Public-health officials across Minnesota prepare to hold vaccination clinics as a line of defense against the H1N1 flu, and one county had an unusual opportunity on Tuesday to give it a dry run.
St. Paul-Ramsey's public health department held a mass vaccination drill to test its ability to quickly immunize large numbers of people.
Bruce Montgomery of St. Paul was one of about 300 volunteers who agreed to literally roll up their sleeves for mock injections. The St. Paul man was playing the role of a client seeking a flu vaccination.
But as he entered the site, Montgomery was given a card with explicit instructions suggesting he may not be the best candidate for inoculation.
"It said, 'I don't feel well,'" Montgomery said. "And if asked what's wrong, [to] reply, 'I am very weak and did not check my blood sugar today.'"
Public-health workers whisked him away to a set of tables identified as the triage center. There, nurse practitioner Margaret Patterson shuddered when she read Montgomery's paperwork that noted his fever.
Patterson's colleague, Barb Thomala, dug into her fanny pack for her phone and pretended to call for an ambulance.
Montgomery's fake fever was just one surprise thrown at public-health workers. In his case, they did everything they were supposed to do.
“Public health is really great at certain things, however, crowd management is not our expertise.”Robert Einweck, public-health preparedness manager
Montgomery said they got better with practice. He went through three rounds of the exercise, which gave volunteers who appeared to be in good health a pen mark on the arm instead of a shot.
"It's been pretty smooth," he said. "Some of the workers are unsure of what they have to do. My third time through, it's going a lot smoother."
Robert Einweck, Ramsey County's public-health preparedness manager, said the drill has taught him a lot about himself and others in his field.
"Public health is really great at certain things," Einweck said. "However, crowd management is not our expertise."
The department wanted to see if it could provide vaccine to as many as 250 people an hour. That's not something public-health workers do every day, nor do they typically operate handheld radios or babysit supplies. Throughout the day, Einweck said, some items went missing.
"Pens, clipboards, forms, that sort of thing," he said.
But Einweck said Ramsey County will be vastly more prepared for an H1N1 flu outbreak if a mass clinic is needed, yet even that is still up in the air.
While about 80 percent of counties across the state have expressed interest in holding mass vaccinations at local schools, the virus is considered so unpredictable that charting an exact course of action now may be premature.
"The problem with H1N1 is we don't know," Robert Fulton, director of the county's public health department, said.
Fulton said while the first doses of the H1N1 vaccine could arrive as early as next week, it will probably be November by the time his staff can study the demographics of the county, and figure out who should be getting the vaccine but isn't. The county is urging people to seek the immunizations at the same place they receive their seasonal flu vaccine.
Fulton said there are other challenges that are beyond the control of local public health workers. He recently heard that some people may have concerns because some of the H1N1 vaccine supply contains gelatin, which is made from animal parts.
"There may be people who believe the gelatin comes from pork, and for religious reasons, don't want to have pork [injected] into them," Fulton said. "It's an issue we're now researching whether there will be a vaccine that doesn't have gelatin in it."
Many of the volunteers who acted as vaccination clients said they were happy to help out with the effort.
Doreen Colangelo was asked to play someone extremely anxious about receiving the vaccine.
"I just basically was kind of loud and obnoxious," Colangelo said. "It was a lot of fun, but I understand the seriousness of it, and I understand everybody here has a role, and they have to practice that role. So if I could help with it that was what I wanted to do."
And for her part, Coangelo and the other volunteers will get a $10 gas card.