In summer 2026, the FIFA World Cup will bring millions of international visitors to 11 host cities across the United States, transforming communities into global destinations for more than a month. For local health departments (LHDs), this is far more than a sporting event. This is a large-scale public health operation requiring early, coordinated planning to manage increased population density, global travel, and sustained pressure on local systems. These conditions elevate risks related to infectious disease transmission, heat-related illness, injury, and healthcare capacity. In Dallas County, TX, preparation began more than a year in advance, highlighting a key lesson for LHDs: large-scale events require early, coordinated, and cross-functional public health planning.
This work is inherently multidisciplinary. Dallas County engaged epidemiology, immunizations, environmental health, communications, laboratories, opioid response teams, and the Medical Reserve Corps (MRC), alongside external partners including hospitals, airport operations, the CDC quarantine station, and community organizations. Coordination also extended across jurisdictions and through national networks like NACCHO to share tools and resources.
With a surge of international visitors, immunization planning becomes a core preparedness function. Dallas County’s epidemiology team worked with state partners to identify country-specific disease risks and develop protocols for screening and investigation. This approach ensures readiness to detect and respond to potential cases linked to global travel.
Key strategies included pop-up vaccination clinics to increase community access with a focus on vaccines with immediate relevance, such as mpox, influenza, COVID-19, and HPV. Additional strategies included partnerships with hospitals to expand reach, and training public health nurses and MRC volunteers to support surge capacity. For LHDs, this reinforces the importance of integrating immunization efforts into broader preparedness planning, leveraging existing infrastructure while scaling for increased demand.
Effective communication is central to managing population health during large events. Dallas County prioritized messaging on heat-related illness prevention, West Nile virus awareness, and general hygiene practices. To reach both residents and international visitors, materials were translated into multiple languages and deployed across high-visibility channels such as airports, public transit, hotels, rideshare platforms, social media, and restaurants. This multi-platform approach reflects a key best practice: meet audiences where they are with timely, accessible, and actionable information.
In Dallas County, preparation for the FIFA World Cup began more than a year in advance, highlighting a key lesson for LHDs: large-scale events require early, coordinated, and cross-functional public health planning.
Beyond traditional messaging, Dallas County implemented targeted, place-based outreach strategies to address real-world risks. They conducted opioid overdose prevention efforts, including naloxone distribution and training at watch parties, bars, and restaurants. QR code campaigns were implemented to connect individuals directly with public health resources. Sexual health outreach included condom distribution and education in high-traffic areas. The Medical Reserve Corps was also deployed to support both outreach and response activities. These approaches demonstrate how LHDs can embed public health interventions directly into community settings associated with large events.
To ensure consistency and accuracy, Dallas County is enhancing internal communication capacity, including exploring AI-enabled tools to provide staff with real-time, verified information. For LHDs, this highlights a growing need to equip staff with clear, standardized messaging, prepare for rapid information dissemination, and proactively address misinformation risks.
Dallas County’s experience underscores several actionable lessons:
Start early and plan comprehensively across all public health domains
Prioritize cross-sector and cross-jurisdiction collaboration
Integrate immunization planning into event preparedness efforts
Use varied, multilingual communication strategies across multiple platforms
Leverage community-based outreach to reach high-risk settings
Build surge capacity creatively, including through MRC and partnerships
Even in a constrained funding environment, innovation and collaboration can significantly expand impact.
Large-scale events like the FIFA World Cup test the resilience and adaptability of local public health systems. As Dallas County demonstrates, LHDs are essential to ensuring these events are not only successful, but safe. Through coordinated immunization efforts, strategic communications, and community-centered outreach, LHDs serve as the backbone of public health preparedness when the global stage comes to town.
