1. Experience with Pediatric Influenza Mass Immunization Clinics Karen Rea, MSN, RN, BC Kristin Kazem, CHES

2. History  Inova Health System: A large multi- hospital, integrated health system in Northern Virginia  10 years experience with adult immunizations in community & corporate setting  70,000 adult vaccinations were given this year through our Fight the Flu campaign

3. Identification of need  Decrease in availability of pediatric flu shots in physician office setting  Difficulty of immunizing the siblings of high risk pediatric clients  Requests at adult vaccination sites for pediatric flu shots  CDC recommendation for immunization of 6-23 month old infants

4. Planning  Clinic Medical Protocol developed with Chief of Pediatrics, Inova Fairfax Hospital for Children  Planning group v Inova HealthSource Department head & senior manager v Manager of Fight the Flu program v Fight the Flu Senior Wellness Nurse v Three Fight the Flu nurses with pediatric experience

5. A Challenge for Pediatric Sites..  Unlike adult mass immunization clinics, pediatric clinics in Virginia are required to have a physician on site  This limits our ability to take a clinic into community settings

6. Clinic Sites  The Atrium at Inova Fairfax Hospital for Children v Next door to the emergency room v Pediatric house staff were on call in event of emergency or questions v Monthly clinics during October – January  Inova Pediatric Lung Center v To facilitate immunization of siblings of their patients v Bi-weekly clinic on a day the office was not seeing many patients  No appointment needed for either clinic

7. Operational Issues  Fee for 1 shot versus 2 shots  Authorization to give consent  Special consent form required for pediatric patients v Differing doses according to age v Need to return for 2 nd immunization  Notification of primary care physician of immunization  How to handle the post-immunization waiting period

8. Advertising the Clinics  Letter sent to all area pediatric, OB/GYN and family practices  Message on our Fight the Flu telephone hotline  Memo in the Inova employee newsletter  Decision made not to advertise in media at same time as our regular adult flu clinics, to avoid confusion over where children could be vaccinated

14. Statistics  Total number of immunizations: 421 v Ages 6 – 35 months: 109 (26%) 6-23 months 79 (19%) 24-35 months: 30 (7%) v Ages 3 – 9 years: 111 (26%) v Ages 9-18: 67 (16%) v Adult: 134 (32%)  Physician practices represented: 27  No adverse reactions were note

15. Challenges During the Clinics  Sniper attacks during the early weeks of the campaign  Unusually early snow storm requiring cancellation of 1 clinic in early December  Number of forms needed for families with multiple children  Reminding parents to bring their child back for the 2nd immunization

16. For Next Year...  Change clinic focus to “Family” immunizations  Conduct clinics at all 4 Inova Hospitals, not just the children’s hospital  Advertise clinics along with regular clinic dates/locations  Collect data on ethnic background  Collect written data on whether this was the first flu shot  Reminder cards about 2 nd immunization dates

17.  Kristin Kazem, Manager, Adult Vaccination Program v kristin.kazem@inova.com v 703-208-2632  Karen Rea, Senior Wellness Nurse v karen.rea@inova.com v 703-204-3360 2832 Juniper Street Fairfax, VA 22031