Vaccination Report and Flu Clinic Suggestions

Jessica O’Neil

KINS-4306
 1. Introduction

There is always a risk of a disease outbreak, but they are further organized by specificity.

Outbreaks are more common than epidemics, and more so pandemics. According to the Centers

for Disease Control, an outbreak consists of a heightened rate of a communicable or chronic

disease within a limited geographical location. Epidemic defines an increase in incidence rates

of a communicable disease over a larger geographical region, and a pandemic defines an

epidemic occurring on a global scale (Section 11: Epidemic Disease Occurrence, 2012).

Outbreaks, epidemics, and pandemics are preventable with the proper health infrastructure and

education but are treated differently due to their perceived severity. For example, outbreaks of

the common flu, medically the ‘influenza virus’, regularly occur annually in different areas of the

world due to environmental conditions and due to the flu’s expected occurrence, the public is

less intimidated by the higher infection rates and commonly prepare by receiving the flu shot.

The Center for Disease Control and Prevention (CDC) identified four major pandemics since

the year 1918, however that does not include the ongoing pandemic (Centers for Disease Control

and Prevention [CDC], 2018). Coronaviruses describes a family of zoonotic agents that typically

infect only animals, however three strands of coronaviruses have moderately to severely infected

humans since 2002 (National Institute of Allergy and Infectious Diseases, 2021). Towards the

end of 2019, a novelty respiratory impairing viral agent emerged from a seafood market in

Wuhan, China before rapidly spreading over entire world through direct transmission

(Mahalmani et al., 2020). The year following the onset of the pandemic consisted of virology

advancements and a new focus on public health. This new emphasis on health allows the perfect

opportunity to increase the population’s health education and promote other forms of healthcare,

in this case flu vaccinations. Vaccinations for COVID-19 have been rapidly administered and
the new emphasis on vaccinations further increases the opportunity for increased flu

vaccinations.
 2. COVID-19 Data and Assessment
Georgia COVID-19 Cases and Deaths
Data from the Georgia Department of Health
CONFIRMED
STATEWIDE DEATHS
CASES
1/25/21 4/21/21 1/25/2021 4/21/21
GEORGIA 820,513 871,460 12,484 17,272
COUNTY
BALDWIN 3,341 3,816 85 111
BIBB 11,398 13,243 281 401
GLASCOCK 116 144 4 7
HANCOCK 743 832 51 62
JOHNSON 681 784 32 42
JONES 1,319 1,564 23 53
LAURENS 3,282 3,691 122 143
TALIAFERRO 96 100 0 3
TELFAIR 686 713 42 45
TWIGGS 455 508 22 36
WARREN 351 373 7 13
WASHINGTON 1,427 1,602 30 60
WILKINSON 645 727 21 28
Georgia COVID-19 Vaccinations Statistic
Data from the Georgia Department of Health
STATEWIDE VACCINES FULLY FULLY VACCINATED
ADMINISTERED VACCINATED PERCENTAGE
GEORGIA 5,596,431 2,263,375 22%
COUNTY
BALDWIN 18,063 8,401 19%
BIBB 60,627 28,215 18%
GLASCOCK 850 415 14%
HANCOCK 1,800 1,641 19%
JOHNSON 2,680 1,254 13%
JONES 11,069 5,946 18%
LAURENS 17,264 8,366 18%
TALIAFERRO 572 271 17%
TELFAIR 3,110 1,471 9%
TWIGGS 3,110 1,479 18%
WARREN 1,869 882 17%
WASHINGTON 6,180 2,946 14%
WILKINSON 4,282 2,039 23%
Highlighted CHCS county clinics have CHCS COVID-19 vaccination clinics.
 The data above shows that although CHCS improves vaccination rates in the counties

receiving vaccination clinics, the served counties still fall below the statewide vaccination rate.

This signs a shortage in healthcare in these areas.

3. COVID-19 Vaccination Clinics

The United States’ Food and Drug Administration (FDA), the entity that regulates

vaccinations, approved Pfizer’s BioNTech COVID-19 vaccine on December 11, 2020 and

Moderna’s COVID-19 vaccine on December 18, 2020. Although the FDA approved Pfrizer and

Moderna COVID-19 vaccines, the approval only extends to Emergency Use Authorization due

to needed continued trails for full drug approval. The Johnson & Johnson one shot vaccine

received FDA Emergency Use Authorization, but recently been paused due to concerning side

effects. Pfizer and Moderna vaccinations require two doses before full vaccination but ensure

over 90% effectivity for COVID-19 prevention and hospital admission due to the virus.

Vaccination rollout in the United States administered the Pfizer vaccination December 15th,

vaccinations beginning with those most at risk. Each state was left to formulate their own

vaccination rollout plans but received rollout recommendations from public health experts.

Georgia Governor Brain Kemp formulated a rollout plan that places healthcare workers, first

responders, law enforcement, individuals aged 65 or older and caregivers of those 65 and older.

Georgia’s vaccine rollout plan went through phases as vaccinations became more available. The

phases place those with high-risk conditions or occupations in priority phases before opening

eligibility to all adults. On March 25th, Governor Kemp opened COVID-19 vaccination eligibility

to all adults over the age of sixteen. Some states require proof of state residence upon vaccine

administration; however, Georgia had no limitations on out of state individuals receiving their

vaccine in Georgia if they met eligibility requirements.

 Beginning in January 2021, Community Health Care Systems initiated COVID-19

vaccination clinics throughout nine counties in rural Georgia. In three of the nine countries,

CHCS administered mass vaccination clinics for the district’s teachers and educational staff.

Besides the few mass vaccination clinics, CHCS utilized a drive through methodology for the

regular clinics. Each vaccine clinic location had a different outdoor setup and staff had to adjust

their methods to fit the location. Each clinic location varied slightly, but all involved the patient

remaining in their vehicle for the duration of vaccine registration, administration, and

observation period. Registration staff collected the patient paperwork and checked for any errors

on the consent form. The COVID-19 consent form, which the patient must complete upon each

dosage, includes questions on the patient’s current health and medical history. The medical

history aspect of the consent form is crucial for the nurses to identify individuals at risk for a

dangerous vaccination reaction, for individuals with a history of anaphylactic allergy reactions or

previous adverse reactions to injectable medicine. The baseline observation period is fifteen

minutes, but those with risky characteristics are observed for thirty minutes.

Community Health Care Systems administered the Moderna COVID-19 vaccine. The

Moderna vaccine requires two dosages 28 days apart and each Moderna dosage is 0.5 mL, which

is given in the patient’s preferred arm around their triceps region. The administrators of CHCS

bulk ordered the Moderna vaccine because at the time, it was the most available option in the

initial rollout. Patients are automatically scheduled at their original appointment time for their

second dosage 28 days from their first dose. Before they receive the dosage, patients must

complete the registration sign a final time. The nurses will sign and return their vaccination

record card once their final observation period is over.

4. Patient Management
 The communities that Community Health Care Systems serve are those who face

geographical and economic disparities. These communities are in rural, middle Georgia and

have limited access to general healthcare. Due to these community’s limited access to

healthcare, the population served is somewhat skeptical of care because of the unfamiliarity of

care. Vaccinations are intimidating procedures to those unfamiliar and vaccine needles normally

cause stress for those without decent exposure to it. Through CHCS administered COVID-19

vaccination clinics, a vast majority of patients expressed a general unawareness of public health

issues and concerns, leaving it up to CHCS staff to educate and empower patients during their

brief vaccination appointment.

Patient management in rural Georgia requires health education and cultural awareness. The

United States Census for 2019 shows that all counties CHCS serves face high poverty rates and

no health insurance, making it difficult for individuals in these areas to receive quality care. Not

only do these communities face economic disparities, but also socially caused disparities. A

large percentage of these populations consist of senior citizens and/or Black individuals, two

populations that the healthcare system severely neglects. The healthcare disparities faced by

CHCS communities’ results in the population’s general distrust in healthcare, however CHCS

takes the time and initiative to educate their patients and provide healthcare opportunities to all

individuals in the community, regardless of their demographics or economic status. Offering

easily accessible flu vaccination clinics encourages health in the disparaged populations and

ensures increased health protection for the entire community. Promoting community health is an

overall mission of CHCS and these vaccination clinics will bring the community together to stay

healthy.

5. Recommendations
 The COVID-19 Vaccination clinics Community Health Care Systems administers operate

based on a socially distanced model. Patients were instructed to remain in their cars throughout

the entire process, a strategy I recommend for future flu vaccination clinics. Because the flu

vaccinations clinics will not require an observation period, and long registration period, so there

will only need to be one register and one vaccination nurse per clinic. The clinic will begin at

8am and conclude around 2pm. I decided to start the clinics before 10am, so working patients

may receive their vaccine before work, or they may receive it during the lunch break. This drive

through process will be very fast and should take under ten minutes. The COVID-19

Vaccination clinics have provided more exposure and normalization of vaccinations, so it is a

perfect time to implement this clinic. These clinics will be held once a month in each of CHCS’

clinical locations and will last from October to March.

 References

Centers for Disease Control and Prevention. (2018). Pandemic Influenza: Past Pandemics.

Centers for Disease Control and Prevention, National Center for Immunization and

Respiratory Diseases (NCIRD). Retrieved from https://www.cdc.gov/flu/pandemic-

resources/basics/past-pandemics.html

Centers for Disease Control and Prevention. (2012). Principles of epidemiology in public health

practice: An introduction to applied epidemiology and biostatistics. U.S. Department of

Health and Human Services. Retrieved from

https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html#:~:text=Epidemic

%20refers%20to%20an%20increase,more%20limited%20geographic%20area.

National Institute of Allergy and Infectious Diseases. (2021). Coronaviruses. National Institutes

of Health, U.S. Department of Health and Human Services. Retrieved from

https://www.niaid.nih.gov/diseases-conditions/coronaviruses?researchers=true

Mahalmani, V. M., Mahendru, D., Semwal, A., Kaur, S., Kaur, H., Sarma, P., Prakash, A., &

Medhi, B. (2020). COVID-19 pandemic: A review based on current evidence. Indian

Journal of Pharmacology, 52(2), 117–129. https://doi.org/10.4103/ijp.IJP_310_20