MRC members celebrate in Westford, after supporting their first emergency flu and pneumonia clinic.

The nationwide shortage of influenza vaccine during the fall of 2004 caused varying levels of distress among vulnerable populations. When the state of Massachusetts distributed an extra supply of doses in November, local public health agencies were eager to set up additional flu clinics right away. However, many needed help to respond quickly.

The seven communities in the Upper Merrimack Valley support over a quarter million residents. Four of those towns - Westford, Chelmsford, Tewksbury, and Tyngsboro - requested support from the MRC for emergency clinics.

MRC member Carol Devanney prepares paperwork for staffing the Tyngsboro flu clinic.

The result was a perfect example of the MRC's ability to offer "surge capacity." Although many towns have an existing cadre of nurses that are called upon for clinics, the urgency for offering vaccinations meant that some of those nurses wouldn't be available to support the clinics on short notice. Furthermore, MRC volunteers who provided additional capabilities (such as people movers and screeners) were able to make a big difference in the quality of response.

Nurses preparing syringes in Westford.

Judy Dunigan, Public Health Nurse for the Town of Chelmsford, saw the value of an MRC's quick response. "The lack of flu vaccine, and delays from the state in letting us know when we could hold our clinics, meant that we had to notify our usual group of nurses by a late date," said Dunigan. "We benefited by drawing from the MRC to staff our clinic."

Judy Dunigan draws vaccines for the Chelmsford clinic.

The biggest challenge was to engage the right people from a large contingent of new members. Recruits had joined from all seven communities in the region, to serve in many crucial categories: nurses, dentists, EMTs, pharmacists, nurse-practitioners, non-medical support personnel, and other specialties. The roster was increased even further with additional applications, which arrived from other sources.

David Eberiel, Ph.D, trains Sue Johola, RN to take over his shift of phone screening and registration for the Tewksbury deployment.

Members were invited to deploy through personal phone calls. Although the MRC had trained its first members only recently, the requirements for this deployment and skills of its recruits allowed the unit to respond effectively.

Sue Rosa served at two clinics, handling paperwork in Westford and administering vaccine in Chelmsford.

This deployment proved to be an ideal way of testing the unit's early standard operating procedures. Even better, members were able to participate in a deployment where the levels of stress, severity, and urgency were minimal. Members appreciated the chance to sharpen their skills and work together as a unit, in a relatively low-key environment.

Carol Devanney (left), with Sheila Perrault and Nancy Dowling-Meehan: Three Tyngsboro BOH members who are also RNs, staffing their town's clinic. Devanney and Dowling-Meehan joined the MRC in September

Because these members were known and trained in advance, they could be deployed with assurance that each person could serve well in this kind of public health emergency. Their roles included screening and registering patients at a phone bank, handling patient intake at the clinics, directing patients to their seats for inoculations, drawing syringes, delivering medications, and answering each patient's questions.

MRC Director Sandy Collins provides final instructions to members before the clinic opens.

Many of the phone registrations demanded significant diplomacy. Although a flow chart determined who could receive shots, some callers didn't agree with the criteria set forth by the state of Massachusetts. Don Delikat recalled, "We had to handle some callers with kid gloves, because they were so anxious. But we were glad to alleviate the duties of the health department." Furthermore, he added, "We used our expertise to help people, and I made a professional contact."

Donald Delikat, an industrial hygienist who had served at Ground Zero, screened registrations in Tewksbury.

Tom Carbone, director of the Tewksbury Board of Health, appreciated the MRC's involvement. "We are grateful for all the help these people have provided, because we couldn't have done it without them," said Carbone.

Donna Harrill was relieved to dust off her skills and get to know her fellow members in a calm atmosphere. A retired RN, she gained confidence in her ability to respond to public health emergencies. "It helped that I wasn't pushed into a crazy disaster situation right away," said Harrill. "We had plenty of time to get ready, and got to know some of our fellow members." Even more important, she explained, "I hadn't given a shot in 40 years! You don't forget, but it helps to brush up and be ready for the next deployment. I feel really comfortable about it now."

Donna Harrill, who refreshed her skills at two clinics in the deployment, started by helping with set-up procedures.

Some members had never staffed a vaccination clinic, and were eager to experience this type of event hands-on. The MRC director had run many similar clinics, so members were able to learn the ropes from a highly capable and seasoned organizer.

Linda McCarthy shares a light moment with a "brave" patient at the Westford clinic.

Each of the members who participated had rather glowing feedback afterwards. This initiative also made the need for a regional MRC feel much more tangible - for the community as well as the MRC's membership.