During the coronavirus disease (COVID-19) pandemic, mass vaccination centers became an essential element of the public health response. This drive-through mass vaccination operation was conducted in a rural, medically underserved area of the United States, employing a civilian–military partnership. Operations were conducted without traditional electronic medical record systems or Internet at the point of vaccination. Nevertheless, the mass vaccination center (MVC) achieved throughput of 500 vaccinations per hour (7200 vaccinations in 2 days), which is comparable with the performance of other models in more ideal conditions. Here, the study describes the minimum necessary resources and operational practicalities in detail required to implement a successful mass vaccination event. This has significant implications for the generalizability of our model to other rural, underserved, and international settings.

Mass vaccination campaigns have been used effectively to limit the impact of communicable disease on public health. However, the scale of the coronavirus disease (COVID-19) vaccination campaign is unprecedented. Mass vaccination sites consolidate resources and experience into a single entity and are essential to achieving community (“herd”) immunity rapidly, efficiently, and equitably. Health care systems, local and regional public health entities, emergency medical services, and private organizations can rapidly come together to solve problems and achieve success. As medical directors at several mass vaccination sites across the United States, we describe key mass vaccination site concepts, including site selection, operational models, patient flow, inventory management, staffing, technology, reporting, medical oversight, communication, and equity. Lessons learned from experience operating a diverse group of mass vaccination sites will help inform not only sites operating during the current pandemic, but also may serve as a blueprint for future outbreaks of highly infectious communicable disease.

In this study, we describe a contained measles outbreak in a London prison, the second such outbreak in a custodial setting. Once vaccination commenced, just under a third of eligible prisoners were immunised due to a low uptake of the vaccine. We conducted a root-cause analysis in order to identify factors which may have prevented or altered the course of the outbreak. Our analysis revealed that many of the factors identified are those that cannot be easily changed. It is unlikely that mass vaccination at the time, even in the absence of some of the more easily rectifiable issues, could have fully avoided further cases in the event of a mass outbreak. Both measles outbreaks in a custodial setting started with a member of staff and immunisation status of the staff were largely unknown. We argue that mass vaccination following an outbreak in a prison is unlikely to fully prevent a mass outbreak, and that implementing opt-out testing, empirical vaccination and insisting on full immunisation of staff are most likely to both prevent and contain outbreaks in the future.

The public plays an important role in controlling the spread of a virus by adopting preventive measures. This systematic literature review aimed to gain insight into public perceptions and behavioral responses to the 2009 influenza A (H1N1) pandemic, with a focus on trends over time and regional differences. We screened 5498 articles and identified 70 eligible studies from PubMed, Embase, and PsychINFO. Public misconceptions were apparent regarding modes of transmission and preventive measures. Perceptions and behaviors evolved during the pandemic. In most countries, perceived vulnerability increased, but perceived severity, anxiety, self-efficacy, and vaccination intention decreased. Improved hygienic practices and social distancing were practiced most commonly. However, vaccination acceptance remained low. Marked regional differences were noted. To prevent misconceptions, it is important that health authorities provide up-to-date information about the virus and possible preventive measures during future outbreaks. Health authorities should continuously monitor public perceptions and misconceptions. Because public perceptions and behaviors varied between countries during the pandemic, risk communication should be tailored to the specific circumstances of each country. Finally, the use of health behavior theories in studies of public perceptions and behaviors during outbreaks would greatly facilitate the development of effective public health interventions that counter the effect of an outbreak. (Disaster Med Public Health Preparedness. 2015;9:207-219)

In order to contain a measles outbreak in a German asylum-seekers' shelter, serological testing of all residents was performed, followed by selective vaccination of those with negative test results/not tested. In this paper we describe the outbreak epidemiologically and then compare the implemented strategy with a hypothetical mass vaccination of all individuals unvaccinated or with unknown vaccination status born after 1970 as recommended by the German Standing Committee on Vaccination in terms of potentially avoided cases, logistics, and costs. Three hundred (70%) residents participated in the serological testing, of which 39 (13%) were seronegative. In total, 144 individuals were eligible for vaccination, while a mass vaccination would have targeted 359 persons. However, serological testing was time- and personnel consuming and revealed several logistical problems. Its costs amounted to €90 000, double that of mass vaccination that additionally might have avoided three of the eight cases. Mass vaccination seems the preferred measure for measles outbreak control in such settings.