Ensuring Linguistic Access in a Coordinated Public Health Response: San Mateo County's H1N1 Flu Vaccine Clinic Experience

Between December 2009 and February 2010, the San Mateo County Health System (SMCHS) held several H1N1 influenza vaccination clinics for county residents. Because of the size and scope of these clinics, the Incident Command System (ICS) was activated to coordinate planning. Attendance at initial vaccination clinics held at the San Mateo Medical Center averaged approximately 150 people. These initial clinics served as small-scale, pilot sites in advance of community mass vaccination clinics. Demographic data collected at the Medical Center clinics revealed that many of the recipients were limited English proficient (LEP). Over 45% of those vaccinated in the initial clinics identified themselves as Hispanic/Latino, with a majority being primarily Spanish speakers. It was evident that language access needed to be incorporated into the planning of these clinics. The ICS Planning and Logistics sections responded by arranging for bilingual staff and/or qualified health interpreters to serve at each of the mass vaccination clinics. Telephonic interpretation was also made available at these clinics. Demographic data collected at five subsequent mass vaccination clinics revealed a racially diverse clientele with varying language needs: 35% of vaccine recipients were Hispanic/Latino, 12% were Chinese, and 24% were Filipino. These three ethnic groups comprise the largest LEP communities in San Mateo County. The presence of language assistance services at each of the clinics facilitated effective communication during both clinical and non-clinical functions. Language access should be a consideration at the earliest planning stages of any coordinated public health response to ensure equitable access to services.