Establish the purpose and goal(s) of your clinic, including target population, whether it is open to the public or only for targeted groups, numbers to be served, and vaccine(s) to be offered. Once the purpose is established, identify mission-essential staffing and resources appropriate for the clinic location and size.
Leadership and Staffing
Establish a staffing plan and identify functional roles and responsibilities for each clinic. Not all functions may be necessary for all clinics. Staffing plans should be scalable to the expected number of people who will be vaccinated. In some instances, such as small clinics, a staff member may be able to perform multiple tasks. Functional roles and responsibilities for large-scale clinics (e.g., “Vote and Vaccinate” campaigns or multi-day events held at large arenas or stadiums) will require additional consideration.
Leadership Roles and Responsibilities*
Designate leaders to oversee and coordinate the following pre-clinic, clinic, and post-clinic operations and tasks (backup leaders are highly encouraged):
- Administrative functions, including requirements for data management strategies
- Emergency medical services (EMS) or other options for handling emergency situations
- Finances related to all staffing, logistics, and vaccine purchase
- Logistics during the clinic, including securing all services and material requirements of the clinic
- On-site infection control measures
- Post-clinic evaluation
- Post-clinic reporting and recording of vaccinations administered, including reporting to the jurisdiction immunization information system (IIS)
- Preordering vaccine in advance if not using an already available supply
- Public information and communication
- Identifying all staff needed for the clinic
- Security planning and implementation, including evacuation plans
- Site selection
- Training of all staff, including training clinical staff on vaccine storage, handling, and administration
- Vaccine storage and handling pre-clinic, during the clinic, and post-clinic
*Extensive planning and coordination will be necessary if there are multiple clinics at multiple sites. There should be a higher-level leadership team handling the planning for all clinics, with separate leadership at each clinic site.
During the COVID-19 pandemic, additional staff may be needed to:
- Help enforce physical distancing measures.
- Clean the facility frequently.
- Provide IT support for online processes, including registration, scheduling, screening for eligibility, contraindications, and precautions, obtaining insurance information, providing vaccine information statements or emergency use authorization (EUA) forms, etc. This process can help avoid repeated use of materials (such as pens and keyboards) and cut down the time a patient is in the clinic.
Ensure adequate staff has been secured to provide the following functions:
- Administer vaccine (staff must be licensed to provide vaccine within the jurisdiction).
- Communicate with non-English-speaking patients.
- Direct clinic flow.
- Educate patients about the vaccine.
- Greet patients to ensure they are at the correct place and to guide them as appropriate.
- Implement infection control measures.
- Monitor logistical, administrative, and financial activities to support the clinic, including any IT needs.
- Monitor vaccine temperatures before, during, and after the clinic.
- Provide emergency medical services.
- Provide security.
- Provide traffic monitoring for drive-through or curbside clinics.
- Register patients, including collecting any insurance information or fees, as appropriate.
- Report vaccines administered to the jurisdiction IIS (during or after the clinic).
- Screen for vaccine eligibility and contraindications and precautions.
- Manage vaccines, including storage, handling and transport to clinic if necessary. Secure and safely transport vaccines to the clinic.
An organizational chart can help establish roles and responsibilities.
Vaccination Clinic Location and Layout
Satellite, temporary, or off-site locations must consider federal, state, and local guidance when establishing measures to protect clinic staff and clients from the virus that causes COVID-19. Regardless of the site type (i.e., walk-through, curbside, drive-through, or mobile clinic), temporary locations must have sufficient capability to accommodate physical distancing, inventory management, and appropriate personal protective equipment (PPE) for staff and face coverings for patients.
Clinic locations and processes that were successful in previous years might not be appropriate during the COVID-19 pandemic because of the need for enhanced safety precautions. Even if the same space is used, it will likely need to be set up and function differently because of COVID-19 requirements.
Consider conducting appointment-only temporary clinics held in schools, churches, and pharmacies. Smaller clinics can be laid out more efficiently and serve fewer people to help reduce exposure risk for staff and patients. Large-scale clinics, particularly those held indoors, may not be feasible during the COVID-19 pandemic because they might be difficult to implement under federal, state, and local guidance for physical distancing. Curbside and drive-through clinics may provide the best option for staff and patient safety during the COVID-19 pandemic.
For walk-through clinics, it’s important to establish line queues that maintain separation between individuals or to ask individuals to wait in their vehicles or another location until called. Clinic flow should be one way. individual sites will have benefits and limitations and that site assessments will be required prior to use.
Consider using online or phone options for scheduling appointments and completing paperwork, when possible. Such processes should include registration, obtaining insurance information, and billing (if needed), screening for contraindications and precautions, and texting or emailing vaccine information statements (VISs) or emergency use authorization (EUA) forms.
Consider populations to be served, environmental conditions, and individual site capability when selecting the type of clinic to offer:
- Indoor clinic such as one in a school, church, auditorium, theater, pharmacy, or inside a medical facility in a hallway, classroom, or cafeteria
- Curbside or drive-through clinic
- Outdoor walk-through clinic or clinic in an outdoor tent outside a medical facility
- Mobile clinic
In choosing the site type, also consider:
- Ability to accommodate weather if it is a walk-through, curbside, drive-through, or mobile clinic
- Ability to maintain appropriate vaccine cold chain, storage and monitoring, as well as ability to resupply as needed
- Accessible restrooms
- Accessible waiting areas, if applicable
- Adequate entry and exit points, including the one-way clinic flow
- Adequate heating and cooling
- Adequate lighting
- Capacity to adhere to infection prevention, equipment specifications, and public safety regulation requirements and protocols
- Compliance with Americans with Disabilities Act (ADA) standards, along with ease of accessibility by the elderly and those with disabilities and mobility issues
- Data collection and management strategy based on site capability (manual processes must be planned for temporary sites lacking specific infrastructure)
- Internet access
- Access to vaccination history (if applicable)
- Reporting to an IIS or electronic health record (EHR)
- Enough power outlets and electrical capacity for clinic needs, including portable vaccine refrigerators and computers, if applicable
- Proximity to population centers and mass transit
- Space for clinic functions such as screening, registration, vaccine storage and preparation, vaccination, waiting areas to monitor for adverse reactions after vaccination, and emergency care
- Traffic flow, parking, entry/exit, and line queue
It is always preferable to have vaccine(s) shipped directly to the clinic site instead of transporting them from another facility. Therefore, if possible, select a location with on-site equipment that can secure and store vaccines at appropriate temperatures. Plans must be in place to ensure staff can check the shipment immediately upon arrival to ensure there has been no temperature excursion, place the vaccines in storage unit(s), and regularly monitor vaccine temperatures.
If direct shipment is not possible, plans must be made to ensure vaccines can be handled safely and the cold chain can be maintained during transport and throughout the clinic workday. Vaccine can be transported in a stable storage unit and monitored with an approved temperature monitoring device. If the facility doesn’t have the capacity to refrigerate the vaccine on arrival, then a portable vaccine storage unit or qualified container and packout may be used along with a digital data logger.
Regardless of whether vaccines are delivered to the site or transported there, plans must include regular monitoring of vaccine temperature before, during, and after the clinic.
Vaccines cannot be administered if they are not kept at appropriate temperatures based on information in manufacturer package insert and CDC guidance.
Specific guidance can be found in CDC’s Vaccine Storage and Handling Toolkit.
Coordinate with Government, Nonprofit, and Private Sector Partners
Government entities, including state and local immunization programs and state and local public health preparedness programs, as well as other nonprofit and private sector organizations can assist with your plans.
For example, your local or state immunization program can provide information about:
- Underserved areas and populations
- The Vaccines for Children (VFC) program and how it functions related to temporary vaccination clinics
- Possible options for government-funded vaccine for adults
- Your jurisdiction’s IIS for reporting vaccination or regulations about providing information to a patient’s primary care provider
- Additional legal and regulatory requirements, including the requirement for standing orders to vaccinate
State and local preparedness programs can provide expertise on:
- Budget support
- Clinic flow charts
- Coordination with the jurisdictional emergency management agency
- Floor maps
- Inventory management strategies
- Job action sheets
- Organizational and incident management structures
- Transportation, law enforcement, and EMS coordination
- Volunteer coordination and management strategies
Always check with your immunization program for specific requirements on how vaccines should be delivered, stored, monitored, and documented.
These programs and organizations can assist in promoting your event and may be able to assist with staffing and other resources. Depending on the support offered, you may wish to have formal agreements with partner organizations.
Standing orders pdf iconexternal iconauthorize licensed nurses and pharmacists, where allowed by state law, to administer vaccines according to an institution- or physician-approved protocol without the need for a physician’s examination or direct order. If standing orders related to vaccination and emergency medical care will be used, check with your state immunization program to ensure you have met any state requirements, and obtain a signed standing orders document.