Despite the availability of an effective vaccine, influenza continues be a significant public health burden in the United States. Approximately 5% to 20% of the population becomes ill with influenza annually; on average more than 200,000 people are hospitalized, and about 36,000 die. Accordingly, current guidelines promulgated by the Centers for Disease Control and Prevention recommend that people who are at high risk for having serious flu complications and people who live with or care for those at high risk for serious complications receive the vaccine annually. These guidelines are available for reference at http://www.cdc.gov/flu/protect/keyfacts.htm.
Given the Centers for Disease Control and Prevention recommendations, the Medical Reserve Corps (MRC) has taken active steps to protect the public's health throughout this flu season. First among the efforts taken by the Office of the Civilian Volunteer Medical Reserve Corps was to call upon MRC leaders and volunteers to serve as community role models by receiving flu vaccinations themselves. MRC members also were asked to encourage all health care workers in their community to receive flu vaccinations. Local MRC units also worked to disseminate influenza-related information, as contained within the US Department of Health and Human Services' Office of Public Health and Sciences' publication entitled Health Care Personnel Initiative to Improve Influenza Vaccination Toolkit. This document is accessible at http://www.hhs.gov/ophs/programs/initiatives/vacctoolkit/index.html.
Furthermore, MRC units have promoted, supported, and even hosted flu vaccination clinics within their respective communities. In some cases, MRC units facilitate the introduction of point of dispensing (POD) models. The use of PODs not only makes flu clinics more accessible to the public but it also provides a valuable training opportunity to prepare MRC volunteers to respond to potential pandemic flu events. Other units worked closely with response partners to promote and host clinics. Again, these exercises not only benefited the individuals whom MRCs serve but also fulfilled the additional purpose of demonstrating that MRC units and their partners are capable of effectively responding should an actual emergency occur. Such combined response and training efforts have proven efficacious in testing MRCs' rapid response capabilities and enhancing community resiliency by preparing local organizations and volunteers to assist in disaster response efforts.
More specific examples of flu-related activities undertaken by local MRCs include the following:
Members of the Carson City, NV, MRC supported the local health department in a preparedness exercise by distributing free flu vaccination to community members. There were 2 locations, walk-in and drive-through.
The Clark County, OH, MRC participated in a flu POD exercise involving 2 simultaneous POD sites and more than 1000 flu shots. Most of the MRC participants were nurses, used to screen and vaccinate the clients who came through the PODs.
Volunteers with the Big Island, HI, MRC donated more than 300 hours of their time to help the local health community administer free flu vaccinations to schoolchildren.
The Phelps County, MO, Health Department conducted a POD exercise using the National Incident Management System during their 2008 Fall Flu Clinic. MRC volunteers also supported the Health Department staff, providing assistance with completion of all paperwork and computerized data entry, and offering information about flu vaccinations. In all, 401 flu vaccinations were provided as a result of the day's activities.
Three hundred flu vaccinations were administered by the Anderson County, KY, MRC over a 12-hour period during a drive-through clinic.
The Boston, MA, Medical Reserve Corps provided nurses and translators to a flu clinic on the Boston Common, where hundreds of flu vaccinations were administered to community members.
Four volunteers (1 medical, 3 nonmedical) from the Woodford County, KY, Health Department MRC assisted at a drive-through flu clinic held in an adjacent county. The clinic operated for 3 hours on a Saturday morning. More than 2400 vaccinations were given.
The Lake County, CA, MRC participated in the area's annual Flu Vaccination Clinic. Volunteers were able to administer more than 1300 vaccinations to older adult community members.
Bear River, UT, MRC member Dr Neal Mortensen joined the Bear River Health Department at the KVNU radio station to help promote flu vaccinations and the MRC program.
Among these events, 1 in particular stands out as having set a world record. The University of Minnesota MRC partnered with the university's Boynton Health Service, the School of Nursing, the College of Pharmacy, and the Minnesota Visiting Nurses Association in a public health deployment. The goals of this deployment included the mass vaccination of individuals, training MRC members in methods of mass medication dispensing, and ultimately, to achieve a world record for the most immunizations given in 1 day. In marketing the effort as a Guinness Book of World Records event, the goal to increase awareness of the benefits of influenza immunization was achieved. Moreover, this endeavor indeed succeeded in establishing a new record of providing 11,810 vaccinations in a single day, which far exceeded the standing record of 3271 individuals.
It is important that local MRCs be activated to promote influenza preparedness, but it is equally important that they measure the impact of their public health activities, including those related to flu vaccinations. To achieve the latter goal, the Office of the Civilian Volunteer MRC has partnered with the National Association of County and City Health Officials, Harvard School of Public Health, and George Washington University colleagues to develop a set of evaluation tools that MRC units can use to assess the effectiveness and impact of their activities. The evaluation tools that were developed will be tested among MRC units that helped staff flu vaccine clinics, with preliminary findings to be made available in early 2009.
