There isn’t anything quite like visiting a mass vaccination clinic.
When you park at the DuPage County Fairgrounds, the site of a new COVID-19 vaccine center, you’ll head to Building 1, a massive, echoey, hangar-like structure with a high oval ceiling and a floor that’s been painted for an indoor tennis tournament. Inside, there’s a meticulous organization at work. Chairs are arranged in a grid, six feet between each; signs point to important areas; staff in neon vests direct you from station to station.
First, you’ll check in. As long as you scheduled an appointment in advance and aren’t feeling sick, a worker will scan a QR code on your phone and let you in. Now, take a seat. A few minutes later, your name will be called, and you’ll receive a vaccine, perhaps from one of the graduating Elmhurst University nursing students who recently joined the team. After your shot, you’ll return to your seat for fifteen more minutes, to make sure you don’t experience any adverse symptoms. Then, you can leave this otherworldly bubble and get back to your day.
It’s like clockwork. If there were enough vaccines—there aren’t—this site alone could process a thousand people or more each day. In fact, the clinic is so organized, so fast, so factory-like, you almost get the sense that distributing and administering vaccines to the public is, well, easy.
“It’s not easy,” Christopher Hoff told us on a recent Zoom call. Normally, if there wasn’t a global pandemic, Chris would be introduced as the Director of Community Health Resources at the DuPage County Health Department (DCHD). Today, he is the Deputy Incident Commander. Chris oversees the DCHD’s COVID-19 response; he and his team have orchestrated everything from testing and contact tracing to communication and vaccination in DuPage. Right now, the primary focus is vaccination.
The day we spoke to Chris, DuPage had just reached a milestone: The number of residents vaccinated had surpassed the number of local COVID-19 diagnoses since the beginning of the pandemic. Since mid-December, DuPage had administered about 100,000 doses—and, as reported by local media, had vaccinated a greater percentage of its residents than any other Illinois county.
While only a small portion of the local population has been vaccinated—just shy of 3 percent, as of writing—the DCHD has built a coordinated infrastructure of providers, clinics and staff to quickly get vaccines to the residents next in line. The infrastructure is flexible; it’s designed to scale based on the volume of vaccines DuPage receives from the State of Illinois.
So far, that’s mostly meant scaling down to accommodate an extremely limited and inconsistent supply. However, in the coming months, as the State delivers more vaccines, DuPage’s distribution infrastructure will be ready to quickly scale up—reducing the time residents have to wait for vaccines and potentially saving lives.
Vaccine distribution is the art of managing uncertainty.
The DCHD doesn’t know how many vaccines they’ll receive a few weeks from now. Each week, the State tells the DCHD how many vaccines they’ll have to distribute over the next seven days (so far, the number has wavered from less than 10,000 up to 20,000). They have no idea how many vaccines they’ll have to distribute and administer until, essentially, it’s on their doorstep.
Despite the uncertainty, DuPage has managed to move vaccines quickly and efficiently. The success is largely due to a community-wide collaboration, formed of new and existing partnerships across the private and public sectors, that’s unique to the region.
The DCHD isn’t a huge agency; they have a staff of about 600. With more than 900,000 residents in DuPage County, a few hundred people couldn’t possibly vaccinate the target 80-100% of the population. While the health department of a smaller county might handle distribution on their own, it just isn’t practical in a place as large as DuPage.
“We really need those partners,” Chris said. “They all have a role to play.”
Within the pandemic response, the DCHD plays the role of coordinator. They’re the conductor, focusing on the big picture, organizing all the disparate parts, cuing organizations when it’s their turn to step up. The DCHD makes sure the right people and resources are in the right place at the right time. Nearly every week, the department meets with mayors, village managers, school superintendents, fire chiefs, police chiefs, hospital administrators, business leaders—all the stakeholders.
As the chief coordinator of DuPage County’s pandemic response, the DCHD shares tools and resources with partner organizations throughout DuPage. They hire nonmedical staff to shepherd people through vaccination sites (110 part-time staff for the fairgrounds alone). They sit down with the leaders of public schools, some of the biggest employers in the state, to answer questions and help them make key decisions. As vaccines become available, the DCHD has partnered with 96 providers across DuPage County—including hospitals, medical offices, your local Jewel, among many others—to coordinate distribution.
“These organizations and leaders have to know what they should do, what their role is. Every aspect of the pandemic response, we’ve coordinated to some extent.”
Elmhurst University is a good example. In February, 60 graduating students from the school’s nursing program joined the DuPage County vaccination team. Working with an instructor from the University, the students are learning to administer COVID-19 vaccines, monitor patients and educate community members about the vaccine.
“The students are thrilled,” said Diane Salvador, PhD, Executive Director and Professor at Elmhurst University’s Department of Nursing and Health Sciences. “They’re serving the community, learning important population health concepts, and being a part of this historic endeavor as we fight to conquer the pandemic.”
In addition to providing much-needed volunteers, the partnership helps DCHD solve a particular challenge. The process of training volunteers is often resource-intensive and logistically complex. But, with the new partnership, Elmhurst University is handling the major components of the training: providing the structure for the course, working out schedules and communicating with students. This takes a burden off DCHD.
“When we work with programs like Elmhurst University to figure out these logistical hurdles, like training personnel, it makes it ten times easier,” Chris said.
DCHD has relationships with higher education institutions throughout DuPage. In the coming months, Chris said, the DCHD’s partnership with Elmhurst University serve as a model for training additional staff.
“I think this kind of collaborative thinking is engrained in DuPage. We have all these partners in the community we can draw on, no matter what the issue is. We couldn’t execute this level of pandemic response without it.”
With all the careful planning, coordination and collaboration, why is it so many of us still can’t get a vaccine?
The problem isn’t the County’s distribution effort. If it were, that would be an easier problem to solve. The problem is the supply shortage, the gap between the volume of vaccines DuPage County is capable of distributing and the volume they receive from the State government.
Currently, there just aren’t enough vaccines. As you read this, the DCHD and their partners have the resources to distribute more than five times the volume they’re receiving from the State. (The week we spoke to Chris, they had the capacity to distribute 53,000 vaccines; they received 10,000.)
For those of us waiting for a vaccine, that’s a frustrating figure. It’s also a reason for hope. When the vaccine supply increases—and it will increase—the network of providers lead by the DuPage County Health Department is poised to quickly scale-up their operations, so they can get vaccines to residents as soon as possible.
When it’s your turn to be vaccinated, and you sit in that chair and roll up your sleeve, you probably won’t be thinking about all the time, planning, energy, resources, creativity and community-wide collaboration that went into bringing the vaccine to you. In fact, it will all look pretty ‘easy.’ And that’s kind of the point.