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Story from the Field


Name of Health Department/Agency: Casper-Natrona County Health Department
State: WY
Date Added: 11/10/2009
Themes: Communications - Vaccine Safety,Vaccine Planning and Administration
Issue Summary: Mass vaccination hindered by vaccine safety distrust and staff unfamiliarity with ICS structure.
Description of Issue(s):

Reluctance of Health Care workers (Physicians, Nurses and others), including our own staff, to take the H1N1 vaccine. Several local pediatricians and OB/GYNs advised their patients to NOT get the vaccine. Most of those declining cited concerns that the vaccine was "rushed into production," and that risks were unknown or unacceptably high.

On a lighter note, we were surprised at the number of early pregnancies and widespread asthma, as people self-declared in priority conditions.

Actions taken to address the issue(s): Close cooperation with schools, planning information campaigns, and monitoring absenteeism.

Regular meetings of a select group of Senior staff as a Flu-Plan/Command Group

Large-scale mass vaccination clinics at multiple sites off-premise from our normal facilities. At the first one, we administered 1200 vaccinations to high-risk persons in 4 hours, and at the second, about 1100 persons were vaccinated in about 3.5 hours.

Outcomes that resulted from actions taken: Because we must question patients more closely than usual about their risk status, and because we must then apply that information to two different vaccine formulations, Triage at our mass clinics was somewhat slow.

Despite repeated trainings and exercises, some of our staff still have difficulty understanding and operating within an ICS structure, even though ours is much simplified compared to the clumsy examples in the various FEMA training modules. We have learned that we can minimize this by NOT placing people in the same functional position for each deployment, but rather moving people to different functions each time to help emphasize that they are NOT under their normal chain of command/authority, and that decisions must go up and down the ICS "tree," not laterally.

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