Abstract
BACKGROUND: Surge demands for annual influenza vaccines challenge healthcare systems. Mass immunizations differ from the traditional care model. The coronavirus 2019 (COVID-19) pandemic challenged current care models with amplified demand and infection risks while challenging the organization to create new and improve existing processes. METHODS: Using the Model for Improvement, the team set out to (1) safely meet a surge in vaccination demand and (2) adopt pandemic-driven innovations into routine immunization practice. RESULTS: This free-standing pediatric system delivered 87,000 COVID-19 vaccines (~1.3% state total). It administered over 50% of COVID-19 vaccines using new mass immunization processes, including 37,000 adult vaccines before pediatric authorization. In the 2021-2022 influenza season, it used the new or improved immunization processes to deliver 22% of influenza vaccines. CONCLUSIONS: Pandemic-driven adaptation for the COVID-19 vaccine substantially increased the efficiency of influenza vaccination processes but did not result in a clear increase in influenza vaccine administration rates.