Establish the purpose and goal(s) of your clinic, including target population, whether it is open to the public or only for specific 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., 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 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 prevention and control measures, based on COVID-19 community transmission
- 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; how to recognize an allergic reaction to vaccination; and what to do if a medical emergency occurs
- Vaccine ordering, storage and handling pre-clinic, during transport and 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.
Ensure adequate staff has been secured to provide the following functions:
- Provide IT support for online processes (e.g., registration, scheduling, screening).
- Provide security.
- Provide traffic monitoring for drive-through or curbside clinics.
- Monitor logistical, administrative, and financial activities to support the clinic.
- Implement infection prevention and control measures.
- Greet patients to ensure they are at the correct place and guide them as appropriate.
- Communicate with non-English-speaking patients.
- Assist people with disabilities.
- Register patients, including collecting any insurance information or fees, as appropriate.
- Screen for vaccine eligibility and contraindications and precautions.
- Direct clinic flow.
- Educate patients about the vaccine and provide vaccine information statements or emergency use authorization (EUA) fact sheets.
- Manage vaccines, including storage, handling, and transport to clinic if necessary.
- Monitor vaccine temperatures before, during, and after the clinic.
- Prepare and administer vaccine.
- Observe patients post-vaccination for syncope or allergic reaction, if applicable.
- Provide emergency medical services (e.g., CPR and management of allergic reactions).
- Report vaccines administered to the jurisdiction IIS (during or after the clinic).
An organizational chart can help establish roles and responsibilities.
Vaccination Clinic Location and Layout
Consider populations to be served, environmental conditions, individual site capability, and ability to comply with federal, state, and local guidelines 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
Consider the existing infrastructure of the location, including:
- 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 and waiting areas
- Adequate heating, cooling, and lighting
- Adequate power outlets and electrical capacity for clinic needs, including portable vaccine refrigerators and computers, if applicable
- Compliance with Americans with Disabilities Act (ADA) standards
- 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)
- Proximity to population centers and mass transit
Finally, consider the ability to accommodate for clinic layout.
It is always preferable to have vaccine(s) shipped directly to the clinic site instead of transporting them from another facility. If possible, select a location with on-site equipment that can secure and store vaccines at appropriate temperatures. 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. Transport vaccines in a stable storage unit and monitor 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 container qualified to maintain appropriate temperatures 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, EUA factsheet 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 authorize 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.