Ahead of Print -Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009 - Volume 20, Number 4—April 2014 - Emerging Infectious Disease journal - CDC

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Ahead of Print -Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009 - Volume 20, Number 4—April 2014 - Emerging Infectious Disease journal - CDC

Volume 20, Number 4—April 2014

Research

Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009

Article Contents

• Methods
• Results
• Discussion
• Acknowledgment
• References
• Table 1
• Table 2
• Table 3
• Table 4
• Table 5
• Table 6
• Suggested Citation

Shubhayu Saha , Brandon Dean, Steven Teutsch, Rebekah H. Borse, Martin I. Meltzer, DeeAnn Bagwell, Alonzo Plough, and Jonathan Fielding

Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Saha, R.H. Borse, M.I. Meltzer); Los Angeles County Department of Public Health, Los Angeles, California, USA (B. Dean, S. Teutsch, D. Bagwell, A. Plough, J. Fielding)

Suggested citation for this article

Abstract

During October 23–December 8, 2009, the Los Angeles County Department of Public Health used points of dispensing (PODs) to improve access to and increase the number of vaccinations against influenza A(H1N1)pdm09. We assessed the efficiency of these units and access to vaccines among ethnic groups. An average of 251 persons per hour (SE 65) were vaccinated at the PODs; a 10% increase in use of live-attenuated monovalent vaccines reduced that rate by 23 persons per hour (SE 7). Vaccination rates were highest for Asians (257/10,000 persons), followed by Hispanics (114/10,000), whites (75/100,000), and African Americans (37/10,000). Average distance traveled to a POD was highest for whites (6.6 miles; SD 6.5) and lowest for Hispanics (4.7 miles; SD ±5.3). Placing PODs in areas of high population density could be an effective strategy to reach large numbers of persons for mass vaccination, but additional PODs may be needed to improve coverage for specific populations.

Mass vaccination outside clinical settings (e.g., in pharmacies, workplaces, businesses, schools, and religious institutions) has been used to safely and efficiently provide a high volume of influenza vaccinations (1) and expand access to the vaccine (2,3). Success for such operations depends on the rapid dispensation of vaccines, the number of vaccines administered, and the communities reached. In Los Angeles County, California, USA, the 2009 influenza A(H1N1) pandemic was considered widespread by September 20, 2009 (4,5). Distributing the influenza A(H1N1)pdm09 (pH1N1) vaccine through points of dispensing (PODs) was the principal prevention strategy of the Los Angeles County Department of Public Health (LACDPH). PODs are vaccination clinics that operate at designated locations throughout the community for the temporary, large-scale dispensing of vaccines to persons at risk during a public health emergency. During October 23–December 8, 2009, the LACDPH distributed the pH1N1 vaccine through 60 POD locations in Los Angeles County. Clinical and nonclinical staff (including LACDPH-trained volunteers) registered patients and facilitated the vaccination process. The PODs were placed throughout the county to reach diverse, high-risk populations who would be less likely to receive the vaccine otherwise (6). We reviewed data from this effort to determine how future mass vaccination campaigns can improve the efficiency of vaccination at PODs and provide equitable access to PODs among demographic groups considered especially vulnerable to the vaccine-preventable outcome.

Acknowledgment

We thank Djesikah Amendah and Michael Washington for input during the design of the study; Leticia Moisa, Susan Montenegro, Deborah Davenport, Catherine Knox, Mike Stuhley, and Mark DiCamillo for providing the data necessary for this analysis; Sinan Khan and Jee Kim for their assistance in formulating the research questions central to this evaluation; and Melissa Volk, Charisma Atkins, and Manjunath Shankar for their assistance with data management.

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Tables

• Table 1. Patient characteristics and POD data from 101 influenza vaccine events, Los Angeles County, California, USA, October 23–December 8, 2009
• Table 2. Factors affecting average number of patients vaccinated per hour (throughput) per influenza vaccine POD event, Los Angeles County, California, USA, October 23–December 8, 2009†‡
• Table 3. Residence, rate of vaccination, and distance traveled for persons visiting PODs for influenza vaccination, Los Angeles County, California, USA, October 23–December 8, 2009
• Table 4. Average distance persons traveled to the 3 closest PODs for influenza vaccination, Los Angeles County, California, USA, October 23–December 8, 2009
• Table 5. Numbers and rates of persons receiving influenza vaccine at PODs by ethnic group and population density, Los Angeles County, October 23–December 8, 2009
• Table 6. Numbers and rates of persons receiving influenza vaccine at PODs by ethnic group and median household income, Los Angeles County, California, USA, October 23–December 8, 2009

Suggested citation for this article: Saha S, Dean B, Teutsch S, Borse RH, Meltzer MI, Bagwell D, et al. Efficiency of points of dispensing for influenza A(H1N1)pdm09 vaccination, Los Angeles County, California, USA, 2009. Emerg Infect Dis [Internet]. 2014 Apr [date cited].http://dx.doi.org/10.3201/eid2004.130725

DOI: 10.3201/eid2004.130725

CrossRef reports the supplement should be "Supplement" not "Suppl 5" in reference 2 "Glazner, Beaty, Berman, 2009".

Medline indexes "Biometrika" but cannot find a listing for reference 7 "Shapiro, Wilk, 1965". Please check the reference for accuracy.

Medline indexes "Health Serv Outcomes Res Methodol" but cannot find a listing for reference 11 "Higgs, 2009". Please check the reference for accuracy.

Medline cannot find the journal "Challenges, Explorations, and Breakthroughs." (in reference 17 "Lee, Smalley, Zhang, Pietz, Benecke, 2009"). Please check the journal name.

Cannot find a title to match the journal "Challenges, Explorations, and Breakthroughs." (in reference 17 "Lee, Smalley, Zhang, Pietz, Benecke, 2009").