long way. For me, I feel like I have relationships across the city, and it’s been really critical and beneficial to be able to achieving our goals and our missions at DC Health.

Brent Ewig 15:19
That’s really great. And I was gonna ask you about some of those partnerships and what what the keys are. And I think you really touched on that, that the deep relationships of trust and relationships, the respect and kindness of cover that really well, thank you. Let’s turn to COVID a little bit and talk about some of those unique challenges. And you’ve had the notable success there, particularly around achieving equity in the vaccine distribution. Can you tell us how you approach that and how that was accomplished?

Heather Burris 15:48
Sure. So from the jump, one of our, my deputy director and director, together, had the foresight, I would say, to develop a scientific advisory committee that really had a mission to implement a safe and effective equitable vaccination distribution program. And so I was, you know, supportive in that along the way, we assembled a team of clinicians, community members, researchers, stakeholders, you know, from all across DC, really leaders in their own outright and gathered them initially, it was about every three weeks or so in that fall of 2020, just to kind of help us shape and make sure that we didn’t leave anything off the table. I remember at one point that we were in a, having a challenge with our distribution, in terms of being more the equity that we wanted to see, I’ll say it that way, in terms of our registration system. And, you know, we brought that before that group, just to Dr. Nesbitt did, brought that before the group and just kind of laid out, you know, here’s what we’ve tried, here are the challenges that we see and here’s where I can use your input. And people just really shared their their thoughts, their feedback, and their experiences. And I always thought, you know, it was a very open forum for those types of conversations that that helped to guide us and, and kind of get a feel the vibe of the city, I would say. And so that was one thing I thought that we did really well, that I was happy to be part of. We met early and immediately like I said. It helped guide our equity strategy for phase one, helped us to do early population surveys, focus groups on target communities. And then we utilized our special initiatives, and we did a lot of public and private partnerships that focus on equity and access. So we were really thinking, our deputy director at the time, I think, we thought about the vaccines and which spaces they could live well in if that makes sense. So Pfizer was a good product at the time because of its storage conditions for hospitals. And then Moderna was easier to move, maneuver in the community. So we built, I would say, partnerships around those organizations and how they were carrying out and holding that vaccine. So we did one with Sibley Hospital – Sibley Memorial Hospital – who was under the umbrella of Johns Hopkins Medicine, Johns Hopkins in Baltimore, had a team, a COVID response team, that was all volunteer, that was going around and doing different vaccination events. And so there were a series of meetings; we were able to engage them to use Sibley’s vaccine, travel down from Baltimore for about a good month to two months to vaccinate residents of our housing authority communities, our district housing authorities, and those were seniors who were, you know, in a priority eligibility group because they were more vulnerable to disease. And so when we thought about that strategy that way, kind of delineating, like, morbidity and mortality versus essential workers. We built partnerships around those two arms for distribution and then allocated our vaccine types according to the organizations that those bodies met if that makes sense. And so it became pretty like routine to establish those partnerships. We knew how much Pfizer we were gonna get, we knew what type of partnership we would want it, and which hospital had it. And so we just kind of went through there and put them with an organization or a group in the community that had a need, and then we could make that, you know, that connection to carry it out. We did that similarly with Moderna. With our faith and vaccine initiative, we had our churches, our faith coming in, getting in churches who are emailing the director and contacting us, like, how can we help? How can we help? But they…churches…were not necessarily good places for vaccination outright on their own because they don’t have places to store vaccine appropriately. So we thought, you know, how can we partner with an organization who’s already receiving vaccines and still work with them to get it in the communities that they want to serve, you know, which is basically their congregants and, and their reach in this faith community, which for us is primarily, you know, black and brown residents, and target communities and wards of our city. And so we were able to work through an FQHC, who we allocated Moderna vaccine to, and we were able to do partnerships with that faith group, which was a couple of groups – Leadership Council for Healthy Communities, Black Coalition Against COVID-19 – and then our subcontractors, Five Medicine, to really target these different faith communities with pop-up clinics all across the city, early in the phase, and they were responsible for vaccinating a significant amount of our black and brown senior populations who are not, I would say otherwise living in congregate settings. So just thinking of innovative approaches, and utilizing all of our partnerships and extensions in the community, to the best of our ability, based on the resources that we were given, I think is one way that we were able to achieve some success.

Brent Ewig 21:34
That’s really terrific. And you mentioned a number of really important partnerships, and taking that as a whole, any tips that you’d share on how to kind of maintain and how to how to form those, those great partnerships that you referenced?

Heather Burris 21:46
Yeah, I think, um, you know, realizing, who you already do business with, and who made, they may know, was one thing, like I said, being in DC and being kind of close proximity, I always feel like there’s two degrees of separation, like, between me and somebody who I need to get to. So just kind of thinking through, like, you know, who do I know, or who might have a connection to someone that’s working in this space, or working in this community, or an organization or at an agency or stakeholder level, who could probably get us what we need or make the connection? To do that, our previous deputy director, he was not shy about introductions. And I think there was a high amount of willingness to be helpful early in the pandemic, and people were just like, ‘hey, yeah, I’m stepping up, how can I help?’ And so a lot of those conversations happened early that I was a part of and, you know, was able to continue successfully because of that relationship building that was established in a good light early on.

Brent Ewig 22:55
And you referenced this earlier about all the the national resources because they’ve been in the federal seat of government. How do you leverage that? And you’d mentioned, you know, too, that can cut both ways. Can you…can you tell me a little bit more about how you kind of work in that environment where you have so many resources and people wanting to be helpful? So close, how do you leverage that?

Heather Burris 23:16
Well, you know, we just, we think about maybe how we can, like I said, best utilize people to achieve what we need. A lot of people come through DC, I will say, and you know, have heard of the things that we do, or they want us to be represented. And…and in a good show and in a good light. And so just keeping that in mind, I would say and taking advantage of the opportunities, and always, you know, asking, asking around, is usually how we find the right partners, and make sure that we’re leading Yeah, and bringing others along. That makes sense, or, or whatever we’re tackling.

Brent Ewig 24:01
Really great. So there’s three questions we asked for in every episode to kind of wrap things up. Are you ready If I just kind of shoot these at you rapid fire?

Heather Burris 24:11
Sure.

Brent Ewig 24:12
First of all, what’s one thing you wish you could tell your younger professional self?

Heather Burris 24:17
I would say every job is preparation. I have a some siblings who have children, and they’re quite older than me, so I have older nieces and nephews. And I’ve told them, and I would look back and reflect and tell myself that, you know, what I was doing 10 or 15 years ago might seem mundane, or it might have been overwhelming at the time, but it was a bread crumb. You know that when I reflect back, that I now see as part of the steps along the journey. And so to always take advantage of the space that you’re in, and the opportunity that you’re given because you don’t know where it’s going to take you or how it’s gonna prepare you for the next thing. And so, so much of my, my younger years were focused on the destination. You know, once I get there, once I get there, that you forget that the journey is important and that those pieces that you’re experiencing along the journey are really preparing you for that next stop. And so that’s one thing I think I would tell my younger, professional self: don’t take anything for granted and take advantage of, of all of the opportunities that are coming my way.

Brent Ewig 25:29
Really well said. And you mentioned the journey, so where, what are you looking forward to professionally in the coming year?

Heather Burris 25:36
I’m looking forward to having a full complement of staff. I think I, I came and changed positions, you know, some a little bit out of need and a little bit out of, you know, promotion, and doing good work. But you know, I wasn’t always able to backfill along the way, and so we do have some some gaps that were with this entire infrastructure change that we’re excited about filling. So I’m looking to just, you know, fully grow our team, professionally as well. I’m also really looking forward to reconnecting with colleagues and traveling for work again. So I’m super excited about the opportunity to attend AIM as a member for the immunization program here, and to connect with colleagues and meet new ones, and really benefit from the AIM advocacy and support groups. And then even future conferences for immunization. I think we have done some good stuff in DC and I’m excited to share that as best practices and success stories and then learn from other jurisdictions. And then really just like enjoy the fruits of our labor we’re getting, we have some new data systems coming down the road, we’re putting a lot of funding and support into our infrastructure and technology. And so what we’ve been able to build for COVID, I’m excited and look forward to replicating for all of our vaccines, especially our routine pediatric vaccines, and being able to have data at our fingertips like we have been for the last year and a half.

Brent Ewig 27:08
Super. And you alluded to this, but if you could just speak a little more, the last question is, what is the greatest value you get from the AIM community?

Heather Burris 27:17
I would say the wealth of experience of colleagues and the support when I first started here. Me and my previous program manager were hired on the same day, and I felt like, with her being the member for for DC, she received so much support, and I was a little bit jealous because there was conferences and there was meetings of it. So you know, it just seemed like an open-arms community for her. So I’m excited to be in this seat and to receive that support as well. AIM seems to be have the answer to everything, or if they don’t, I would say that their advocacy will get the answer that they need for us. It’s a great resource set program managers. And you know, I’m just happy to be benefiting from it as a new kid on the block.

Brent Ewig 28:07
That’s terrific. Well, Heather Burris, you really, you shared a lot of wisdom with us in just a few minutes. There’s some really exciting stuff that’s happening in the district. And I loved how you talked about the importance of living in the community that you’re serving and having leadership that looks like the people you’re serving. So I want to just thank you for that. I want to congratulate you on your success and your recent promotion. And really, thank you for joining us on the AIM podcast today. Thanks so much. It was great talking with you.

Heather Burris 28:35
Thank you, likewise.

Brent Ewig 28:39
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.