The Marion County Health Department in West Virginia used a mobile H1N1 vaccine clinic to reach small, rural communities across the region.
The Marion County Health Department serves a population of approximately 59,000 people, many of whom live in rural and semi-isolated areas of the county. For instance, people living in parts of western Marion County are approximately 25 to 30 miles away from the Health Department and the only major city in the county. The traveling distance, combined with snowy roads and the limited hours of vaccine clinics, made it difficult for some rural residents to access H1N1 vaccine. The health department knew that standard vaccine clinics held in local health departments, schools, and community centers were not reaching people who lived in some of the more rural hollows. The health department wanted to make sure that anyone who wanted to be vaccinated had the chance to access vaccine, said Jamie Moore, Public Health Emergency Response Coordinator for Marion County Health Department.
The health department partnered with the Office of Emergency Services (OES) to use the OES mobile command center to deliver vaccine to people who lived in remote regions. The command center operates out of a 30-foot, pull-behind trailer that was modified to meet the needs of a mobile vaccination initiative. The mobile clinic traveled to nine different locations around the county and spent approximately one to two hours administering vaccine at each site. Some communities visited by the mobile clinic had populations of fewer than 100 people, and planners would park the clinic at a central location, such as a country store or community center. Many people who wanted to be vaccinated drove to the clinic's location, and some people were even able to walk to where the clinic was parked.
Several local health department staff members were required to operate the mobile clinic successfully. Necessary staff included the OES driver of the truck and trailer, two OES staff to set up the trailer for vaccination activities, two people to register vaccine recipients, one person to direct traffic, and one to two nurses to administer the vaccine.
The mobile clinic experienced some challenges on its first day of operations, when it was late to a location due to snowy roads. People wishing to be vaccinated had already gathered at the site where the trailer was due to arrive, and health department staff had to begin vaccinations outside in the falling snow. Despite some challenges due to winter weather, the health department never canceled a mobile clinic.
Rural residents responded positively to the clinics, and health department staff vaccinated about 200 people during the approximately 10 hours that the mobile clinic spent in nine communities. Outreach and communication were key to the clinic's success, since this was the first time that Marion County had brought influenza vaccine into rural communities. The health department advertised the clinics via radio, television, and newspaper. The county also had a call-in line where the mobile clinics were advertised as vaccination locations.
Public health planners in Marion County used their knowledge of county residents' needs and geographic situation to develop a plan that would benefit the greatest number of people. Rather than deciding that certain communities had too few residents to merit the resources needed for a clinic, the health department invested in a plan that made vaccine easily available for rural residents. The county's efforts to overcome the challenge of vaccinating isolated and rural communities demonstrated respect for local living situations and dedication to assuring the health of all county residents. "Delivering high quality public health programs in a rural community presents many challenges. Success is achieved by our ability to overcome these challenges," said Lloyd White, Administrator, Marion County Health Department.
