Health Canada – Mass Immunization Clinics in Remote and Isolated Communities
Remote and isolated communities* require a pandemic plan that is realistic, regularly tested and updated1. Health care services in many remote and isolated communities, including mass vaccination clinics, are carried out in small to medium sized nursing stations and health centers by a small number of staff. Communities may determine that mass immunization clinics are not a suitable method for delivering the pandemic (H1N1) 2009 vaccine to their members, such as in the case of a community with a very small population. In this case, vaccine may be offered in the regular clinic setting or by appointment, at the discretion of the health care professional who will deliver these services.Persons residing in remote and isolated settings or communities have been identified as a group who should receive the first allocations of pandemic (H1N1) 2009 vaccine2. There are several reasons for this including: limited access to medical care; potential for development of mass immunity and prevention of infection; logistically easier to target the whole community; equity; high concentration of persons with chronic conditions; and the observed morbidity/mortality in some remote Aboriginal communities.
For these reasons, this document has been developed to assist remote and isolated communities across Canada develop a plan for mass immunization as an adjunct to their existing pandemic plans. Suggested operational details are provided to assist in planning and conducting mass immunization clinics. Although communities have seasonal flu clinics each year, a mass immunization clinic is different in that the number of individuals to be vaccinated will increase dramatically as the aim is to immunize the entire population with the exclusion of those with contraindications or those who do not wish to receive it. Other differences include the rapidity and urgency of immunization that will be required during a pandemic.
1.1 Goals of Mass Vaccination in Remote and Isolated Communities
The Remote and Isolated Task Group has identified the following as goals of mass immunization clinics in remote and isolated communities;
Primary Goal
a. To minimize or prevent mortality and morbidity associated to the pandemic strain of H1N1 virus.
Secondary Goals:
b. To administer the vaccine to the greatest proportion of individuals as rapidly as possible
c. To administer the vaccine in a safe and efficient manner
d. To monitor the safety and effectiveness of the immunization campaign
* Remote: describes a geographical area where a community is located over 350 km from the nearest service centre having year-round road access.
Isolated: describes a geographical area that has scheduled flights and good telephone services; however, it is without year-round road access. It is noted that not all homes in a community will have phones, and that flights may be cancelled or delayed due to weather.
The Remote and Isolated Task Group (RITG) of the Public Health Network H1N1 Task Force has been engaged in building on and adapting existing national guidelines to better ensure an effective and coordinated federal, provincial and territorial influenza pandemic response in remote and isolated communities, in the context of the H1N1 outbreak. The purpose of the task group is to review issues associated with public health response and delivery of health services in a pandemic in remote and isolated communities, and to determine what is unique to these areas, what specific planning/response activities are required, and develop guidelines in response to pandemic (H1N1) 2009.
