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Story from the Field

Name of Health Department/Agency: Franklin County Health Department
State: KY
Date Added: 12/17/2009
Themes: Vaccine Supply and Distribution
Issue Summary: Public demand for H1N1 that far exceeded initial supplies
Description of Issue(s):
  1. As stated above, exacerbated by ever increasing news reports of widespread H1N1 activity and deaths
  2. Lack of understanding by general public regarding the CDC targeted tiers, particularly by those persons over 64 and those with chronic diseases and other "underlying conditions."
Actions taken to address the issue(s):
  1. Key staff spent most of August and early September trying to educate the public through community organization meetings (often broadcast on local cable TV) and local news articles and other public venues. We continue to update our website at least weekly, sometimes daily, and we now are on Facebook.
  2. HD pushed seasonal flu out starting in mid-August, including mass clinic drive thrus. One was held for free as a preparedness exercise, using several drive thru lanes after business hours at a local credit union. Over 1,400 persons were vaccinated in four hours. These drive thru's involve many of our own staff, the American Red Cross volunteers, law enforcement, transporation personnel, and volunteers.
  3. HD made decision that all H1N1 coming into county would come through the HD, in order to maintain better control on very limited supplies. When H1N1 began to arrive and the first week's allocation was just LAIV, direct healthcare workers and emergency responders were the first to begin to receive coverage. When injectables were included in following weeks, pregnant women were also then targeted as HCP's continued to be covered, through direct HD visits to their worksites and in partnership with providers. As allocations increased, caregivers of infants were included, too. After about the first month, HD teams including contracted RN vaccinators and support staff visited every childcare facility in the county (a forum for staff was held prior to October and participants were handed or mailed packets with information and parental permission slips). We have just completed our second booster visits to these facilities. As supplies continued to increase, we expanded our closed clinics to all schools in the county (public city and county schools, private and faith-based, a large special needs residential facility, an alternative school and a state university). As of today, we are completing our second booster visits to these schools. Following initial school coverage, we held our first drive thru and advertised for the targeted population through age 24. We were overwhelmed and perhaps at least 1/3, maybe 1/2 of those coming through, were over that age. Many agreed to return when we could expand coverage but many refused to get out of line. Many who were otherwise eligibile for LAIV insisted on the injection, so we ran out of that form before the end of the drive thru. Then, supplies inceased to the point that two weeks later, we held our first 25-64 with underlying conditions drive thru. Although some persons were over 64, we did not say anything because our supplies had increased considerably by then. We held our first general drive thru last Friday and saw about 750 persons in four hours. We are repeating this clinic tomorrow. Also today, for the first time we distributed vaccines to all other registered providers, including the major pharmacy chains.
Outcomes that resulted from actions taken:
  1. Since mid-August, we have provided over 10,000 seasonal flu vaccines and some 9,000 H1N1 vaccines - covering about 20% of our county of nearly 50,000.
  2. Our community partnerships have been enriched and expanded.
  3. This has been an excellent public health exposure and we have had many, many positive comments about efficiency.
  4. Our internal relationships have improved as we've had nurses working side by side with environmentalists, working with health educators, workiing with support staff, Home Health RN's working with Clinic RN's. We've tried to enable as many of our nearly 100 employees as possible who wish to do so, to "work" a drive thru. Many have commented about the fun of doing these, although they are exhausting.

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