Learning Objectives for this Presentation:
By the end of this presentation participants will be able to:
1. Understand the potential role of an immunization network at a temporary vaccine clinic
2. Implement immunization protocol for groups with no experience in mass immunizations
3. Facilitate implementation of multi-vaccine mass immunizations



Background:
As per CDC “Interim Immunization Recommendations for Evacuees of Hurricane Katrina,” LSU Health Sciences Center with the La Office of Public Health (OPH), initiated a mass immunization effort in Baton Rouge shelters. Recommended vaccinations were: HAV, influenza, Td, MMR, and varicella.


Setting:
Red Cross shelters in Baton Rouge.


Population:
Shelter inhabitants and volunteers.


Project Description:
Computers, printers, IT personnel, vaccine and medical supplies were provided by OPH. United States Public Health Services (USPHS) physicians, nurses, and pharmacists were available for support. Volunteers helped patients complete a Vaccine Administration Record (VAR) page and a screener for contraindications. Immunization history and recommendations were printed from the state immunization network (LINKS). Physicians reviewed forms and assigned color-coded dots on specific areas of the patient's arms. Nurses vaccinated corresponding to the colored dots. LINKS was updated and patients received records. Personnel needs were determined for a vaccine station (VS) to immunize 60 patients/hour. Number of VS's reflected population size. For every 500 patients, 10 non-medical volunteers completed forms, 5 worked LINKS, 4 directed patient-flow, and 3 printed/distributed updated records. There were 2 physicians/500 patients and 3 nurses/VS.


Results/Lessons Learned:
This multi-vaccine effort optimally utilized nurses with no prior immunization experience, thus the rate-limiting step for patient flow was data entry. LINKS allowed for quick update and distribution of records. USPHS nurses did not use the color-coded dots system; community nurses did and felt it reduced orientation for new nurses. In the largest shelter, within eight hours, 378 patients received 922 vaccinations in one assembly area, and 788 patients received 1,982 in another.