Practicing for the Next Public Health Emergency: Influenza Clinic in Pinellas County, Florida Elizabeth Kim, MSPH Public Health Associate Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2015 PHAP/PHPS Summer Seminar June 2, 2015 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

Flu Clinic Flyer

Significance to Public Health  Seasonal Influenza (flu)  Affects about 5-20% of the U.S. population each year  More than 200,000 people per year are hospitalized from flu-related complications  Up to 49,000 flu-associated deaths occurred between 1976 and 2006  Most effective way to prevent the flu is by getting a flu vaccination * Centers for Disease Control and Prevention. Influenza (flu). April 9, 2015.

Background  Florida Department of Health in Pinellas County  Annual no-cost flu vaccination clinic *Pinellas County Government Home Page. April 9,  Pinellas County, Florida  Most densely populated county in Florida  Estimated population of 916,542 (3,347 persons per square mile)  Attracts tourists year round  Two international airports in close proximity

Objectives  Objective 1  To improve flu vaccination rates among those who may not normally get vaccinated  Objective 2  To exercise the department’s point of dispensing (POD) plan by engaging in mass prophylaxis tactical operations and mass dispensing

What is a POD?  Point of Dispensing (POD)  A fixed location where medications can be provided to a large group of people in response to a public health threat or emergency  The goal is to prevent the spread of an infectious disease

Greeting & Initial Screening Medical Triage Form Check EMS to transport to Healthcare Center Dispensing Area & Form Collection Exit Potentially ill Non-symptomatic No need for further evaluation Further evaluation or treatment needed Basic POD Flow

 POD opened and staffed by 35 individuals (Health Department and Medical Reserve Corp) Methods

Incident Command System (ICS) Structure Incident Commander Safety Officer PIO Planning Section Chief Operations Section Chief Drive-Thru POD Manager Walk-In POD Manager Logistics Section Chief

POD Structure POD Manager Inventory Manager Runner Medical Triage Floor Operations Leader Dispensing Team Administration/ Clerical Leader Clerical Support Greeter Traffic/Flow

Methods  Eligibility Criteria: Any individual age 6 months and up  Location: Pinellas Park Health Department  Date: October 29, 2014  Time: 6 pm – 9 pm  Types of Flu Vaccines Offered:  Trivalent  Quadrivalent  High dosage (age 65 and up)  Intradermal, intramuscular, and egg free variants  Two drive-through lanes and three walk-in stations used to dispense vaccinations

Walk-In Layout

Drive-Through Layout

Results  40.7% (n=44) utilized drive- through option  108 vaccinations administered, an increase of 100% from the year prior  All volunteers were integrated into the POD structure  Evaluated POD set-up, flow, and staffing

Results and Implications  The CDC identifies the elderly, young children, pregnant women, and people with certain health conditions as high risk for serious flu complications  Our clinic served:  Elderly (n=10, 9%)  Young children (n=1, 0.9%)  Pregnant women (unknown)  People with certain health conditions (unknown) * Centers for Disease Control and Prevention. Influenza (flu). April 9, 2015.

Recommendations  Provide the vaccine at no-cost  Make vaccine available after normal business hours  Provide dual option to walk-in or drive-through  Things to consider:  Accessibility to the site  Location of the POD  Timing of the exercise/clinic  Tying in themes  Marketing/messaging/community outreach  Data collection

For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support 4770 Buford Highway NE, Mailstop E-70, Atlanta, GA Telephone: CDC-INFO ( )/TTY: The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Thank you! Questions? Elizabeth Kim, MSPH Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support