BACKGROUND:
The Chester County Health Department's bioterrorism preparedness grant required us to plan and test a clinic that could provide immunizations or distribute medications to large numbers of patients. As the Department's influenza/pneumococcal immunization program is typically the largest clinic based event, it was determined this program would provide an opportunity to meet this requirement.

OBJECTIVE:
To immunize as large a number of patients as quickly and effectively as possible using the CDC's smallpox clinic plan as a model.

METHOD:
Planning group selected dates to run two 12-hour clinics. Post card announcements were sent to past patients. Nine patients were scheduled every 10 minutes. 35-40 staff was assigned to each of the three shifts. Staff and volunteers recruited from throughout the Department and assigned a variety of professional and administrative tasks. Staff from Emergency Services, Sheriff's, and Facilities Departments also involved to help with logistics, traffic/patient flow, and security. When the influenza vaccine shortage occurred, staff screened patients scheduled for the second clinic. 20% did not meet the eligibility requirements; their appointments were cancelled.

RESULT:
Over 1300 patients were seen during the 2-day period. Very positive feedback. No waiting lines; patients processed through the clinic in twenty minutes.

CONCLUSION:
CDC smallpox model, amended to allow for the collection of fees, worked effectively at the local level. Pre-planning prevented having to make major changes during the event. Attention given to patient flow and staffing levels was critical. Effort was very labor intensive, and provided an excellent opportunity for team building within the Department and the external Departments.

LEARNING OBJECTIVES:
1.How to test and adopt CDC's smallpox plan at the local level.
2.How to plan and execute a mass immunization program using multidisciplinary staff.
3.How to train and schedule staff for optimal efficiency and productivity.