My experience prior to medical school helped prepare me for taking a lead on the Tdap vaccination drive. Before I came to medical school, I was a Peace Corps Volunteer, assigned as an American community health volunteer in Senegal. During this time, I assisted with the Meningitis A vaccination campaign, which occurred each year before the harmattan rolled in. I attended the Matam regional doctor’s careful training, traveled with the Senegalese nurses and their carefully-guarded cold chain, and supported their meticulous adherence to protocols. 

 

Fast-forward to medical school where Dr. John Luk, Assistant Dean of Interprofessional Integration, introduced our Interprofessional Practice and Education (IPE) class to the 2017 Austin Public Health Critical Health Indicators report. What I found as I casually flipped to the section on vaccine-preventable disease surprised me. The map showed a disproportionate incidence of whooping cough occurring in low-income, working-class neighborhoods; areas where English is just one of multiple languages that people speak with varying degrees of proficiency; areas where people tend to face barriers to access health care. I wanted to do something about this problem and I envisioned another vaccination campaign – this time, not a global endeavor with international NGO funding, but local, with our own neighbors.

 

At the time, Dell Medical School’s free student-run clinic for the homeless (CD Doyle Clinic) received monthly visits from the nurses of the Austin Public Health Adult Outreach Unit. They were enthusiastic, busy people who donated their Sunday afternoons once a month to spend time vaccinating the homeless. However, their service is in high demand and they had other pressures on their time. They had to leave us after a few months, but they left us with love and guidance, and showed us a path to build a vaccination team that would (hopefully) one day work with them again.  

 

Motivated to address the disproportionate numbers of whooping cough, I applied for a grant from the Texas Medical Association – a Be Wise Local Impact Grant – to fund free vaccination clinics for Tdap shots in the spring and influenza shots in the fall. My grant application was successful; however, after a quick survey of my medical colleagues, nobody was trained in giving vaccinations, nor formally trained to draw blood. The obvious places to look were the School of Nursing and the College of Pharmacy, where our colleagues were routinely trained to administer vaccines. Through this process, I was lucky enough to meet our impassioned vaccination advocate, Sharon Rush with the College of Pharmacy. Professor Rush teaches pharmacy students to give vaccinations and works with University Health Services on the annual flu shot clinics. Her students were organized, but lacked funding; I had funding and desperately needed some organization. A solution was found as Professor Rush helped us – especially Ben Wroblewski, Ife Shoyombo, and Thomas Varkey – to design a class to train medical students on the Tdap vaccine, including practical administration. Dr. Whitney Keller, Assistant Professor in Women’s Heath at Dell Medical School, supervised the event and provided invaluable mentorship.

Sixteen medical students signed up for our vaccination training class, completing hours of CDC modules on top of their already-packed calendars. Of those sixteen, more than half still needed to get BLS training and willingly added that training to their grueling schedules. Deanna Baker from the School of Nursing worked with us to set a time that worked for all of us and it was a really great experience.

 

We selected to host our Tdap vaccination drives at the Gus Garcia Recreation Center located at 1201 Rundberg Lane in East Austin, as this location was near the population we were hoping to reach. The recreation staff suggested we co-host with El Mundo Newspaper which was hosting “Festival de los Niños,” and with Austin Public Health Equities Unit which was hosting “Fiesta de Salud.” So I reached out to the respective points of contact, introduced the Tdap vaccination campaign, and successfully coordinated to be at the recreation center for four consecutive Saturdays in April. 

 

We were told to expect many participants who do not speak English as a first language and, in particular, who speak primarily Spanish, Chinese, Vietnamese, Korean, or Arabic. We got English and Spanish educational material from the Texas Medical Association and the Department of State Health Services to help bridge communications gaps. We got vaccination cards from the Immunization Action Coalition and established a partnership with Austin Public Health to facilitate Texas Immunization Registry applications in English and Spanish as well.  At the May 4 event, Austin Public Health had interpreters present for multiple languages. Some of our medical students (including Ben Wroblewski, Julia Taylor, and Kayli Kallina) have excellent Spanish language skills. When we didn’t have colleagues who were skilled in a language, people’s kids would often try to help their parents talk with us.

 

With a combination of the TMA grant and Student Affairs funding, we were able to purchase epinephrine, diphenhydramine, Tdap vaccine, pre-orders of influenza vaccine, syringes, and the other peripheral supplies needed to give vaccinations. Pharmacy students from Operation Immunization came out to educate at first and then, when they got their own training, they came to give vaccines as well.

 

We had no idea what to expect in terms of turnout. The recreation center staff told us that we might see thousands of people each weekend we were planning to be there. We coordinated 4 drives and administered a total of 16 vaccines, a far cry from the hundreds I’d envisioned needing. However, connecting with individuals who otherwise might not be able to get the vaccine made it very rewarding. As one participant said, “We’ve got a new baby grandchild, our son asked us to get the Tdap shot to protect him from whooping cough. The shot is so expensive – we saw you on the news, and we’re glad that you’re giving these shots for free.” 

We learned quite a lot along the way, got great experience with giving vaccinations, and enjoyed time spent with people in the community. Further, this experience truly illuminated the importance of having an interprofessional team (defined by two or more health professions) work together to address a public health issue. We keep in touch with our pharmacy colleagues from Operation Immunization, including Any Jivan, Emily Allen, Kelsie Ellis, and Liem Do. As we continue to expand our vaccination program, we’re going to continue to collaborate at the student-run clinic and on future vaccination initiatives. 

 

Thanks to the collaborative, interprofessional efforts of medical and pharmacy students, as well as nursing professionals from the Austin Public Health Adult Outreach Unit, our inaugural Tdap vaccination campaign in the Rundberg community was successful in bridging UT and the community, as well as setting the groundwork for future vaccination drives. For next steps, we’re looking at securing more funding to build out a full roster of vaccines. We received feedback that the community would like for us to provide more vaccination options, including the shingles vaccine (especially given the current shortage), HPV vaccines, flu vaccines, pneumonia vaccines, hepatitis vaccines, and vaccines for kids. We would also like to bring in our colleagues from the nursing public health program. Professional nurses have been incredibly helpful to us and I believe our interests are well-aligned with the nursing public health program as we share a passion for serving our community and facilitating the health of all people in Travis County. Leveraging the strengths of other health professions will make these vaccination drives more effective and comprehensive. 

 

We’re building this program one step at a time, and we deeply appreciate the collaborations across health professions that have brought us to this point.