H1N1 MASS VACCINATION CLINIC OVERVIEW

The goal of the Larimer County H1N1 Mass Vaccination Clinics is to quickly immunize large numbers of Larimer County residents so that we can slow the spread and reduce the impact of the current influenza epidemic. There will generally be two influenza vaccines dispensed at each clinic—the “shot” [H1N1 Inactivated VIS] and the nasal spray vaccine [H1N1 LAIV VIS]. Depending on the site and the availability of vaccine, we expect to serve from 2,000 to 4,000 people per clinic shift.

A large number of trained staff and volunteers and an effective command and management system are needed to meet this demand. An organizational structure known as Incident Command System or “ICS” (FEMA ICS 110.a) will be followed. The ICS system utilizes an orderly chain of command. Each worker reports to just one supervisor and has specific roles and responsibilities that are documented on their Job Action Sheet.   

The Public will be required to preregister for a specific clinic and time for the initial clinics. This is to minimize waiting lines and avoid having to turn people away since amounts of vaccine will be limited. Walk-ins may be allowed in later clinics as vaccine supplies begin to meet demand. Persons may pre-register on-line or by phone (http://larimerflu.org/clinics.htm). If done on-line they will be instructed to print out their completed registration forms and bring them with appropriate picture IDs to the clinic. If they register by phone they will be given a registration number to write down and bring with them.

Public health authorities have identified priority groups for H1N1 vaccination (http://larimerflu.org/shots.htm). Only persons in priority groups who reside or attend school in Larimer County, or who work as caretakers of infants or health care workers in Larimer County will be eligible for vaccine. Eligible groups will be expanded as higher priority groups have been vaccinated.

FACILITY LAYOUT AND CLINIC FLOW

It is important to know the layout of the facility where you are working.  Refer to the map (The Ranch, Lincoln Middle School, Thompson Valley HS) that identifies building entrances, rooms and exits.  Note the pathway that people are directed to follow, also known as the “clinic flow”, plus the location of the stations. The names of the stations in mass vaccination clinics are Greeting and Late Registration, Screening, Vaccination and Observation. Each station will have at least one leader/supervisor. The functions of the stations are detailed below.

Greeters will be stationed at the Entrance to the clinic. This is where the all potential vaccine recipients check-in. Greeters will ask to see registration forms or registration numbers and check appointment times. For those with valid appointment slots and forms, greeters will note which type of vaccine the person selected, handout the corresponding Vaccine Information Statement and direct them to the Screening Station. If people don’t have forms they will be directed to Late Registration.

Registration clerks will be stationed in a side room if available. They will give people clipboards with blank registration forms and ask them to fill them out. Clerks will assist those who need help and secure translators for Spanish speaking clients. Once registration forms are completed clerks will go over the form to identify those whose answers indicate they should not be vaccinated, or are not in the H1N1 vaccine priority groups targeted for that clinic. If clients indicate they are ill, the clerks will send them directly to the Consult Area where they will be interviewed by Medical Screeners. For others, clerks will note which type of vaccine the person selected, handout the corresponding Vaccine Information Statement and direct them to the Screening Station.

At the Screening Station, Screeners will check identification, make sure each person’s registration form is complete, that they haven’t marked any answers that would indicate that they should not be vaccinated, refer persons who indicate they are ill to the Medical Screener and screen those selecting the nasal vaccine to determine if they can receive it. If the person has technical questions after reading the VIS, or if suitability for receiving the nasal spray is unclear, they will be referred to the Medical Screener. Screeners will assure that the person has read and signed the consent, or if a minor is to be vaccinated, that their parent or guardian has signed the consent. They will then direct the person to the appropriate vaccine station line: Families with young children (less than 10 years old) will go to the Family Vaccination Line and adults or families with no younger children will go to the Individual Vaccination Line.

At the Vaccination Station, 2-person teams of vaccinators will be stationed at each end of long tables where there will be chairs for patients to sit in as they are being vaccinated. Tables will be arranged in pods, with two parallel tables separated by a supply cart.  A Vaccination Team Leader will be assigned to every two adjoining pods.

Patient movement staff will be asking people in line to pull up their sleeves. While one vaccinator is preparing vaccine for administration, the other will be interacting with the patient, reviewing their form, asking about allergies and selecting the appropriate vaccine type. Both vaccinators will verify the product being given; while the vaccinator administers it and places a band aid, the other is affixing the Brand and Lot number sticker to a CDC Immunization Card and noting if a second dose is needed. The vaccinator then places a lot number sticker on the registration form, enters the site, dose and date, signs the form, reminds the person to wait for 15 minutes before leaving and if indicated, to remember to get a second dose in a month.  Families or individuals will then be directed to the Observation Area.

General Observers and Medical Observers will be stationed in the Observation Area to answer questions and assist those who are experiencing symptoms that may be adverse reactions to vaccination. There will be a separate room or screened off area with cots or Gurneys for those who are feeling weak, light-headed, have fainted or require medical evaluation or treatment. Emergency Medical System staff (ambulance and EMT-Ps) will be posted just outside the facility near the Observation Area and can respond immediately.

SPECIAL SERVICES AND EMERGENCY PERSONNEL

In addition to the workers and leaders directly involved in the clinic flow, there are the following special services or functions:  Translators (English-Spanish), staff to assist with mobility issues, staff to guide patient movement and runners of supply/equipment. There will be emergency responders at all clinics including a safety officer, Emergency Medical System (ambulance) staff and security officers.