Local Health Department Public Vaccination Clinic Success During 2009 pH1N1

The 2009 H1N1 vaccination campaign was the largest such effort in U.S. history. Local health departments (LHDs) were responsible for administering vaccine to the public, but they had little guidance or experience to inform such a large campaign. Under these circumstances, LHDs used various processes to deliver vaccines to the public. As noted in quality improvement literature, excess variation indicates an opportunity for improvement. The objective of this project was to identify and learn from successful LHDs in the 2009 pH1N1 vaccination campaign. This project was a retrospective qualitative study. Process mapping was used to define the key mechanisms for vaccine administration to the public. Positive outliers in H1N1 vaccination efforts were identified from the NACCHO Stories from the Field Database, state and local health department After Action Reports, and recommendations from LHD staff. In-depth interviews were conducted with high performing LHD staff in order to learn about the context and mechanisms that led to successful public vaccination clinics. Study outcomes focused on the combinations of context and mechanisms that led to successful outcomes in high performing LHDs. Although LHDs administered vaccines to the public in varied ways, there were key mechanisms in specific contexts that led to successful public vaccination clinics including flexibility, clear communication, and appropriate staffing. LHDs that understood the needs of their local community and communicated effectively experienced successful vaccination clinics.The experience of successful LHDs outlined here can assist others in implementing successful public vaccination clinics in the future.