Episode 5: AIMing to Inform Guest Stephanie Schauer

Brent Ewig 0:03

Welcome back to AIMing To Inform. I’m your host Brent Ewig and today, I’m really excited to be joined by Stephanie Schauer, the Wisconsin Immunization Program Director.

Stephanie already knows we share some common roots. Grew up in Wisconsin. She’s been a Program Director there now for some time. She also knows my affinity for dad jokes. She knows that dad jokes in Wisconsin aren’t just groaners, but they’re actually quite cheesy.

Stephanie Schauer 1:40

Awwww

Brent Ewig 1:40

And there we go with the first one of the episode. I know you thought it would be too gouda to be true to escape the dad jokes, but if you’re ready, let’s get mooooving. First if you could just kind of briefly describe your career and what brought you to your current position.

Stephanie Schauer1:55

Yeah, so I actually got into public health a little bit through a, an unusual back door in that I started my career as a research scientist and received a Ph.D. first in microbiology and immunology, and after doing that for a couple of years, realized that I really wanted something that had a more interactive, more direct effect on people and made a switch over into public health and working at the Massachusetts Department of Health in their immunization program, and worked there for about eight years.

And after that transitioned over to the Wisconsin program and, and now I find myself here as the program manager.

Brent Ewig 2:33

Wow, I didn’t know about the Ph.D. Did you do that out east or where’d you…

Stephanie Schauer 2:36

Yep. At Boston University and then a, a postdoctoral fellowship out there for a couple years, and then realized public health was my calling.

Brent Ewig 2:45

So that’s perfect. Can you tell us a little bit about what motivates you to do this kind of work?

Stephanie Schauer 2:49

Yeah. You know, I think healthcare is a basic human right and vaccines are part of that. And I, think what motivates many of us is that it’s important that everyone has access to these lifesaving things and that we can really help communities be healthier and avoid people suffering and dying. And it’s really a, a calling to go ahead and a privilege to be able to work at a state level to, to really promote immunizations.

Brent Ewig 3:18

I love that. I love that. Can you tell us a little bit about your program in Wisconsin? Tell us about your team, how many staff you have.

Stephanie Schauer 3:24

Yeah, so we’re a smallish program of about 30 people. We’ve got some folks who have been there for quite a while and we’re talking 40-plus years. And then we’ve got a blending of new folks that are coming in. And so it’s a great melding of new ideas and having that historical knowledge of, of what happened.

The one thing I can think is that as the polio situation has sort of emerged and looking at, well, when were our last polio cases, and I have a staff member who got the paper file and put it on my desk. She knew exactly where it was and there I could see where the last polio cases that occurred in Wisconsin in 1979 and all the information about it.

And then I have data analytics folks who are pulling data from the Wisconsin Immunization Registry and mapping it out by zip code. And so it’s just this really great blend of sort of the past, the present, and the future. You know, coming together into 30 some odd folks.

Brent Ewig 4:21

Yeah. Wow. Fascinating. So talk a little bit about some of the biggest challenges and opportunities you have there in Wisconsin.

Stephanie Schauer 4:27

I think one of the opportunities that we have that came out of Covid is that there’s been so much more interest in immunizations and in using data and furthering the work. And I think it’s building off of relationships like with community-based organizations that were forged and strengthened and made a new in Covid, and pulling those forward and expanding to really use those and leverage those for routine immunizations as we move into the next year and continue to try and refocus back to the routine and talk about flu, that it’s good to bring those partners along. And that’s what I’m really excited about is leveraging all of those relationships and thinking about how we worked with them and how we can work with them going forward. So I think, I think that’s one of the, the things that I’m most excited about with Covid.

I think some of the challenges are sort of the infrastructure that we have and thinking about what infrastructure we need and how that moves forward. Particularly with things like our, you know, immunization information systems is how we make sure that those systems continue to be robust and can help deliver on what is needed to really shape, you know, immunizations going forward.

Brent Ewig 5:47

So I wanna ask a little bit more about Covid but have another question first, just about the landscape in policy funding in, in Wisconsin. But speaking of landscapes in Wisconsin, obviously a lot of farmland there. True story – grandparents were immigrants from Germany in 1840s. Settled on a farm.

There was great story about him standing out in, in the farm field one day and my, my grandmother looked out the window and noticed him standing. And couple hours later she looked and he was still standing in the same place and she thought that was a little odd, and she kept doing her work.

And then at dusk, she saw he was still standing out in the same place. Finally, she went out there – ‘Harvey, what are you doing here?’ He said ‘I’m trying to win one of those Nobel Prizes in farming.’ She says, ‘What are you talking about?’ He said, ‘Well, I heard they give it to somebody outstanding in their field.’

Stephanie Schauer 6:35

Oh.

Brent Ewig 6:36

Yeah.

Stephanie Schauer 6:37

I should have known. I bet you keep those in a database. Dada-base.

Brent Ewig 6:42

Indeed that’s where the dad jokes are stored. But a serious question on the landscape. What, what is the landscape in Wisconsin when it comes to supporting immunizations on the policy and legislative front?

Stephanie Schauer 6:52

I mean, I think, in general, people are supportive of vaccination and continue to get their children vaccinated. I will say, you know, in Wisconsin, we have seen a bit more hesitancy and parents questioning vaccines that, and for, for those routine vaccines. And so we did lose some ground with routine vaccinations in the last couple of years because of the pandemic.

And I think some of it is due to access, but I think it’s also parents are starting to think about and and have questions. And so that’s really the challenge that we have before us as well, is to make sure that parents are getting questions answered and that we’re really addressing what their concerns are as we can’t take it for granted that every child will show up and be vaccinated and, and really making sure that providers have the information about what is being said, what are those concerns coming out of Covid so that they can help parents, you know, understand or get their questions answered. And so I think there’s work to do and yeah, I think hesitancy is, is continuing there, but I don’t think that that’s unfortunately unique to us.

Brent Ewig 8:00

No, no. A nationwide challenge. So let’s, let’s go back to Covid a little bit and I know that you very much focused on letting the data drive your rollout and how important that was. Can you just think back and tell us a little bit about the process? What were some of your successes? What rates did you achieve? Where, where did you run into some bumps?

Stephanie Schauer 8:20

So right now we’re at about 65% of Wisconsinites have received at least one dose of COVID-19 vaccine. It’s higher than it is for influenza, but clearly there’s, there’s more, more ground to be gained. I think the, some of the challenges with the, the rollout were that piece about infrastructure and really getting things like provider registration up and going.

So that we had a really robust network. The, the decision from Wisconsin was that we, we. We called it the peanut butter spread, is really making sure that we had a really strong network of vaccinators throughout the state. And so trying to get as many locations as in many different areas with vaccinators.

So that was, I think, a strength in the end, but it was a challenge to sort of enroll as many providers as we could in, in a quick timeframe. And so we had over 2,500 providers, you know, sort of at the height of vaccination. But that was a, a bit of a challenge to build the infrastructure and get all those providers through so that we knew that they knew what they were doing, knew how to handle the Covid vaccine, and were administering it in accordance with the, the recommendations.

Brent Ewig 9:35

That’s a great, great overview and then when you, when we think…the youngest populations, are there any particular learnings that you have to share on what are the challenges in reaching the youngest populations and, and what are you trying in Wisconsin?

Stephanie Schauer 9:47

Yeah, so I, I think what we’re learning with Covid and vaccinating the youngest is that it’s not just enough to say vaccine is available. That parents of young children have different questions than some of the older, or for other different age groups or maybe for themselves. And so I think it’s really important that we’re tailoring message to address those specific concerns. Because if we’re using the talking points that we used from even six months ago or earlier on, or that we used for you know individuals who are 65 and older, it’s not going to resonate. And we really need to talk to parents and, and understand what their concerns are with vaccinating children or understanding what motivates them.

So I think it’s a different set. The other thing is also that you know, sometimes the, the big settings are not always the most conducive for children to be vaccinated at. And thinking about making sure that our vaccination locations are in places where families feel comfortable. One of the things that we’ve been doing and have continued to support our mobile vaccination clinics, so local health departments or businesses or schools can request from the state a, a vaccination, almost a popup clinic to come to them.

And so you don’t have them being vaccinated in a, an unfamiliar place, but it ends up being a school or the YMCA – places where they normally and feel more comfortable. And so I, I think thinking about not only the delivery of the vaccine from that perspective, but then as I said also the, the communication.

So I think being more mindful of they’re not just little people, but they, they come with their own sets of challenges and things that we need to make sure that they’re, they’re feeling comfortable. Yeah.

Brent Ewig 11:39

So two-part question here. Anything you’d do differently in Covid vaccine rollout and then, on the flip-side, looking forward, what are some of key lessons we can apply when it comes to catch up for kids, influenza, that infrastructure that to needs to be there for everything? What are your thoughts?

Stephanie Schauer 11:57

Let’s see, what will we do differently? I definitely think there were some lessons learned in that whole provider registration piece of it. And I think making sure we had a, a good robust solution. That one that was a little bit bumpy. I think one of the things that we were fortunate was that we did use the Wisconsin Immunization Registry, and we had worked with providers previously about making sure we had good race and ethnicity data and that we continued that with Covid and so that we had as the Covid expanse rolled out, that we were able to actually have race and ethnicity data that could help drive our vaccination efforts.

And so I think that that was an important piece was continuing to highlight and impress upon providers that they needed to collect and send that information because it really was driving vaccination decisions, whether it was where to send a mobile popup clinic or where we needed to think about focusing efforts because there certainly were and are disparities in vaccination, both Covid and in routine vaccinations. Clearly there’s more work to be done and, and having that data really helps, you know, move us forward.

Brent Ewig 13:12

Yeah. Good. So switching gears a little bit. This is kinda delicate subject, but all, all of the stress that people have dealt with and certainly we’ve seen, you know, the burnout and turnover, but one thing we noticed about you is you, you have a calm demeanor and a focus, thoughtful presence. And so just wanted to ask how, how do you stay calm and focused in such a high-stress position?

Stephanie Schauer 13:34

Yeah, I think one of the important things is being able to disengage from the work at the end of the day. A while ago, my teenage daughter, who is into mountain biking, said, ‘You know, Mom, you should get involved. My team actually needs parent coaches.’ And when your teen asks you to do something, you don’t say no.

And so, I found myself with a mountain bike and going to practices, and I can tell you that when you are on the bike and trying to navigate rocks or get that corner done, you can’t think about anything else. And I think that really helped me and, and I think it’s important that people find a passion, find something that they really love, that they can engage in and forget about work and that allows you to then come back the next morning and to jump right back in it is, is you really, truly do need to disengage on a regular basis. That, I think, that was part of being able to do that is doing that on a regular basis.

So that’s, that’s one piece. And I think also just thinking about figuring out what you have at hand. You’re not gonna be able to change with how you got here, but you can change what you can, what you need to face, and what’s in front of you. And thinking about what step is going to be best now, but then will this step also serve us well in the future?

And really helping that future guide where you need to go. I think those are sort of two of the pieces, or that I…that came out of, out of the, the whole Covid for me.

Brent Ewig 15:02

No, that’s that’s really wonderful. That reminds me – we were just talking at an AIM staff meeting about saying priorities and the quote came up from Arthur Ashe to start where you are, use what you have, and do what you can. And that, that kinda sounds like the, the outlook you had there. What advice would you give to other program managers on staying focused on the job?

Stephanie Schauer 15:21

Yeah. Other advice, other than finding something might be mountain biking. It might not be. I think, you know, trusting staff. I think staff are your greatest asset and that it’s important that you have staff that feel that they can go ahead and give input. And sometimes if it’s showing a blind spot, that that’s important. That you’re really creating an atmosphere where you can get all of the feedback back about here’s how we need to move forward and, what are you guys thinking?

How do we need to do this? And I think really listening to staff as much as you can. Certainly there’s times where you have to do what, what sort of comes to you. But there’s also times for you to think about how to do that in a way and really using their, their subject matter expertise to help guide that.

Brent Ewig 16:09

Good. So we have three questions. We had every episode but before, let’s do, let’s little more uh, cheese jokes. The other day my wife asked ‘Where’s the cheese grater?’

The cheese and I said, you know, a lot of people say it’s in France, but I really think it’s Wisconsin. Frances. Speaking of French cheese, did you hear about the accident they had at the French cheese factory?

Stephanie Schauer 16:34

I, No, I didn’t.

Brent Ewig 16:37

Yeah, there was de-brie everywhere. As I said, we close the episode with three questions, are you ready?

Stephanie Schauer 16:47

Sure.

Brent Ewig 16:48

What is one thing you wish you could tell your younger professional self?

Stephanie Schauer 16:53

I think that, that this work is hard, and the wins don’t come quick. Is that, you know, we’re in this for the long gain. Vaccination rates typically don’t, you know, skyrocket up from one year to the next. And that it’s just important to sort of look over a spread of five or 10 years and, and you’ll see a trajectory.

But sometimes it’s, it’s, you know, parts of percentage points where you see change, but that still doesn’t mean that you’re not making progress because when you look over, you know, an entire state, that can mean thousands of children actually were vaccinated. And so I think it’s just keeping in mind that the numbers are one thing, but there’s also stories behind it.

And, and, and just keep, keep perspective.

Brent Ewig 17:36

Good. What are you looking forward to professionally in the coming year?

Stephanie Schauer 17:40

Yeah, I, I think it’s the engagement with our community-based organization partners. It’s really seeing what they can do in the community. That’s not an area that we had a lot of experience with prior to the pandemic and as part of the COVID supplemental funding, we’ve funded over a hundred community-based organizations to do work on an ongoing basis or, you know, in different spurts.

And so really looking to be able to continue that work with them and, and as I said, move into that routine immunization space. The other thing is we’ve got a a statewide coalition that has been stood up, and so really looking forward to that coalition, working with all of our local coalitions and healthcare partners and local public health and really having a much bigger presence that can stand with the program and help really move immunization issues forward. So that’s another area that I’m, I’m really excited is, I think, you know, we’re all in this together is, is sort of what it feels like as opposed to immunization program, trying to think about, ‘Oh, we’ve got so much to do and, and how do we do all of that?’

Brent Ewig 18:54

Yeah. And then the last is, what is the greatest value you get from the AIM community?

Stephanie Schauer 18:59

Oh, it’s having peers who know what you’re talking about and you don’t have to explain the acronyms, and they understand when a situation comes up, what that truly means in the immunization speak. And so I think it’s just being able to be amongst your people and I think learn from each other because they talk about what they’re doing in their programs and thinking about ‘actually, maybe we could try that.’ And I can’t tell you how many times I’ve come home from an AIM meeting, go back to my staff, and they’re like, ‘All right, so what are they doing in, you know, X state or X state? And how do they tackle that?’ And so I think it’s really valuable to, to see how others have implemented and, and see the possibilities that we have.

Brent Ewig 19:41

Well, wanna really thank you for sharing your wisdom and insight. I would be remiss…you mentioned your, your Ph.D. work at Boston University up top. I didn’t mention that we share in common the same undergraduate institution – Valparaiso University. So speaking of community, a shout out to our, our alma mater there.

And just really appreciate you being on AIMing to Inform thanks again for sharing your wisdom with us today.

Stephanie Schauer 20:04

Thank you so much.