The department had to rewrite its plan after the layoffs in the spring, just as the first cases of H1N1 influenza were being reported in the state.
“Much of our previous influenza pandemic planning was actually conducting mass vaccination clinics,” said department director Sherri McDonald.
In the spring, the county cut its general fund from $76 million to $70.6 million, a 7.1 percent reduction, calling for cutting about 60 positions through layoffs. Thurston County Public Health and Social Services was among the hardest hit.
The department cut about 25 positions from 125 staff members, which included people who managed the family planning program and the Women, Infants and Children nutrition program, and who provided access to medical and dental care.
The lack of vaccine generally and the county’s sudden lack of employees who are registered nurses has contributed to a change in direction, McDonald said.
“When we had a huge number of staff to lay off, because we had to cut those programs, we rewrote the plan and we’re using our existing systems of care that we know work,” McDonald said.
So far, Thurston County has received nearly 18,000 doses of vaccine, which is about 11 percent of what the county ultimately expects to have and enough to vaccinate about 7 percent of county residents.
The vaccine is available only for people at highest risk of complications, which is pregnant women, people between 2 and 25 years old, and adults with chronic illness, and for health care workers.
But unlike in Pierce and King counties, Thurston County has not held mass vaccination clinics for those target groups. Instead, in Thurston County, distribution has been through pediatricians, gynecologists and large family practices.
Several other entities have been able to deliver vaccine to target groups.
The Evergreen State College and Saint Martin’s University both held H1N1 vaccine clinics last month, representatives of the schools report.
Evergreen distributed about 100 doses of vaccine at a clinic, spokesman Jason Wettstein said.
Saint Martin’s inoculated about 92 students at a recent clinic, and its health clinic hopes to receive at least 200 more doses of the vaccine in November, said spokeswoman Genevieve Chan.
McDonald said that the county also has a corps of medically trained volunteers who can administer vaccines, should enough vaccine become available.
But based on the rate at which the vaccine has come available, pharmacies won’t start receiving H1N1 until December, she said.
The state has doled H1N1 vaccine to counties in proportion to their populations, state and county health officials have said.
Because of the vaccine shortage, it is unclear whether the county would have been able to stick to its plan even if the county had kept all its public health employees, she said.
“You need to have vaccine to hold a clinic,” McDonald.
The Union Gospel Mission plans to offer H1N1 vaccinations at its Free Clinic on Wednesday and Thursday, targeting people without insurance.
The organization will have 200 doses of the vaccine available, and it is not known whether the clinic will need more, said Union Gospel Mission executive director Skip Steffen.
“I’m highly concerned about that. I’m concerned that it isn’t going to go very far,” he said.
He said that the volunteers will put people on a waiting list and provide the vaccine to the uninsured as fast as the medical clinic can receive it.
The vaccination clinic is being organized with the help of volunteer registered nurses, who will screen those who come for services, he said.
Volunteer nurse Dawn Cutler said that local school districts and other groups that help children have also been contacted about the opportunity for the free H1N1 vaccination.
The Union Gospel Mission medical clinic, which operates with volunteer doctors, serves the chronically ill and is one of a number of programs for the homeless and low-income. Other programs include alcohol and drug recovery programs, dental and vision clinics, and delivery of about 60,000 meals a year.
The vaccination clinics are planned from 8 a.m. to noon Wednesday and 4 to 7 p.m. Thursday at Union Gospel Mission, 412 Franklin St.
