A collaborative model to meet community and institutional needs during a medical emergency: Lessons learned from an influenza vaccine shortage

BACKGROUND/OBJECTIVE: This university medical center (MC) is a 470-bed tertiary-care referral center. It was anticipated that for the 2004-2005 influenza season 15,000 doses of vaccine would be administered to both patients and healthcare workers (HCWs). On October 5, 2004, the Health and Human Services Department announced that the influenza vaccine to be supplied by Chiron – the company contracted to provide vaccine to the MC – was lost to contamination. The MC sought to mobilize the community and MC resources to address the unexpected vaccine shortage and ensure preparedness for a severe flu season. METHODS: Community Effort: On October 8, 2004, the local health department (HD) established a task force with representation from community hospitals, nursing homes, pharmacies, laboratories, local government, medical society and infection control (IC). An inventory of all available vaccine was developed. Each healthcare facility provided an estimate of vaccine needed to immunize the highest risk patients. The retail pharmacies were urged to adhere to the Centers for Disease Control and Prevention (CDC) guidelines. Healthcare facilities with no vaccine referred all patients to the patientʹs local health department. Later, each healthcare facility provided an estimate of vaccine need to immunize HCWs. Institutional Effort: An influenza vaccination task force with representation from physicians, pharmacy, nursing, lab, and IC was established to assess patient and HCW needs. Patients with high-morbidity diseases were deemed the most vulnerable. IC prioritized the HCWs needing immunization to those providing care to the most vulnerable and maintaining functionality, including those that could take FluMist® (live attenuated influenza vaccine). IC also launched a “Cover your Cough” campaign to heighten awareness of mask use and hand hygiene. RESULTS: The HD processed and had oversight in reallocating vaccine to the community and healthcare facilities according to CDC criteria. The MC administered approximately 3200 doses of vaccine, including live attenuated influenza vaccine (LAIV) to patients and HCWs. This represents <25% of the vaccine administered in prior years. CONCLUSION: A collaborative city-wide effort along with a multidisciplinary institutional effort provided an effective means to maximize the distribution and use of the flu vaccine during an unexpected shortage. While the flu season was mild, we believe that the lessons learned from this model can be successfully deployed to respond to other healthcare-related crises.