Vaccination Clinics and Public Incentives to Attend

John J. Burke Adjunct Professor / Fellow

Boston University School of MedicineConsortium for Excellence in Healthcare Emergency Management (CEHEM)

May 26, 2010

Fire Insp. John J. Burke• Employed by Sandwich Fire

Department for 16 years, Advanced EMT and Nationally Certified Safety Officer.

• Adjunct Professor and Fellow at Boston University School of Medicine, Consortium for Excellence in Healthcare Emergency Management

• Type III Operations Section Chief for Barnstable County Incident Management Team

• Consulted on ICS and Pandemic Operations for IHS, CDC, DOD and USCG

Background

• Flu and other Vaccines are distributed yearly per local health departments.

• Great opportunity to practice Public Health Emergency Response Plans.

• H1N1 brought to light extended wait times to receive vaccine.

Background

• Some clinics overwhelmed with panic and distress for H1N1 vaccine.

• Extended wait times became a public safety issue for some jurisdictions.

• Multi-agency contingency planning to alleviate wait time stress.

Background• Colville Indian Reservation is

1.4 million acres, located 100 miles West of Spokane, WA

• Tribal Nation known as the Confederated Tribes of Colville: Nespelem, WA is main town.

• Conducted Drive Thru Seasonal Flu Clinic in September 2010 using Sandwich, MA template

Operational Concerns

• All of the additional screenings put a stress on the operational plan.

• If people know they are getting their shot, more apt to have compliance in these areas.

• Involve those in public safety and military that have major incident planning experience.

Local Solutions

• Town of Sandwich (MA) added car seat checks for the pre and post shot areas.

• Colville Indian Reservation to potentially add a USPHS Veterinarian to the observation area as an incentive for 2010.

• Animal questions or concerns could be answered as part of observation area.

Local Health Partnerships

• Coordinate with local vision and hearing testing facilities to conduct vision and hearing screening.

• Coordinate with local “WIC” providers for information sharing. (Colville clinic had WIC on site)

• Coordinate with Social Family service organizations to provide information during the clinics.

Local Employer Agreements

• Reach out to Tribal Council and Chamber of Commerce to see if local employers to allow workers on duty to receive vaccine.

• Reduces potential lost work time and allows the system to be “stressed” which benefits clinic planners.

• Post shot area, workers can be questioned as to if they would have received shot if not working.

H1N1 Hygiene Brochures

• Pass out hand washing brochures, sanitizers while people are waiting.

• Information on social distancing, cough covering and recommended school absence policy.

Obesity Awareness

• Obesity awareness / screening can be done for either drive thru or walk in.

• Health Education Group can be formed under OPS with an Obesity Awareness Unit assigned.

• Unit can distribute educational material to those interested.

Diabetes Screening

• Diabetic screening station can be added after registration.

• Can be staffed by Fire-EMS personnel or RN students to gain experience in blood glucose screening.

• Those being screened can review paperwork on diabetes awareness

Blood Pressure Screening

• Can be added to pre and post vaccine stations.

• Use EMT / RN students with supervision from Public Health to practice BP skills.

• Dual benefit for trainers of health care workers to provide a real time environment to practice.

Car Seat Inspections

• Multi-Agency agreement with Public Safety car seat inspectors to hold installation and inspections stations as part of the clinic.

• Potential insurance benefit to have seat certified by technician.

• Can be done at the 15 minute post vaccine observation station, assigned to OPS as Pediatric Safety Inspection Unit.

Emergency Preparedness

• Partner with the American Red Cross on handing out Emergency Preparedness information.

• Partner with local law enforcement on “finger print” identification program in coordination with the Missing and Exploited children ID programs.

Animal Care

• Assign a local or USPHS Veterinarian to the clinic.

• DVM can answer animal impact questions regarding disease or general animal health issues.

• Can be stationed in the post vaccine observation area to ease the 15 minute holding time requirement

Multi-Agency Potential (Business)

• The local Chamber of Commerce along with the local business associations would have a seat at the table.

• Good cross over with the commerce departments providing for employee health and welfare.

Multi-Agency Potential (Local)

• The Public Safety and Public Works agencies would need to be involved.

• The local or county Public Health Department would be the Unified Incident Commander.

• The AHJ for the area would be in unified command or Finance Section

Multi-Agency (State)

• The State Police or Highway Patrol would need to be involved for traffic potential.

• The National Guard Units for the jurisdiction could play a role in support and vaccination functions.

• The State Department of Public Health would have someone as an Agency Representative on the ICS 203 form

Multi-Agency Potential (Federal)

• The United States Public Health Service could have a significant role depending on geography and need. (ie: DVM, MD’s, RN’s etc..)

• Centers for Disease control for documentation and support services.

• Homeland Security/FEMA for ICS paperwork and HSEEP compliance.

Operations

• Any incentive group can be assigned to operations and placed in the Public Health Branch.

• Each incentive can be assigned as a unit or group.

• Provides good ICS training/real time experience for the assigned unit leader.

Potential Organizational ChartIncident Commander

Operations SectionChief

Planning Section Chief

Public Safety Branch Law Enforcement Branch Public Health Branch

Vaccination Group

Registration Group

Observation Group

Health and Wellness Group

Obesity Awareness Unit

Pediatric Safety Unit

Diabetic Screening Unit

Animal Medicine Unit

Traffic Group

Security Group

Special Operations Group

Triage Group

Treatment Group

EMS Transport Group

Car Seat Tech Strike Team

Sandwich EDS

Colville EDS

Questions & Comments

John J. BurkeAdjunct Professor

Boston University School of MedicineConsortium for Excellence in Health Care Emergency Management

774-313-0178jjemt8@bu.edu