BACKGROUND:
Inova HealthSource is a part of the Inova Health System, a large multi-hospital integrated health system in Northern Virginia. It's Fight the Flu program was anticipating administering 80,000 flu shots in 2004, with vaccine for 70,000 of those shots ordered from Chiron. At the time of notification that Chiron would be unable to deliver any vaccine, the program had 2,500 doses of vaccine in hand. The employee health office had another 4,000 doses of vaccine available, and a small amount of vaccine was available at various high-risk clinics throughout the system.

OBJECTIVE:
Given that there was not enough flu vaccine available to meet anticipated needs, what was the best way to allocate the remaining doses? How could the Inova Health System work as a combined entity during this period of shortage?

METHOD:
The shortage situation was taken before the system-wide disaster planning team. A Flu Shortage ad-hoc sub-committee was formed with representatives from across the system. The Flu Sub-Committee worked through a process of identifying priorities for the system and the community. Meeting on a weekly basis, it adjusted the plan as it was unfolded to meet the current situation.

RESULT:
The Flu Sub-Committee set up a tiered approach to vaccine distribution. Vaccine storage was centralized into one location, and Fight the Flu nurses were utilized to administer the vaccine according to the plan developed. It also implemented a comprehensive communication plan for the community as well as the Inova Health System employees.

CONCLUSION:
By working together, the system was able to meet the most urgent vaccination needs. We discovered potential weak areas in communications and “land mines” in implementing an unpopular rationing system. Knowledge from this exercise may be applied to future shortage scenarios.

LEARNING OBJECTIVES:
Describe the use of a system-wide disaster planning team to plan for vaccine shortages.