Open Data

Recommendations for COVID-19 Mass Vaccination Site Setup and Operations

Many Federal, State, Tribal, Territorial and Local Jurisdictions use drive-through mass vaccination clinics (hereafter MVCs) as part of their Medical Countermeasures (MCM) Response Plan. The goal of such clinics is to serve the most people needing vaccination in the shortest amount of time feasible. After conducting an overview of studies done on the efficiency and advantages of MVC operations, the following information is a summary of recommended Best Practices that DHS/FEMA can use in planning to carry out and accomplish President-Elect Biden's stated goal for federal government assistance to organize, and setup operations of MVCs for COVID-19 inoculations:

1. Detailed planning is necessary to maximize the efficiency and safety of MVCs.

2. MVCs have been found to have the following advantages over smaller walk-through or indoor vaccination clinics:

a. Faster throughput times. A study on MVCs in South Korea concluded they use one-third of the time to

vaccinate patients than in-hospital clinics use; Average vaccination wait time in the U.S. is 26 minutes;

b. Require less staff overall, especially with the use of preregistration;

c. Provide better physical distancing and thus reduce disease transmission risks;

d. Staying in their vehicles affords patients more convenience and comfort;

e. Better serve people with mobility challenges;

f. Can reach geographically dispersed populations and all segments of society;

g. Reduce reduce morbidity and mortality rates;

h. Allow for faster reopening of the economy.

3. Staffing Issues:

a. Separate staff is needed for Traffic Control, Check-in/Screening, Vaccine Administration, Data Entry and

Administration, Security, Safety, and Incident Command;

b. The Incident Command System organization structure and an Incident Action Plan with clear

defined roles and responsibilities should be used;

c. Training staff in advance is recommended, especially in the proper use of PPE;

d. Use vaccine personnel with previous infectious disease inoculation experience if possible;

e. Recruit volunteers from the Medical Reserve Corps, Citizen Corps, COADS, VOADS and similar volunteer

organizations for other roles. And pharmacy students, educational, vocational and contract nurses,

doctors, paramedics and trained Fire Department, National Guard, DOD and HHS DMAT personnel to

administer vaccines;

f. Medical Associations, Veterinarian Associations, and Medical Licensing Boards

can be contacted to seek their assistance in contacting their members. The same can be done at

medical and veterinarian schools;

g. States have emergency power legal ability to change regulations on who they allow to give vaccinations.

They also have legal authority to use emergency orders and standing orders. This usage should be

compatible with federal FDA Emergency Use Authorizations at federally-assisted MVCs to avoid

conflict of state and federal laws/regulations.

4. Communication Issues:

a. Use a Joint Information Center/PIOs as part of the ICS structure;

b. Use multiple channels to disseminate information to reach the widest audience possible and reduce

vaccine hesitancy:

1. Community Outreach: Faith-Based organizations, COAD/VOAD members, local newspapers, tv/ radio

PSAs and vaccine information direct mailings done in languages spoken in each targeted area;

Also use social media platforms, mass emails, text messages, phone calls, and enlist Community

Business Organizations like Chambers of Commerce and educational organizations as part of

Community Stakeholder Working Groups to encourage vaccination and reduce misinformation

being spread about the COVID-19 vaccines;

c. Use DHS/FEMA MERS and/or MCOV vehicles and staff for communications support at large MVCs.

5. Use GIS in conjunction with the Social Vulnerability Index (SVI) to map vulnerable populations when

determining where to locate MVCs.

6. Traffic Issues:

a. Locate MVCs near major roads/highways;

b. Ensure large access and exit points with multiple traffic lanes;

c. Use a space large enough for multiple vaccination lanes;

d. Use traffic control and site safety plans to reduce congestion and traffic overloads.

7. MVC sample models and flowcharts;

a. Los Angeles City Dept. of Public Health has a POD Incident Action Plan;

b. The National Association of Community Health Centers has a 2020 tool to use for MVC setup;

c. The National Association of County and City Health Officials has a drive-through POD Guide

for Special National Security Events done in 2012 that contains an organization chart sample;

d. The CDC put out a Capability 8 medical vaccination dispensing guide done in 2020;

e. DHS reviewed a study done by the Louisville School of Public Health and Information Sciences

on MVCs and asked for an updated model to include plans for both big and small vaccination sites.

DHS has the updated model using 2-10 drive-through lanes, listing the necessary length of the lanes,

staffing needed and average waiting times based on the expected traffic volume. These operational

aspects of MVCs were also based on the Bioterrorism and Epidemic Outbreak Response Model (BERM)

and Public Health use of software model RealOpt and Maxi Vac which was developed by the CDC.

Other software models include Any Logic North America stimulation software that displays full drive-

through layouts and service lane layout charts;

f. Dodger Stadium in L.A., the Jarvis Center in NYC, and the State Farm Stadium near Phoenix are all

currently in use or development as MVCs. They all have MVC plans that can be reviewed. The Jarvis

Center is planning to administer up to 25,000 vaccinations a day;

g. A company called Alaska Structures has an online guide on their website showing samples of

structures they sell for drive-through vaccination clinics and steps to open those clinics for COVID-19

vaccine administration. Their website listed their contact phone number as: 1-907-344-1565.

B.A. Mills/FEMA

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