2009 H1N1ARKANSAS STATEWIDE RESPONSE
State of Arkansas – 52,000 sq. mi. across 75 CountiesEstimated population – 2,889,450Arkansas Department of Health is a centralized health department:
Central Office in Little Rock5 Regional Offices93 Local Health Units
Advantages
Arkansas Department of Health has conducted seasonal mass flu clinics for 7 years.
Tobacco tax funding mass clinics and school clinics
Mass Prophylaxis
Medical Supplies Management and Distribution
Emergency Public Information and Warning
Laboratory Testing
Epidemiological Surveillance and Investigation
2009 H1N1 Workgroups
Table 2‐1: 2009 H1N1 Workgroups
2009 H1N1 Workgroups
Early Vaccine Allocation
Vaccine AllocationoPregnant womenoFamilies with infants under 6 months of age
oChildren ages 5 to 18oAdults with underlying medical conditions
Major Activities TimelineApril 2009• ADH activates statewide surveillance including hospitals, physicians, schools,
daycare centers, laboratories, and health officials.• ADH did not recommend the closure of schools.May 2009• The first case of H1N1 was confirmed in Arkansas on May 8.July 2009• On Wednesday July 29, ADH confirmed that 150 cases of novel H1N1 Influenza
A cases were present in 38 of the state’s 75 counties.August 2009• On August 10, the state’s first death attributed to H1N1 was announced.• The ADH reminded the public of the 3‐Cs – Clean, Cover, and Contain• Medical supplies were shipped to Local Health Units for October vaccination
clinics.• Free hand sanitizer was distributed by ADH.
September 2009• Increasing numbers of children returning to school are diagnosed with flu.• School absenteeism began to increase during September.• Pregnant women were encouraged to seek flu vaccination.• The availability of H1N1 vaccine was limited.October 2009• New refrigeration units were purchased for installation at the local health units.• Facemasks and Flu Stop Signs were shipped to local health units for the public.• On October 6, the ADH announced that the state was to receive 17,000 of flu
mist.• Priority groups were established for vaccine administration.• The ADH announced that school vaccine clinics would begin on the 14th and
continue through December.• The ADH announced that county mass vaccination clinics would be conducted on
October 29th through 31st.
Major Activities Timeline
Major Activities TimelineNovember 2009• On November 3, the ADH reported that a total of 172,873 doses of seasonal
and H1N1 vaccine were administered during the clinics that were conducted October 29 – 31.
• A daycare vaccination program was initiated in November that continued through March 2010.
December 2009• The second round of mass flu clinics were conducted from December 7
through December 28 in all counties.January 2010• January 10 – 16, 2010, was National Influenza Vaccination Week (NIVW).• The last of school clinics was held in early January.• On January 21, the ADH announced that over 500,000 doses of H1N1 vaccine
were distributed to health care providers.• Vaccine was made available to all CDC target groups as demand for H1N1
vaccine began to decline.
Mass Flu Clinics
• Flu Updates for LHU Staff
• Coordination with other groups
• Clinic site selection and scheduling
• School‐Located Vaccination Clinics
• Targeted and Special Needs Populations
• Volunteer Recruitment
• Billing, paper work (Automation 2010)
• 178 mass flu clinics in 75 counties
Drive‐ThroughImmunization
Cleveland County Drive‐Through
Gentry School Flu Clinic – Benton County
Processing …Processing …
Nurse Volunteers
Bella Vista Nurse Volunteers
Washington County Flu Clinic at Jones Center
School Clinics
• Coordination with School Districts
• 2.5 million forms
• School Nurses
• Different approaches
• 1,100 school clinics
• Daycares other facilities (Teams)
School Flu Clinics
Bella Vista Mass Clinic Logan County Mass Clinic
Washington County Flu Clinic
Newton County Flu Clinic
Clinic Medical Supplies
• Medical supplies• Vaccine Refrigeration• Forms• Medical Waste Disposal
Quantities of Medical Supplies
Antiviral Distribution
• Chain Pharmacies• Independent pharmacies• Arkansas Association of Charitable Clinics
Public Information
• Message Coordination and Consistency
• Targeted Information
• Media Relations
• Challenges Overcome
• Speakers Bureau
• ADH Website, email, and Social Networking
• Influenza Hotline
Educational / Promotional
Educational / Promotional
Lab
• Laboratory Working Group• Increased Capacity• Influenza Samples• Testing Activities
Surveillance
• Sentinel Physicians
• Student Health Clinics
• Schools
• Day Cares
• Hospitals
• Adverse Event Monitoring
• Data Collection, analysis, and reporting
• Isolation and quarantine
Results
• Only 4 states had a higher % children immunized (ME, MA, RI, VT)
• Only 10 states had higher % immunized all persons
• 90.5% of vaccine went to high risk groups in first 7 weeks (National average 52.8%)
Total Vaccine Doses Administered by Age Group as of 11/21/2009
Age Group Arkansas Total Admin Doses as of 11/21/09
Arkansas Cumulative % of Admin Vaccine
National Total Admin Doses as of 11/21/09
National Cumulative % of Admin Vaccine
6‐23 mo 7,197 4.13% 842,458 5.7%
24‐59 mo 17,110 9.83% 1,718,372 11.62%
5‐18 yrs 133,236 76.54% 5,246,737 35.48%
Total 90.5% 52.8%
ADH Objectives Accomplished :Two mass flu vaccine clinics in each of the state’s 75 counties.Conducted 1,093 SLV clinics.A total of 258,966 doses of H1N1 and 367,612 doses of seasonal vaccine were administered by the ADH.The ADH also provided H1N1 vaccine to over 800 healthcare providers across the state.The ADH released antiviral medications distributed through chain and private pharmaciesThe success of both school and community mass flu clinics was directly related to the level of preparedness that the ADH has developed over seven years of conducting flu clinics in preparation for a pandemic event.
Bella Vista Flu Clinic