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Story from the Field


Name of Health Department/Agency: St. Louis City Department of Health
State: MO
Date Added: 11/25/2009
Themes: Vaccine Planning and Administration
Issue Summary: St. Louis City Dept. of Health steers priority groups to private providers and school vaccination clinics rather than mass vaccination clinics.
Description of Issue(s): Over the past four weeks, the St. Louis City Department of Health (in partnership with health providers around the City) has administered
40,000 doses of H1N1 vaccine through 44 health provider groups/clinics
and ten hospitals. These include 10 walk-in clinics, all Community
Health Centers, several group medical practices, and the City’s
children’s hospitals. 

To find out where to get the H1N1 vaccine near their neighborhood,
citizens can go to the City web page and click on Fight the Flu.
Actions taken to address the issue(s): This vaccine was delivered direct to the
providers and administered within 48 hours.  All 900 licensed providers
in the City were invited to participate.  The walk in clinics are open from 8 am to 6 pm five days a week and Saturdays until noon.

These doses were restricted, in accordance with CDC recommendations, to
children under 18 with underlying medical conditions, children 6 months
through 4 years, pregnant women, care givers of infants and pre-school
children, medical workers, and first responders who have direct patient
contact.  The population size of this priority group is estimated by DOH
to be approximately 52,000.

Starting this week, H1N1 vaccine shipments began going to school
vaccination clinics to reach the 50,000 students who attend one of the
145 public, charter, parochial, private, and independent City schools.
The goal is to complete vaccinations in all preK through middle schools
by Christmas.  These clinics are free.  CDC funds will be utilized to
reimburse private vaccinator companies such as the VNA and SARA services
to transport, store, and administer the vaccine.  The reimbursement rate
is $10 per child enrolled whether they get vaccinated or not.

Outcomes that resulted from actions taken: As we move through this priority group and determine demand we will
expand the group being reached through providers to all those under 64
with underlying medical conditions.

The public is constantly reminded that if they don’t want the H1N1
vaccine or do not fit into one of the initial priority groups, they can
still help the City "Fight the Flu" by practicing  good hand washing and
appropriate cough etiquette - and by staying home if you are sick."

As other local health agencies in the state meet the demand for
priority groups in their jurisdictions they have generously offered to
share vaccine with the City.  For example, Butler County Health
Department under the leadership of Robert Hudson, not only offered 720
doses of vaccine to the City they offered to drive the two and one half
hour distance between our health departments and deliver it themselves.

The Department determined early that persons with underlying medical conditions need to be vaccinated in a providers office not standing in line at a public mass vaccination clinic.  In the counties were they have tried mass vaccination clinics four things happen,
1. only half the people they expect to serve show up 
2. those that do, take hours to get vaccinated
3. their confidentiality is compromised and
4. persons not in the priority group get vaccinated.

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