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Want Fries with That?

Wallis, Laura

AJN, American Journal of Nursing: October 2012 - Volume 112 - Issue 10 - p 13
doi: 10.1097/01.NAJ.0000421007.03298.b7
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Paramedic Bob Evans administers a flu vaccine to Maricela Ramos as she sits in her car at the Manheim Auto Auction in Cranberry, Pennsylvania. Photo by Keith Srakocic / Associated Press.

Charged with immunizing as many members of their communities as possible, some local hospitals and health departments have added drive-through vaccination clinics to their bag of tricks in recent years. And according to a recent report, there's every reason to believe the approach is safe.

One community that has pioneered the practice is Louisville, Kentucky, where an annual drive-through influenza vaccination program has immunized more than 50,000 people since 1995. In that time, there have been no reports of syncopal episodes (fainting) or vehicular accidents after vaccination. Recognizing the potential of this approach for mass immunization in public health emergency situations, Ruth Carrico and colleagues decided to explore the risks involved and conducted a search for reports of adverse events in other communities in the United States. Carrico is a nurse and associate professor at the School of Public Health and Information Sciences at the University of Louisville in Louisville, Kentucky.

The researchers conducted extensive searches of legal databases, MEDLINE, and risk management reports from hospitals and major medical malpractice insurers and found no reports of adverse outcomes from drive-through vaccination, even syncope, which is relatively common after vaccination among adolescents. The researchers note that although precautions must be taken to address the threat of syncope, that isn't a reason not to set up a drive-through vaccination program.

There is increasing evidence, says Carrico, “that the provision of immunization in nontraditional settings can be very safe.” At least in the case of flu, anecdotal evidence in other communities seems to back this up. Mary Pat Hastings, director of nursing at the Cape May County Health Department in Cape May, New Jersey, calls the annual drive-through flu vaccine event in her county a “lean, mean, flu machine.” She attributes the program's success and lack of negative outcomes, in part, to the aggressive marketing campaign the department conducts—distributing consent forms and press releases through newspapers, local libraries, and Web sites—which makes prescreening patients fast and easy. People know in advance what to expect, what to wear, and what might disqualify them from vaccination in a drive-through setting; for example, she says, adolescents younger than 14 aren't eligible.

Originally created to serve the elderly, the Cape May drive-through program has taken off in the community because of its sheer convenience and, like the Louisville program, now serves as a model of emergency-preparedness planning throughout the state and across the nation.

The method isn't merely fast; it also facilitates access for those with limited mobility. And keeping patients in their cars could also be a boon in the case of a community outbreak. “We might not want to pull people together inside a building and promote the spread of a respiratory illness,” says Carrico. “In cars they're segregated.”

To the nursing profession, drive-through vaccination clinics also represent an opportunity. “Nurses are increasingly finding job opportunities in nontraditional settings,” says Carrico. The skills and strengths of nurses can be employed not only in assuring the public of the safety of these approaches, she explains, but also in promoting general community preparedness.—Laura Wallis


Carrico RM, et al. J Emerg Manag. 2012;10(3):228–32
    © 2012 Lippincott Williams & Wilkins, Inc.