UCHealth Develops COVID Mass-Vaccination Playbook

Vaccinating 5,000 drivers/passengers in one day against COVID-19 sounds like a tall order. However, this is precisely what Colorado’s UCHealth system has been achieving with its Denver drive-through clinics since late January. The clinics, held in the parking lot of Coors Field (home to MLB’s Colorado Rockies), are a logistical triumph: Sixteen lanes of cars flow first through vaccination tents and then to a holding area where patients are monitored for any adverse reactions before being released 15 minutes later.

As a public service to other vaccination authorities, UCHealth has compiled the detailed plans for these events in a “mass-vaccination playbook” that can be freely downloaded at www.uchealth.org/covid-19-mass-vaccination-planning.

In addition to serving as a master plan for UCHealth’s own drive-through clinics, the playbook has been written as a blueprint for other agencies wanting to stage their own mass-vaccination events. “Our goal is to fight COVID-19 and try to get all of our lives back to some sort of normal,” says Marc Scherschel, senior director of prehospital care for UCHealth. “If we can help other agencies in their efforts and they can learn from what we did, that’s all good for getting vaccine into arms and being able to move forward sooner rather than later.”

A Quick Tour

The UCHealth playbook begins by looking at organizational structure and partner involvement, explaining what roles need to be filled in organizing clinics and the partner agencies that can help. It then digs into the details of pre-event planning, including selecting the right sites, designating the on-site points of contact needed to run these events, and mapping the flow of traffic through the clinic.

Effective preplanning can avoid serious problems during these outdoor events. “Because it can get cold in Denver in January, we had planned to do the first clinic in a covered parking garage,” says Scherschel. “But a pre-event walkthrough revealed it wouldn’t support serving 32 cars at a time, which was our goal to deliver 5,000 vaccinations daily. So we put it outside in the Coors Field parking lot, where there was enough space to meet our goal.”

The UCHealth playbook’s next big focus is on contingency planning, or how to respond when unexpected issues such as extreme weather, traffic delays/accidents, or medical emergencies threaten chaos. “Stuff happens,” says Scherschel. “You need to think about what can go wrong and how you can deal with it before it does. The UCHealth playbook offers solutions for many of these potential emergencies.”

Supplies are central to the success of any mass-vaccination clinic. The UCHealth guide explains the need to create a master list of necessary supplies and the logistics personnel needed to manage them and offers detailed examples of supply/staff checklists to illustrate its points.

“When we hold mass-vaccination clinics at Coors Field, we’re pretty far removed from our brick-and-mortar facilities,” Scherschel says. “If you plan to do the same, you have to make sure you have what you need at the site, and that it’s well organized and easily accessible so you can stay on schedule.”

The UCHealth playbook then looks at patient communications, including contacting and scheduling eligible vaccination candidates, managing them effectively on site, and ensuring they have booked their second shots (if required) before driving away.

“To keep things moving, you have to tell people not to turn up early for their appointments,” says Scherschel. “They also need to be confident there will be enough vaccine for them and generally follow instructions on site—which is why we have flag people, lots of signage, and even a special AM radio station relaying prerecorded information in English and Spanish.”

Next the playbook looks at staff, provider, and agency recruitment: Who needs to do what during the clinics, and how many of them are needed in each position. “We did modeling on all of this, looking at what type of personnel is required in each area to be efficient with our throughput and provide a good experience for the patients and our staff,” Scherschel says.

This section is followed by vaccine storage and handling. This is a very big issue with COVID-19 vaccinations, given their stringent requirements for pre-use freezing and then last-minute thawing for injections. “One of our goals is not to waste a single molecule, let alone a dose, of this scarce vaccine,” says Scherschel. “This requires us to be extremely accurate in tracking people who have arrived for their appointments in real time and factoring in any no-shows so we don’t thaw doses that won’t get used.”

From here the UCHealth playbook looks at media and communications (getting the right messages out to the public), alternative flow considerations (e.g., eliminating a greeting station at the entrance that could cause traffic tie-ups), and financials (how to pay for all this). The document then provides annotated mapping of the Coors Field site flow, sample signage, clinic workflow charts, and other details.

Conclusion

All told, the UCHealth playbook provides truly useful advice and guidance to medical agencies planning mass-vaccination drive-through clinics. “It’s certainly a great model to get mass vaccinations completed,” says Scherschel. “Depending on your needs, this plan can be scaled up or down for different levels of vaccinations per day in jurisdictions with differing levels of support.”

James Careless is a freelance writer and frequent contributor to EMS World.