IV: Discussion

June 2011

Discussion - Successes

  • Over 8000 inmates were vaccinated for pandemic H1N1 influenza in a short timeframe.
  • Cases and outbreaks were effectively addressed and controlled by CSC staff in collaboration with external partners.
  • New tools, including a clinical guidance document, health promotion materials, infection prevention and control guidelines and a surveillance system were developed and implemented.
    • Guidelines were updated regularly as information changed and daily reporting system allowed for real-time monitoring of the immunization rollout and influenza cases.
  • Multi-disciplinary approach was very important to ensure success: health group worked closely with security, human resources, operations and other sectors.

IV Discussion - Challenges

  • Vaccination Campaign:
    • Applying the priority sequencing criteria in the federal correctional environment
      • Determining priority level in the absence of an electronic health record.
  • Delivering a consistent national inmate immunization program
    • CSC operates within 8 different provincial jurisdictions.
    • Varying interpretations of PHAC’s National Sequencing Guidance by the provinces.
    • Vaccine supplies and provision of vaccine to institutions varied from province to province.
  • Cases / outbreaks:
    • Access to testing was limited in some regions
    • Resource pressures (i.e. nurses focused on H1N1, not able to keep up with other duties such as tuberculosis testing)
  • Crosscutting challenges:
    • Coordination of response efforts with multiple players, within and outside the federal government
    • Provision of timely, factual information to the field in an evolving situation, where the scientific information was still emerging
    • Lack of clear, consistent advice from different levels of government and health care organizations