Emergency prophylaxis and/or vaccine administration by public health officials in a biological event

ISSUE: In the event of a natural disaster, infectious disease outbreak, or bioterrorism attack, public health officials are responsible for administering prophylaxis or vaccine to the appropriate general public in an efficient and expeditious manner. Hospital personnel, law enforcement, and firepersons will be prophylaxed or vaccinated in the initial clinics. PROJECT: Thirty high schools were selected that could be used for clinic sites where public health nurses could prophylax or vaccinate a metropolitan community of 1.2 million people. The clinic arrangement was diagrammed on the blueprint of each school. Client registration, screening, and documentation of prophylaxis or vaccine will be done on a wireless data system. First Responder demographics were imported to the wireless system through a CD. Special needs clients and a large minority population were addressed specifically in the plan. Volunteers have been enlisted to help at each site. Processes for credentialing of staff and volunteers, and a process for screening those who may already be infected were developed. Pre-boxed office and medical supplies were prepared and stored for future use, and contracts for other needed supplies such as cell phones and laptops were put in place. It is estimated that Columbus Health Department (CHD) and adjacent Franklin County Board of Health could set up four clinics and be prepared to administer prophylaxis or vaccines within 3 hours. RESULTS: The plan has only been used in pre-event smallpox clinics. The wireless software system was developed in 2004, and CHD piloted the system and uses it weekly in immunization clinics. In the pre-event smallpox clinic, it took 40 minutes to register the client; show the video; screen, vaccinate, educate the client; and observe the client for twenty minutes. It is estimated that four nurses per hour could vaccinate 250,000 people at 30 sites for 16 hours per day. LESSONS LEARNED: It is possible for local and state health departments to prophylax or vaccinate a large population rapidly, if advance planning is done. This includes: training staff; finding a software system to document the interventions; planning for clinic sites; securing necessary office and medical supplies, credentialing staff and volunteers, obtaining the medication or vaccine; and making plans for the handicapped and minority populations.