Mobile Immunizations Toolkit
Welcome to the Mobile Immunizations Toolkit! This toolkit is designed to help local health departments work with schools and healthcare providers to plan and host onsite immunization clinics in their schools or community. It was developed and piloted by the Spokane Regional Health District at 26 schools within 10 school districts in Spokane County.
When you are ready to start planning your immunization clinic, you will find tools here to help you do so! We’ve organized the toolkit through a series of checklists to get you organized from 6 weeks pre-event to post-event. Within each checklist, you’ll find downloadable templates and other useful documents for hosting your own school or community-based immunization clinic. Questions? Please contact us; we are here to help and to connect you with community partners who have utilized the Mobile Immunization Toolkit.
School-located vaccination programs are evidence-based, best-practice strategies that reduce out-of-pocket costs, increase vaccination rates, and increase access to immunizations that reduce morbidity and mortality related to vaccine-preventable diseases.
—Community Preventive Services Task Force
Demonstration Videos
Background
Schools and childcares in Washington State are required to collect immunization records for each enrolled child and monitor those children whose immunization records are out-of-compliance (not meeting the state immunization requirements), in conditional status, or those with an exemption. Schools have the legal authority to exclude children who have not received all of the required immunizations they are due to receive or in the event of a disease outbreak (if there is an exemption or immunity is unknown for the vaccine related to the disease outbreak).
In 2015/16 the Spokane School District (SSD), in response to the large number of students whose immunization records were out-of-compliance, informed parents that they needed to provide up-to-date immunization records or their child(ren) would be excluded from school. The SSD recognized that a proportion of these OOC students were missing or not up-to-date on required immunizations and worked with the Spokane Regional Health District to coordinate multiple free, community-wide, school-located immunization clinics for children and adults. Out of these efforts, the Mobile Immunization Toolkit was developed.
Overview
School-located vaccination events (a.k.a. SLVs, Imms-To-Go events, mobile immunization clinics) are 2-5 hour vaccination events that take place in a facility that has been “transformed” into a clinical setting capable of mass vaccination. These events can be employed with a variety of partners. Key players in Spokane have included: healthcare providers, pharmacies, local health jurisdictions, local universities and colleges, school districts, and childcare centers. The key components to making these events successful are:
- planning
- leadership buy-in
- strong communication
- creativity
- strong detail management
- partnership building and maintenance
Each participant plays a definitive role; these roles can be interchangeable and overlap at times- take a look at this document, which highlights the importance of clearly outlining roles and responsibilities at the very beginning of clinic planning. Most of the descriptions pertain to Spokane County implementation and experience, but it may be useful for communities interested in replicating this model.
Pre-Event Checklist: 6 weeks or more
Are you ready to start planning your school-located immunization clinic? We recommend that you give yourself at least 6 weeks of lead-time. See below for a checklist of what you need to do at this point in time. Click on the links for relevant documents. This week, identify your venue and start recruiting volunteers.
*Lead agency and partners can be any group (local health jurisdiction, school, or healthcare provider)
| LEAD AGENCY* | PARTNER(S)* |
|---|---|
Participate in any informational sessions/meetings with partners to obtain event approval |
Arrange and coordinate any necessary meetings/emails to obtain site administrator approval |
Ensure facility use agreements and other practice agreements have been reviewed and are current |
Ensure facility use agreements and other practice agreements have been reviewed and are current |
Coordinate site assessment date with partner |
Plan and communicate site assessment date; ensure all necessary parties can be present |
Conduct site assessment using Event Planning Checklist |
Participate in site assessment |
Email copy of checklist with action items to partner |
Follow-up on agreed action items per checklist |
Create a volunteer roster document based on event needs and email to partner |
Assist in general volunteer recruitment |
Arrange vaccinator group and associated preceptors |
Provide/review lead agency/vaccine source list of desired vaccines |
Prepare layout design and share with partner; make any additional changes |
Review layout design and provide feedback to lead agency |
Obtain out-of-compliance data from school; necessary for proper vaccine planning |
Determine out-of-compliance/immunization coverage needs among students |
Useful documents for 6 weeks or more Pre-Event
- Immunization Event Planning Checklist (organized by venue/logistics, volunteers, supplies, promotion)
- SRHD Standing Orders for Administering Vaccinations at Offsite Locations
- Point Of Dispensing Staffing Roster Template
- Sample Volunteer Position Description: Vaccinator
- Volunteer Station Assignment At-A-Glance Template
Pre-Event Checklist: 5 weeks
This week, efforts should be focused on developing marketing materials for your event and distributing them to community partners.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Develop communication plan for event marketing, including promotional flyer and social media messaging |
Review communication plan and inform lead agency of any potential issues/or site administrator approval needs |
Prepare event marketing event flyer (sample 1, sample 2, or sample 3) draft and email to partner (obtain all partner logos) |
Review event flyer and submit the print materials through the appropriate channels needed for approval and submit any changes to lead agency |
Distribute all approved marketing materials through agency Public Information Officer (PIO) and other identified sources |
Ensure all marketing materials have received necessary approval |
Prepare contingency plans for any anticipated issues at site |
Distribute flyer to all contacts and networks |
Inform lead agency of any expected/anticipated issues (i.e. conflicting venue events, protesters |
Pre-Event Checklist: 4 weeks
This week, the focus should be placed on ordering all vaccines and photocopying reference materials for your event.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Place order for any needed vaccine for event |
Participate in a planning call with lead agency to review event materials (volunteer roster, checklist action items) |
Organize a planning call with partner to review volunteer roster, checklist action items, etc. |
Follow-up on any action items |
Prepare Vaccinator Job Action Sheets (JAS) and vaccination station reference materials (immunization schedules, available vaccine list with indications, how to administer sheets are current) |
Determine which unit lead position to fulfill for the event |
Follow-up with vaccinator group and provide all training tools via email or cloud account (DropBox) |
Useful documents for 4 weeks Pre-Event
- Vaccination station reference materials
- Sample List of available childhood and adult vaccines
- Medical Management of Vaccine Reactions in Adult Patients
- Administering Vaccines: Dose, Route, Site, and Needle Size
- Diagram of Anatomic Sites for immunization
- How to administer SC and IM injections
- Instructions for Vanish Point Syringe Use
- Medical Management of Vaccine Reactions in Children and Teens
- Medical Management of Vaccine Reactions in Adult Patients
- Preparing Liquid Vaccines
- Preparing Reconstituted Vaccines
- Vaccines with Diluents: How to Use Them
- Summary of Recommendations for Adult Immunization (19 years and older)
- Immunization Schedules for children and adults
- Vaccinations for Adults with Diabetes
- Vaccinations for Adults with Heart Disease
- Vaccinations for Adults with Hepatitis C Infection
- Vaccinations for Adults with Lung Disease
- Vaccinations for Adults without a Spleen
Pre-Event Checklist: 3 weeks
This week, distribute relevant training materials to all event staff and volunteers.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Review volunteer list and recruit remaining volunteers |
Assist in volunteer recruitment as needed |
Prepare job action sheets for all staffing positions and share with partner |
Communicate any restrictions with posting event signs on walls, etc. |
Email all volunteer Job Action Sheets and associated training tools |
Continue communication plan action items |
Continue communication plan action items |
|
Schedule agency vehicle, if needed/ensure transportation for supplies |
|
Confirm that screeners have access to WA State Immunization Registry |
Pre-Event Checklist: 1-2 weeks
This week, begin assembling vaccination station supplies into travel totes and make photocopies of all necessary paperwork.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Inventory available medical/vaccine supplies and determine needs (per Clinic Checklist); order accordingly |
Ensure supplies identified on Clinic Checklist are arranged (tables, chairs, etc.) |
Schedule agency vehicle |
Review registration/consent forms and provide any edits |
Obtain general supplies (per Clinic Checklist) |
Continue communication plan action items |
Adapt Registration/Consent Forms and email to partner for review |
Identify any needs and communicate to partner for assistance |
Make copies of all needed materials (consent forms, educational materials, vaccine information sheets, staff/volunteer evaluations, vaccination station lists, etc.) |
Determine if partner will be able to provide bottled water/snacks to volunteers |
Assemble vaccination station boxes replete with station supplies |
|
Gather needed supplies into travel totes |
|
Prepare volunteer folders with lanyards/badges/vests |
|
Send check-in email to all volunteers |
|
Continue communication plan action items |
Useful documents for 1-2 weeks Pre-Event
- Sample Consent Form
- Template for Public Feedback and Evaluation Form
- Template for Offsite Clinic Staff and Volunteer Evaluation
- Sample Emergency Medical Protocol For Management of Anaphylactic Reactions
- Sample Clinical Incident Report
- Cooler/Freezer Temperature Log and Wasted Vaccine Log
- Sample Next dose due reference guide for adult vaccines
- Sample Notice of Privacy Practices
- Sample Vaccine Administered Record (for each patient child or adult)
- Language Identification Card (shown to non-English speaking clients who may need interpretation services at clinic with 27 most requested languages)
- Certificate of Immunization Status (CIS) Printing Instructions
- Patient Search Instructions for Washington Immunization Information System (WAIIS)
- Supplemental Screening Information: Info for Health Professionals about the Screening Questions for Contraindications for Children & Adults
- 1-200 labels and 201-500 labels (assignment for dispensing queue)
- List of available childhood and adult vaccine for Greeter
- After the Shots factsheet / handout for patients
- Parent Comfort Techniques handout
- Vaccine Activity Book for Children (coloring book)
- Sample volunteer packet includes: Volunteer Emergency Information Form, HIPAA Privacy Rule Acknowledgement, Oath of Confidentiality
Pre-Event Checklist: Day Before
It’s almost time for your event, and most of the hard work is already done! Today, make sure that you have arranged all traffic equipment and promotional signage and send out a confirmation email to all event staff and volunteers.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Notify EMS of event |
Identify any needs and communicate to partner for assistance |
Obtain all traffic/safety/flow equipment and event signs |
Confirm all identified site needs have been arranged or prepared (copier, laptops, printers, etc.) |
Identify any needs and communicate to partner for assistance |
Inform lead agency of any required reminders for volunteers (entrance/exit; footwear-no heels in the gymnasium) |
Confirm arrival time and check-in process for all volunteers |
|
Ensure arrangements for bottled water/snacks (either lead or partner) |
Event Checklist: Day Of
You made it! Ensure that all necessary materials are transported to the site in a timely manner.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Prepare all vaccines for transport |
Begin site set-up based on layout design, if possible; ensure tables/chairs, etc. are available |
Load all supplies into vehicle |
Assist with volunteer check-in |
Arrive 1 to 1 ½ hours prior to start time (promptly communicate any delays to partner) |
Fulfill unit lead position |
Act as Point of Dispensing (POD) supervisor |
Provide general oversight of event and inform POD supervisor of any immediate issues |
Alert/involve site contact/partner in necessary situations |
Useful documents for Day Of Event
- Offsite Imms Clinic Org Chart
- Event Set-Up and Volunteer Communication Guidance for Immunization Clinic Organizers
- Onsite Logistics Lead Just In Time Training Guide
- Language Identification Card (shown to non-English speaking clients who may need interpretation services at clinic with 27 most requested languages)
- Sample Station Guide for Mumps Outbreak Response Clinic
- Just In Time Vaccinator Group Overview
Event Checklist: Post Event
Congratulations on hosting an immunization event! Take some time to meet as a group and discuss what worked well and what could be improved upon in the future.
| LEAD AGENCY | PARTNER(S) |
|---|---|
Facilitate debrief session with partner |
Participate in debrief session with lead agency |
Complete After-Action-Report and submit to partner |
Provide any other feedback |
Send thank you email to all volunteers/site administrator |
Engage in planning talks for the next event |
Useful documents for Post Event
Resources & Literature
Download a copy of the Imms-To-Go Manual that the Spokane Regional Health District developed and what this toolkit is based on. Please email us if you have any questions.
Case Study: Spokane Clinic
Over the past several years, the Spokane Regional Health District (SRHD) has implemented the Imms-To-Go toolkit at numerous schools and has vaccinated thousands of children and adults across Spokane. The SRHD has had tremendous success with this toolkit. For example, in one school year, the Spokane School District went from an out-of-compliance rate of 24.6% to 1.6% among their kindergarteners! Similar efforts occurred with sixth graders; they started with a 46.4% out-of-compliance rate and it dropped to only 1.1%. You can download a PDF of what the clinic planning and implementation looked like at an immunization clinic hosted in 2016.
