Yamhill County launched mass vaccination campaign for school-age children

When news of the first cases of novel H1N1 influenza surfaced in April 2009, mass immunization became part of regular emergency preparedness discussions around the country. In Yamhill County, Ore., the heart of the state's wine industry with more than 95,000 residents, public health planners began to plan how it would work in their county.

With a Public Health Emergency Response grant, or PHER funds, Yamhill County Public Health (YCPH) developed a Point of Dispensing (POD) plan in conjunction with a policy group comprising county health officer, public health manager, health administrator, and board of commissioners.

“Due to the ability of the health officer to make proactive, steadfast recommendations, we did not need to deviate far from the original distribution plan,” said Mike McNickle, Yamhill County Public Health manager. “Having a clear plan enabled staff to efficiently prepare for implementing mass vaccinations at school sites, with healthcare providers, and to effectively communicate key messages to the public.”

School-based vaccinations were the focus of the YCPH plan. Planners hired and trained two liaisons, 25 temporary certified medical assistants and 25 registered nurses. Those staff received training in policies and procedures in sick leave, screening, triaging patients, and altering business practices for social distancing.

The additional staffing help allowed YCPH to set up PODs in all seven school districts, as well as daycares, and childcare centers in the county. The schools recruited help from their own staff and volunteers. School staff and volunteers received job action sheets before training, McNickle said. "We had previously developed basic relationships with schools, but H1N1 put us in the forefront of discussing among other things MOUs for emergencies."

YCPH established a hotline, which informed the public about the target group and where they could find vaccine. Planners said this helped divert traffic from school PODs and gave people another means to receive vaccine without waiting in long lines. At one point during the vaccination campaign Yamhill County had the only walk-in site in the area, so people were coming from neighboring counties to receive their vaccine, McNickle said.

Planners designed signs in English, Spanish, Russian, Vietnamese, and Chinese (Mandarin). Bilingual employees were available during community clinics. Translation was not an issue for school-based vaccinations, planners added.

For school PODs, he added, parents and administrators were given advance notice about the procedures for students who could not be vaccinated. There were also multiple communications sent about the symptoms being triaged to parents, school staff, POD staff, and volunteers.

Yamhill County capitalized on its initial success in vaccination to administer second doses, McNickle noted. As vaccine became more reliably plentiful in 2010, injectors revisited daycares and elementary schools, obtaining a 60 percent vaccination rate for second doses.

An unexpected benefit of the H1N1 response in Yamhill County was the growth of its Medical Reserve Corps (MRC). Many nursing students who volunteered with the PODs also joined the MRC. By the time the PODs were completed, the MRC had 15 members, a helpful beginning to plan future responses.

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