Infection Prevention in a Large Community-Wide Drive-Thru Point of Dispensing (POD) for H1N1 Pandemic Influenza Immunization

Background: Dispensing and administering H1N1 immunization to citizens has been a challenge.  Louisville, Kentucky elected to utilize a unique community-based immunization process consisting of walk-up and drive-thru options where healthcare personnel administered injectable and intranasal vaccine during the 2009 pandemic.  Ensuring infection prevention for vaccine recipients as well as healthcare personnel was a priority and posed unique challenges in the drive-thru.

Setting: On November 11-12, 2009 a community-wide H1N1 immunization point of dispensing (POD) was held at a large stadium parking lot. 

Population: This immunization program provided access for immunization to adults and children in a large metropolitan community of approximately 750,000.  High risk groups were targeted including children, pregnant women, caregivers of small children and healthcare personnel.

Project Description: During those two days, a total of 19,079 vaccines were administered with 12,613 (66.1%) being administered via a ten lane drive-thru.  Specific infection prevention issues were anticipated including 1) vaccine handling, 2) injection site skin disinfection, 3) hand hygiene, 4) environmental disinfection, 5) needle safety, and 6) occupational exposure management. 

Results/Lessons Learned: Providing immunization to adults and children while in their cars required that the healthcare professional administering the vaccine recognize the importance of infection prevention throughout the entire process.  Infection risks involved drawing of vaccine from multidose vials while in a tent with vehicular and worker traffic, performing adequate skin disinfection while assisting the recipient with clothing adjustment, ensuring hand hygiene product and process availability, ability to maintain a hygienic environment for injection supplies, ensuring safe and effective use of safety devices that may be unfamiliar to the healthcare worker, and addressing exposure to blood/body fluids.  No additional infection prevention risks were identified and all were able to be effectively managed.  Although the infection prevention risks posed by a drive-thru immunization process were anticipated, unique aspects of risk emerged.