KEYWORDS:
Immunization blitz, disadvantaged, substance abuse

BACKGROUND:
The Downtown Eastside of Vancouver is a deprived inner city area where as a consequence of poor health status, crowded housing, poor nutrition and hygiene, homelessness and a high rate of substance abuse, many residents are at high risk for communicable disease.

OBJECTIVE(S):
To reduce the high rates of communicable diseases by offering immunizations for hepatitis A and B, pneumococcal and influenza immunizations in a blitz format.

METHOD(S):
Influenza and pneumococcal immunizations were offered to all participants during the month of November 1999 by teams of public health nurses and volunteers in a variety of settings in the community, including single room occupancy hotels, soup kitchens, food banks, a fixed needle exchange site, drop in centers, shelters, pubs, the city jail, parks, street corners and medical clinics. Hepatitis A and B immunizations were offered in January/February 2000 in a similar manner to those who had not been previously immunized. Similar immunization blitzes have subsequently been offered during the fall of 2000 and 2001.

RESULT(S):
During the month of November of 1999 influenza and pneumococcal immunization blitz, 8723 persons were immunized with 79% receiving both vaccines. During the 5-week hepatitis A and B immunization blitz 3542 persons were immunized with 58% receiving both vaccines. Evaluation indicates a marked reduction in reported cases of hepatitis A in Vancouver and a reduction in visits for pneumonia to the local hospital Emergency Department in the 3 months following the influenza/pneumococcal blitz. In addition the low numbers of individuals reporting a usual clinic/physician supports the hypothesis that people might not have been immunized through a traditional primary caregiver.

CONCLUSIONS(S):
Immunizations can be successfully delivered to high-risk inner city populations using public health nursing outreach, in a blitz format.

LEARNING OBJECTIVES:
Describe the process and benefits of blitz immunizations in non-traditional settings.