Multistate Hepatitis A Outbreak: Vaccination of Food Service Workers as Part of the Kentucky Outbreak Response

Background: In August 2017, a local outbreak of Hepatitis A was identified among homeless individuals in Louisville, Kentucky. This marked the first cases in what has now become recognized as the largest Hepatitis A outbreak in the US. When infection was identified in a Food Service Worker (FSW), vaccination efforts were expanded to target this group. Objective: The purpose of this study was to describe: 1) the processes used to provide access to Hepatitis A vaccine for FSWs, 2) results from the immunization activities, and 3) lessons learned from the outcomes. Methods: Through a partnership between the Louisville Metro Department of Public Health and Wellness (LMDPHW) and the University of Louisville Division of Infectious Diseases, a novel approach to vaccination was implemented. Access to vaccine was provided via on-site immunization in 66 restaurants and subsequent availability in a pop-up vaccination clinic. Data were collected using the LMDPHW data collection form and included demographics, risk factors for Hepatitis A, and vaccine documentation. Results for those vaccinated March-December 2018 were analyzed using descriptive statistics. Results: On-site vaccination was provided to 1337 FSW at 66 restaurants during the seven (7) week period from March 28-May 15, 2018. This process involved a team of 42 including Advanced Practice Registered Nurses, Registered and Licensed Practical Nurses, Physicians, and UL team members. During the 35 weeks the walk-in clinic has been in operation (May 16-December 31, 2018), 3068 additional FSW were vaccinated for a total of 4405 FSWs vaccinated as part of the outbreak response. Critical partners included the Kentucky Restaurant Association and the Kentucky Nurses Association. Conclusions: This study demonstrated a successful model for vaccination of a novel population during an infectious disease outbreak and the importance of expanding partnership networks to ensure success. The outcomes emphasized the importance of the resources available in the academic community for reliable and consistent public health emergency response

Implementation of a Drive-Through COVID-19 Mass Vaccination Site: Experiences from LouVax–Broadbent in Louisville, Kentucky

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination. Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked four-hour shifts, and training sessions were held at the beginning of every shift. Training included three overarching goals with associated procedures: to protect the vaccine supply, protect the individuals being vaccinated, and protect the healthcare workforce during a 17-week large-scale community drive-through vaccination campaign. Results: Between January 4, 2021, and April 28, 2021, LouVax–Broadbent was open for operation for 82 days. A total of 109,529 doses of COVID-19 vaccine were administered at LouVax–Broadbent; 2,561 volunteers served the community at LouVax–Broadbent, yielding approximately 81,200 volunteer hours. Three needlestick injuries were reported, all of which occurred during safety device activation. Procedures that served to protect the vaccine resulted in a waste of 132 (0.12%) of the 109,529 prepared doses. Conclusions: Vaccination rate outcomes at LouVax–Broadbent demonstrated an ability to engage, train, and safely implement a large and dedicated group of volunteer healthcare and non-healthcare workers as part of a large-scale community mass COVID-19 drive-through vaccination event