Story from the Field

In our State, Public Health agencies had the option of having vaccine sent directly to their hospitals and clinics, or have vaccine sent to the Public Health department for redistribution to all of our clinics and hospitals.  We wanted to have equal distribution and therefore equal availability of vaccine in our county, so we chose to have all vaccine delivered to us and redistributed by us.  This was an awesome task that we had never planned to take on and many lessons were learned.

We were able to work with our county administration to use one of the refrigerators and storage rooms in our old jail that was closed down. This involved having the refrigerator turned on, inspected and an alarm system set up.

Since the place the vaccine was kept in was the old jail - still a secure facility - Public Health staff had to visit at least twice a day to keep track of the temperature of the refrigerator and had to get help from Administrative (the county cusodians) to enter and leave the jail facility - each time.

We developed several kinds of spreadsheets to keep track of vaccine coming in and redistributed. This helped us to keep an accurate count of how much vaccine we had at any one time and also where it was delivered to. This was very helpful when we had to notify agencies that some of the recalls were vaccine that they had received.

An initial meeting was held with all hospitals and clinics in the county to talk about how distribution would work.

One of the biggest obstacles we had was that all of the large corporate Medical agencies were ordering vaccine directly for all of their own hospitals and clinics. For those corporate hospitals and clinics in our county, we received their vaccine instead of it being sent directly to them. Because the State Dept. of Health could not help us with this issue, we did establish a direct communication with a person at the large corporates who then knew exactly how much vaccine their clinics and hospitals were getting through our system.

We had weekly communication with our clinics (through a telephone conference) regarding how they were doing with doing with ill patients, how much vaccine they were needing and using. Once we started to get vaccine we established a regular day for them to order vaccine and then pick it up.

Public Health also worked in collaboration with the clinics and hospitals in doing large mass clinics with referrals of clients from the clinics.

When vaccine distribution was open to other entities, - Minute Clinics, Walgreens, etc. - Public Health also worked with them to get vaccine to their agencies.

All this was done with using only 6 Public Health Staff on a regular basis in a county of around 116,000 people.

We had many positive outcomes for how we handled vaccine.

All high risk people living in the county had equal ability to access vaccine due to vaccine being available in all clinics, hospitals and Public Health that served those high risk patients. This equal access to vaccine did not happen in other parts of the state where the State Health Dept. was using their own system of prioritizing clinics around the state to receive vaccine. In our area we knew our clinics and who they served and made sure that all who needed vaccine had equal access to it.

There was a very strong bond formed between Public Health and all of the hospitals and clinics in our county because of the open communication about how much vaccine was available and where it was going. In the weekly telephone conferences, we could also update clinics and hospitals on any new information about vaccine that they needed to know about.

There is now more trust with the large corporate agencies. In our county their local clinics actually got more vaccine through our system than they would have gotten by just working with the State Health Department.

We worked together as a community, stuck to the populations being served when there was less vaccine, and became a community working well together in an emergency.

This was only one part of many ways local Public Health worked cooperatively with agencies to do the work needed in the H1N1 emergency, but probably was the one that we learned the most in.