While the timing of COVID-19 vaccine availability is still unknown, Medical Reserve Corps (MRC) units and health departments are practicing and planning now for its distribution—including the possibility of administration both indoors and outdoors during cold weather.

Uncas Health District MRC, Norwich, Conn.

Since COVID-19 vaccines will likely be directed to specific populations (like critical workforce personnel) at first, Uncas Health District MRC Unit Leader Sara Darlagiannis is currently planning to go to them to do vaccination, setting up appointment times and limiting room capacity at clinics. While she is hopeful that public clinics will be in warmer weather, locally they are looking at other options like fire department bays and overhangs at hotels to house clinics. Last month they also used a parking garage and are planning to do so again. Lighting is one consideration for such a location. Facilities with larger window openings provide more natural light, however, they are also more exposed to the elements. Use of the lower level of parking garages are warmer and provide more weather protection, but have lighting issues.

In the month leading up to their clinics, Darlagiannis provided just-in-time training for volunteers via Zoom. The unit offered trainings in late afternoon and evenings, and varied the day of the week offered to help make them accessible. In addition to another just-in-time training the morning of the clinic, volunteers were provided with a double-sided tri-fold paper with important information like the site map and schedule for the day. This took the place of a job action sheet which could provide an overwhelming amount of information. For cold weather days, Darlagiannis recommends heating packs for hands and properly weighted pop up tents with side walls as weather protection.

Southwest Utah MRC, St. George, Utah

Southwest Utah MRC recently concluded its eighth flu “shootout” vaccination event across the five counties served. MRC volunteers assisted with greeting, education, sanitization, and set up. This year’s clinics provided valuable practice for COVID-19 vaccination. One Shootout was moved to the fair grounds and served as practice for a larger scale, drive-thru vaccination site. Another that is usually only offered as walk-in offered both a walk-in and drive-thru option this year. EZ-ups are used to shelter from the weather, with heaters when necessary. A fire station was also utilized allowing clinic goers to drive thru a bay or walk-in.

Unit Leader Suz Roam advised other unit leaders to make sure you have lots of cones and stop signs for outdoor events and to post signage about the different stages people will drive-thru. They made the intake form available on the health department website and encouraged people to print and fill it out before arriving to both speed up the process and limit contact. For the COVID-19 vaccine, the health department is considering using an online registration system for use with the intake form and possibly scheduling.

Cape Cod MRC, Barnstable, Mass.

Cape Cod MRC recently held drive-thru flu clinics at two locations, the county complex and a former school site. At one site people pre-registered—a practice Unit Leader Diana Gaumond highly recommends for COVID vaccination to both manage expectations around limited supplies and to pace arrival of vaccine seekers throughout the clinic’s operating hours. MRC volunteers managed registration and the observation area with about 20 volunteers at each clinic. Four stations were set up for vaccines with three people manning each which allowed opportunities for breaks or faster service when multiple people in a car were there for vaccination. Gaumond said they are considering using a Department of Public Works building or car washes for cold weather clinics.

Additional Ideas

Cold weather vaccination was a topic on NACCHO’s Virtual Communities platform. Additional ideas shared for housing cold weather clinics include:

• Vehicle emission sites
• Local county fairgrounds
• Small municipal airports
• Unoccupied Sears Automotive & Tire Repair Centers on the property of a local mall
• Convention Centers
• Military tents (check with County/City Emergency Manager, State Emergency Management, or National Guard for availability)
• Wash bays in county highway shops
• Utilizing prebuilt wood sheds/tiny houses