Maximizing Safety and Minimizing Injury for Healthcare Personnel and Vaccine Recipients During a Large Community-Wide Drive-Thru Point of Dispensing for H1N1 Pandemic Influenza Immunization

Background: On November 11-12, 2009 a community-wide H1N1 immunization point of dispensing (POD) was held and consisted of walk-up and drive-thru options.  This project aims to describe the activities used to maximize the safety and minimize injury to healthcare personnel (HCP) and those utilizing the drive-thru for receipt of vaccine during in a community wide drive-thru immunization program for adults and children.      

Setting: Louisville KY, large community-wide POD

Population: During those two days, a total of 19,079 vaccines were administered with 12,613 (66.1%) being administered to adults and children via a ten lane drive-thru. 

Project Description: Protecting HCP and citizens required planning focused on maximizing safety and minimizing injury opportunity.  Identified safety risks for HCP included physical contact with moving vehicles, needlestick/occupational exposure to blood/body fluids, ergonomics issues, and exposure to car exhaust fumes.  Risks for citizens included physical contact with other vehicles, injury due to inappropriate vaccine administration or technique, exposure to car exhaust fumes, and immediate adverse events. 

Results/Lessons Learned: During the drive-thru process, specific measures were taken to address each of the anticipated safety risks.    At the end of the two-day event, there had been no identified or reported injuries due to vehicular contact, and tent conditions were reported as acceptable at all checks.  However, four needlesticks occurred including three during safety device activation and one immediately following an injection given to an active child.  For citizens, three vaccine errors were identified including administration of intranasal vaccine to two individuals with contraindications and one dosing error. Although the safety risks posed by a drive-thru immunization process were anticipated, unique aspects emerged including occupational exposure.  The rate of HCP injury was 4/12,613 doses administered.  For citizens, three vaccine errors among 12,613 doses administered were identified and all three occurred when double-check procedures were not followed.