Tuesday, March 18, 2008

Vaccine Handling by Providers During a Massive Power Outage

Julie A. Choudhuri, Lauren Greenfield, Darren Robertson, Jeffrey S. Duchin, and Betsy B. Hubbard. Communicable Disease, Epidemiology and Immunization Section, Public Health - Seattle & King County, 401 5th Ave, Suite 900, Seattle, WA, USA

Learning Objectives for this Presentation:
By the end of this presentation participants will be able to: Describe lessons learned about how clinics managed vaccine storage during extended power outage; and determine whether Geographic Information System (GIS) can identify practices at risk for vaccine loss.

A severe windstorm struck the Puget Sound region on 12/14/2006, causing widespread, extended power outages. Many King County providers tried to move vaccine to other storage during the outage; VFC vaccine losses totaled over $150,000.

Understand how clinics managed vaccine storage during power loss. Identify areas for improvement. Determine whether Geographic Information System (GIS) can identify practices at risk for vaccine loss.

Public Health faxed a survey to 318 VFC providers after the windstorm to triage storage incidents, assess storage practices and emergency preparedness needs; second survey mailed mid-February. Data collected from 12/2006 - 3/2007 were analyzed using SASŪ; Survey data plus rapid assessment data were merged with a geocoded file of the VFC sites, using GIS.

Of the 151 respondents (47% response rate), 58% lost power the day of the storm. Clinics lost power for an average 45 hours; most moved vaccine to another location. Providers frequently packed refrigerated vaccine on ice, and sometimes with dry ice. 29% reported moving refrigerated and frozen vaccine in the same cooler. Providers want written agreements with backup storage sites, clear instructions about packing and transport, and adequate packing supplies to prepare for future emergencies. The VFC site map identifies clinics close to others reporting power outage.

Many provider believe "colder is better" for transport and alternate storage of vaccines, resulting in vaccine loss. Persons who handle vaccine in emergencies must learn best handling practices and plan ahead for potential power losses. A GIS can identify clinics that may have lost power, assisting public health staff to determine if vaccine can be salvaged.