Safety and Security
These recommendations were developed to help local health departments and other mass immunizers anticipate and respond to safety and security issues that may occur at large-scale influenza vaccination clinics. These recommendations are based on the Division of Public Health Mass Clinic Planning Template and the collective experience of persons at the state and local levels who have planned and conducted large-scale vaccination clinics.
- Obtain broadcast and print media assistance.
- For whom the clinic is intended and not intended.
- What patients should bring for identification and, if determined to be necessary locally, risk verification (e.g., medication bottle, medic alert bracelet, or physician's note).
- That persons without risk factors will not be vaccinated.
- How to access vaccination sites via public/private transportation.
- Regarding available services, e.g., transportation, for special needs population.
- Regarding hours of clinic operation.
- Give appointments or appointment blocks to avoid long waiting lines.
- Give appointments to persons waiting in line, permitting those who so choose to leave and return at the appointed time.
- Provide sequential numbers on a first-come, first-served basis up to the number of doses available, and secure the clinic.
Plan for security
- Identify clinic staff to calm patients who are disruptive.
- Contact local law enforcement agency and identify who can be contacted if necessary for crowd/disruptive patient control. The level of law enforcement presence will be determined by the local law enforcement agency.
- Security personnel can be used to maintain crowd control outside and security within the clinic, assist with clinic and traffic control and other security matters.
Plan for response to a medical emergency
- Have clear, written procedures established to deal with emergencies caused by both vaccine adverse reactions and other reactions that could be triggered by stress (e.g., syncope, heart attacks, anaphylactic shock or asthma).
- Identify clinic staff to manage patients who experience a medical emergency or have symptoms of respiratory infection.
- Identify medical personnel (e.g., first responders) who can be contacted if a patient attending the clinic develops a medical emergency.
- Parking should be available adjacent to clinic location, well lit and paved.
- Be sure all areas are accessible to those with special needs.
- Use signage and/or staff to guide people through the clinic.
- Hang signage high enough for maximum visibility. Don't hang signs from tables.
- Signage mounting instructions: Doorway: 60" from floor to center of sign on latch side of door. Overhead: 80" minimum from floor to bottom of sign. Post: 60" from floor to bottom of sign.
- Provide an express lane for frail and disabled patients.
- Provide seating, good ventilation, access to toilet facilities, tissues, alcohol hand-washing gel, wastepaper baskets.
- Screen individuals for risk factors individually.
- If determined to be necessary locally, verify proof of risk.
- Divert individuals who do not have risk factors.
- Apologize that there is not enough vaccine to immunize them this year and note that the Emergency Order prohibits immunizing outside the priority groups.
- Provide handout on other ways to avoid influenza.
- Provide handout on signs and symptoms of influenza and when to seek care.
- Encourage / offer pneumococcal vaccine if person is eligible and vaccine is available.
Respond to unruly patients
- Attempt to calm patients who are very upset or disruptive (designated staff person).
- Contact security personnel if behavior escalates.
Respond to patient with medical emergencies
- Assess patient's medical problem (designated staff person).
- Contact first responder if medical emergency present.
Respond to patients with respiratory symptoms
- Offer tissues and alcohol hand-washing gel.
- Offer surgical mask to contain large droplets.
- If symptoms cannot be controlled (e.g., continuous coughing) escort patient from clinic and advise to delay immunization until symptoms resolve.
Thomas Haupt, Influenza Surveillance Coordinator
Wisconsin Division of Public Health
Bureau of Communicable Diseases