Date:  January 5, 2010

Distribution and administration of H1N1 immunization has been a challenge for communities of all sizes in every state.  Ensuring access to vaccine by targeted high risk groups, using methods that are reliable and accessible, and meeting the expectations of the community has been particularly difficult.  Louisville Kentucky, a metropolitan area with a population of close to one million, chose to utilize a unique approach to community-wide immunization.  On November 11-12, 2009, the Louisville Metro Department of Public Health and Wellness (LMDPHW) partnered with the University of Louisville in order to plan and implement a community-wide immunization event targeting those adults and children at highest risk of H1N1 illness and consequence.  The event was held at the University of Louisville’s Papa Johns Cardinal Stadium south lot parking area. Areas previously identified as point of dispensing sites during public health preparedness efforts were based upon dispensing of oral medication utilizing anthrax release as the planning model basis.  Upon review of those sites, they were determined to be unacceptable for large scale immunization events.  Public pressure due to the incidence of H1N1 illness and broad concern across the community prompted an accelerated planning approach.  Utilizing a unified command structure, planning began on October 26, 2009 when LMDPHW received notice of a large vaccine shipment.  

Eleven planning days prior to the event, a POD plan was suggested by a team of researchers from the University of Louisville School of Public Health and Information Sciences, School of Nursing and Department of Environmental Health and Safety.  Using a simulation model developed by researchers from the University of Louisville Speed Engineer School’s Logistics and Distribution Institute, the framework and capabilities of a unique POD were demonstrated. Planning assumptions were based upon prior implementation of drive-thru immunization programs. Planners from the LMDPHW suggested changes to the process and the concept of the POD was accepted.  Activities necessary for implementation of the POD began the afternoon of October 26th. It was determined that enough vaccine would be available for a two-day event assuming that 10,000 doses could be administered over the course of those two days.  Plans were developed for a POD that would be composed of a walk-in venue as well as a drive-through with both able to provide injectable and intranasal vaccine to adults and children.  

The event was an unprecedented success with 12,613 doses (4310 in the walk-up tent and 8303 via drive-through) administered from 8am-7pm on the first day and 6466 doses (2130 in the walk-up tent and 4336 via drive-through) administered from 8am-1pm on the second day.  

The event opened for operation at 0730 on November 11, 2009 with approximately 600 cars and 100 walk-up individuals waiting on site.  The walk-in venue enabled individuals to enter the stadium area then park in a designated area immediately adjacent to the walk-in tent. In addition, the Transit Authority of River City (TARC) provided continuous bus service from four government centers located in distinct sections of the Louisville metropolitan area. Individuals entered the tent and were directed to one of the fifteen (15) immunization stations. For the drive-thru, vaccine recipients were given a consent form and vaccine information sheets as they entered the stadium parking lot.  They were able to remain in their vehicles and were routed to one of ten lanes leading to five immunization tents.  Faculty and students from the University of Louisville and Bellarmine University Schools of Nursing, faculty and staff and Master of Public Health students from the University of Louisville School of Public Health and Information Sciences and medical students from the University Of Louisville School Of Medicine provided immunization to individuals in their vehicles.