KEYWORD1:
Bioterrorism preparedness, mass vaccinations, smallpox



BACKGROUND:
On November 21, 2002, Baxter County, Arkansas, population 38,000, exercised their post-event mass smallpox vaccination plan. Because this was an exercise, participants were given influenza vaccine instead of smallpox vaccine.

OBJECTIVE:
1) Exercise, evaluate, and improve upon Baxter County’s mass smallpox vaccination plan.
2) Convey the experience and its successes and shortcomings in a public forum to help other communities improve their levels of preparedness.

METHOD:
The Baxter County Health Unit of the Arkansas Department of Health (ADH) coordinated local community stakeholders in a test of their mass smallpox vaccination plan. During the all-day exercise, to achieve maximum participation, the ADH provided influenza vaccine to all participants free of charge.

RESULT:
Nearly 200 staff, mostly volunteers, made the exercise possible. Staff included: ADH nurses and non-ADH nurse volunteers, police, emergency medical services personnel, communication specialists, local political leaders, the Red Cross, volunteer nursing students, and numerous community volunteers.
Even though this was a simulated emergency, and there is no way to accurately approximate the chaos that would ensue during a real event, security staff successfully maintained order throughout the day.
Minor problems were identified regarding on-site supervision/coordination of volunteers during the exercise. The solution likely necessitates dedicating at least one staff each shift to supervise each volunteer role.
Rapid entry of participant data was not accomplished. Red Cross volunteer assistance with real-time on-site data entry will be incorporated in future plans to eliminate this deficiency.
Roughly 5,000 county residents received flu shots at the event.

CONCLUSION:
Exercising a realistic emergency response plan and simulating all necessary components is an invaluable way to identify strengths, weaknesses, and ways to improve. Through this experience, we cannot stress enough the need for direct volunteer involvement and thoughtful coordination of stakeholders in bioterrorism preparedness efforts.
LEARNINGOBJECTIVES:
1) Emergency response planners need to involve stakeholders in early phases of event planning.
2) Practicing the plan is invaluable.