1. Nancy Goodloe, EdD Administrator, Kittitas County Public Health Department Flu vaccine shortage Experiences from Kittitas County, Washington

2. 2 Introduction  Historical Framework Health Department decreasing role as flu shot provider Annual surveillance, coordination, planning Recent philosophical discussions about our role in this issue Yuk! What? Not Again! Cool 700 doses --- Oh, my gosh!

3. 3 Where Would You Start? A) Call a staff meeting; organize and schedule a three-day flu shot clinic. B) Send a press release to the media. C) Formulate a distribution plan. D) Begin to identify high-risk groups in the county.

4. 4  Rookie program manager to coordinate.  Developing our distribution plan: What are our guidelines? Other issues? Who/where are our high risk groups? What information do we need from them?  What are our messages to the press? to the public? Initial Concerns Key Messages?

5. 5 Coordination  Rookie Manager/Nursing staff identified high risk groups using CDC guidelines.  Nursing/clerical staff phone surveys to providers, nursing homes, vaccine providers (local pharmacies/groceries, etc.), developmental disability agencies, Aging & Long Term Care, CWU health center, etc. Who needed? How much? Who has? Anticipated?  Four-phase plan for distribution and administration – provider/BOHAC feedback.

6. 6 What Do You Think?  Getting feedback on our flu vaccine distribution plan from local healthcare providers and from our Board of Health Advisory Committee was a necessary step in our process. A) Strongly Agree B) Agree C) Disagree D) Strongly Disagree

7. 7 How Well Did PH System in Our County Function?  Fantastic cooperation from everyone involved; excellent support throughout the county. Providers, Fred Meyer, Safeway, Rite-Aid, CWU Health Center, KV Community Hospital  On-going communication internally/externally was a challenge. It happened but we really had to work at it. Took a lot of staff time.  Public Health became the cog in the flu vaccine wheel, the central point for information in county. Public Health

8. 8 Distribution/Administration  Challenges Coordinating messages to staff/public/press (small community, everyone knows who you are) Lack of depth in clerical staffing (where is my administrative assistant?) “Clinic from hell” physical plant (confidentiality issues, crowding in hallways)

9. 9 Challenges, continued  Geographic layout of our county  Evolving nature in which we acquired additional flu vaccine.  Budget considerations

10. 10 Opportunities  Evolving nature in which we acquired additional flu vaccine—distributed more vaccine than we have in many years  Strengthened communication/collaboration with community partners. CWU EMT students Fred Meyer/Rite-Aid connection  First Press Conference

11. 11 Opportunities, continued  Good feelings from thorough process – leadership role.  Support for county-wide conversation about how we do flu vaccine in our county in the future; public health role?

12. 12 Lessons Learned  PH Risk Communication training needed.  Internal paradigm shift needed—use Incident Command structure to offset scarce resources.  Rookie managers with strong skills can rise to the occasion.  Electronic registration system worked well; database management needed.

13. 13 Lessons, continued  Flexibility is key.  Historical experience of staff is invaluable.  Re-examining the role of local public health in flu vaccine distribution in this county will be a worthwhile endeavor.  We are not finished yet!

14. 14 That’s the Kittitas Story!