KEYWORDS:
Immunization Registry, Disaster-Recovery, World Trade Center

BACKGROUND:
Following the aftermath of the World Trade Center tragedy, the Citywide Immunization Registry (CIR), due to its proximity to the WTC, had to implement many emergency solutions to continue functioning.

OBJECTIVE(S):
To describe problems that impacted the CIR and solutions implemented to maintain functioning.

METHOD(S):
On 9/11, the CIR lost all of its phone lines and T1 connection to the database. The most pressing need was to re-establish connection to the database. Lack of database and telephone access disabled the dissemination of immunization information to providers and parents. An additional challenge was the need to retain sufficient staff for CIR core activities as many staff were called to DOH recovery work at Ground Zero, injury surveillance, and bioterrorism surveillance. The situation was a test of CIR disaster preparedness protocols.

RESULT(S):
To re-establish connection with the database, the server was brought in-house and the network reconfigured to maintain stable and secure connections. A broadcast fax was sent to all providers from a different location to inform them of how to access the database. Analysis was done on phone logs to determine the most frequent users of the CIR and those providers were individually contacted about changes in protocol. Alerts were placed on the CIR webpage to reach the public. As a final step, emergency protocols and contacts were updated to better respond to future disasters.

CONCLUSIONS(S):
Evaluation of the new protocols indicates that some changes should be permanently adopted to better suit the CIR's needs. One of the main changes was the decision to permanently store the CIR database server in-house rather than using a remote location and vendor. Two months after the tragedy, overall functioning of the CIR has nearly returned to normal.

LEARNING OBJECTIVES:
Describe lessons learned during emergency situations that can be applied to overall disaster-recovery.