As 2009 H1N1 influenza A vaccine became available, local health departments (LHDs) throughout Ohio rapidly ramped up immunization campaigns. In most areas, LHD employees were engaged beyond capacity to handle the logistics of planning and immunizing priority risk groups. While questions about vaccine availability, eligibility and clinic locations could be answered by static resources, including websites and recorded messages, specific questions about the vaccine and its safety, as well as the adverse events potentially linked to vaccination, required trained staff to answer calls.
For many years, the LHDs in southwest Ohio have partnered with the Cincinnati Children's Hospital Medical Center's Drug and Poison Information Center (DPIC). DPIC receives and triages after hour/weekend calls on a dedicated 1-800 Infectious Disease Call Center line from local hospitals and practitioners seeking to report communicable diseases or confer with a LHD. Staffed by health professionals (nurses, pharmacists and physicians) and available 24/7, DPIC immediately agreed to collaborate on establishing a separate 1-800 line to provide information to the public about the safety of H1N1 vaccine and receive calls from immunized persons experiencing adverse reactions.
DPIC developed scripts for answers to frequently asked questions and algorithms for collecting and responding to adverse events. Public health experts reviewed them. All LHDs used a standardized statement informing the immunized person of the vaccine safety hotline, the types of common side effects after vaccination, over-the-counter remedies that may help if side effects occur, and how to reach the hotline if the individual or parent had questions or believed an adverse reaction had occurred.
The Vaccine Safety Hotline went live on October 21, 2009. In the initial four months of operation, 590 calls of the following types were received from people in 12 of the 14 LHD jurisdictions. Adverse reaction questions and comments represented 39 percent of the calls, while 61 percent were other types of inquiries as noted below. Two-thirds of the vaccine adverse reaction calls came from individuals who had received injectable vaccine.
Vaccine Adverse Reaction (ADR): Expected minor to moderate side effects: 225
Vaccine ADR: Severe or Unexpected 5 Vaccine Adverse Events Reporting System (VAERS) report submitted. The cases, which involved different symptoms, were investigated and resolved.
Inquiry: Vaccine Availability: 71
Inquiry: Vaccine Safety Info: 167
Inquiry: Other Info: 127
Overall, both LHDs and DPIC judged the Vaccine Safety Hotline to be highly successful. Fifteen LHDs shared both the cost and benefit of the Vaccine Safety Hotline. As LHD staffs were fully engaged in planning and providing vaccinations, the use of the hotline assured that vaccine safety questions could be answered and adverse reactions reported 24/7 to professional staff trained in drug and biologic safety issues. In addition, this partnership was a natural extension and expansion of the relationship that already existed between LHDs and DPIC, which has been the after-hours and weekend Infectious Disease Reporting Call Center for the departments for the past 5 years.