The Vermilion County Health Department was established in 1966.  Vermilion County is located in east-central Illinois.  We are a border county with the state of Indiana and are a central hub for St. Louis, Chicago, and Indianapolis.  According to the 2020 census, the population of Vermilion County is 74,188.  Vermilion County is a mainly rural population, with Danville, as its main metropolitan area with a population of 31,246 (estimation for 2019).  Vermilion County's population is 82% White, 14% Black/African American, 0.9% Asian, and 5% Hispanic.  Poverty rates for residents of Vermilion County are at 16.8% with a rate of 27% for children.  Vermilion County has a higher population for those with disabilities and individuals over the age of 65.  Over 50% of adults in Vermilion County have an underlying health condition that is more susceptible to COVID19.  Vermilion County ranks in the bottom 25% quartile for health outcomes according to the County Health Rankings.  In 2019, we were ranked 102 out of 102 counties.  Getting the people of Vermilion County to be proactive in their health has always been a challenge among all walks of life.  

The Vermilion County Health Department (VCHD) recognized the need for a larger venue to implement our COVID19 Vaccination Clinics.   Being that the observation piece was a barrier due to a large space needed, it was important to have a place that was centralized in the county and a location that was easy to access.  A partnership with the historical Fischer Theatre was established and clinics were scheduled for once a week.  Volunteers from local nursing schools, Fischer Theatre volunteers, Medical Reserve Corps, and VCHD staff came together to reach a more diverse and larger group.  The Fischer Theatre is located in the heart of Downtown Danville.

The goal of the clinic and changing the location to a less conventional venue was to entice more residents to receive their vaccination and make the process less intimidating and more inviting.  The objective was to also find a location that was centralized in the county due to the lower number of staff and volunteers that were available.  

Meetings were held with Fischer staff and VCHD staff to plan and strategize the clinic.  A total of 10 clinics were held at the Fischer Theatre where we vaccinated over 4,000 individuals.  At the time we began the clinics at the Fischer Theatre, we could have served far more, but were limited in our supply of vaccine.  We continued to do clinics at the Fischer Theatre until the Illinois National Guard were stationed in Vermilion County in March of 2021.     The clinics were a huge success with only minor blips along the way, consistent with any new locations and procedures.  The overall feedback from clients was extremely positive and many were disappointed when we moved clinics back to other locations.  

The Vermilion County Health Department was highly affected by COVID19.  We have a staff of less than 30 and at the time we began vaccinating for COVID19, only 7 nurses.  The skepticism of the vaccines were great in Vermilion County and we began our clinics at our facility with our first phase of healthcare workers.  The uptake of vaccinations, even with healthcare, was very low.  Once we moved to other phases, it grew somewhat and we ran out of room at our facility due to the observation station being too small.  We tried to think of where we could go that would entice people to come and have enough room for the observation piece.  During H1N1, we used community centers, school gyms, and other locations, but some of our normal PODS didn't have enough room for observation with the numbers we needed.  Also in 2009, we had a staff of over 70 people, including 30 plus nurses.   An idea was raised about our community's newly renovated non-for profit theatre that had shuttered its doors due to COVID19 and was now sitting empty.  The Fischer Theatre was a great location for vaccinations.  We knew we could serve larger numbers and definitely entice our older population to come and receive their vaccinations.  Vermilion County has a higher percentage of individuals over 65, individuals with disabilities, and those living with poverty.  Access to the local mass transit station is a block away from the theatre and there are multiple agencies downtown that already serve many of our community who are experiencing poverty.  VCHD felt this location would provide access to many walks of life including many of the underserved.  

This new resource also brought way to expanding our volunteer pool as the Fischer Theatre has a pool of volunteers that we were able to utilize in non-medical capacities.  Most of our current volunteers were nurses or in the medical field, so being able to staff observers, greeters, etc. was going to be a challenge while still trying do our daily functions as a health department. Many of the current volunteers that we utilized in previous years were older, retired individuals, who were also at the most risk of severe illness from COVID19.  We didn’t want to put them at risk,  so we tried to think outside the box to make it as safe as possible.   Utilizing the Fischer Theatre volunteers was a critical addition to make the flow of the clinics successful.  The volunteers also felt a sense of pride to be able to help during what will be a historical pandemic that will be remembered in the years to come.   

What was a huge selling point is that the Fisher Theatre showed movies the whole time the clinic was running.  The clients would come into the theatre and receive their vaccination in the lobby and then proceed to the theatre area and sit and watch a movie during their observation time.  This encouraged people to stay their 15-30 minute wait and we were able to observe them safely.  Each person was given an egg timer with their allotted time to stay and be monitored and so they didn't stay all day.   Many of the older clients who came in were excited not only about receiving their vaccine, but also were excited to come back to a theatre that they remembered as a child.  Not only did this help us, but helped with the morale of our clients and community.  Many were also amazed to be able to come into the theatre for the first time.  As we planned the logistics of using the theatre in early January 2021, it was definitely a unique practice that we didn't find much to compare and gleen from other lessons learned from past experiences.  Thus, we learned along the way and really improved our flow plans, which will pave the way for future mass vaccinations clinics.  

Because of our limited staff and volunteers, the theatre location worked well as many different agencies bussed their clients to us.   The location of the theatre was very helpful in that it was close to the Danville Mass Transit Terminal, so people could easily access this location.  The theatre is also close to other downtown businesses/agencies that serve lower income individuals.  There is a women’s shelter that is a couple blocks away and we were able to reach out to them and we had multiple buses come to the theatre location who served those with disabilities.  They were able to get vaccinated and could then relax after watching a movie.  For most of them, it was the first time being in the Fischer Theatre.   The experience helped with some of the anxieties by the awe of the location.  

In the past pandemics, specifically H1N1.  It was easy to get people in and out for vaccinations.  COVID19 was a new challenge in that people were required to be observed for 15-30 minutes.  Utilizing the theatre really helped as we had a large area for people to sit, be socially distanced, and relax after their vaccination.  Our community was slow to want the vaccine for COVID19 and is still to this day, but we felt this was a good kick-off to get those who were vulnerable and a little apprehensive to receive their vaccines.

A great deal of planning went into the clinics at the Fischer Theatre and took a great deal of partnerships.  Some partnerships had already been solidified over the years due to the ongoing Emergency Planning and Response Department at the Vermilion County Health Department.  Some of these partnerships included our Student Nurse Program.  The Vermilion County Health Department has a long history of being a clinical location for multiple Nursing Programs in East Central Illinois, including Lakeview College of Nursing, University of Illinois Chicago College of Nursing at the Urbana Campus, and thf Danville Area Community College Nursing Program.  Lakeview and UIC, specifically, assist in our annual flu vaccine clinics and in 2021, our COVID19 vaccination clinics.  This partnership was enhanced as more students were utilized than during a normal semester as most other clinical locations had been cancelled.  

Vermilion County Health Department was able to utilize its small Medical Reserve Corps to assist in vaccinations as well.  The Medical Reserve also saw a rise in volunteers and many assisted at the clinics at the theatre.  

A new partnership that was developed during these clinics was the utilization of the Fischer Theatre's staff and volunteers.  While not medical, their volunteers were an intrical part of the clinics assisting as runners, greeters, observers, and other areas.  The Fischer Theatre staff were a critical part of the planning and implementation process since this was a new type of setting for a vaccination clinic.  The Fischer Theatre is a non-for profit organization and they were happy to be able to offer their location as a way to also give back to the community.    

Other partners that helped with the planning and implementation process were the Vermilion County Emergency Management Agency, Danville Police Department, OSF Pro Ambulance, and eventually the Illinois National Guard.  

VCHD was able to work with area agencies that served our most vulnerable populations to help them sign up for the clinics and make travel accommodations.  

While the clinics were successful and we were able to reach many of our population with underlying health conditions, disabilities, and minorities, it still had its challenges.  Because of the lower supplies of vaccine that we had, we had to limit the number of people who could get in during the clinics.  We also had challenges with people coming too early or showing up with no appointment at all which caused some flow and social distancing issues, but we were able to adapt by bringing in more vaccinators that we had on call and relying on our Fischer Theatre staff and volunteers who were accustomed to large crowds and how to create order during chaos.  

We would have liked to have seen more diversity at these clinics, and this is still a challenge 20 months into the pandemic.  When the Illinois National Guard came to Vermilion County in March, we felt it was necessary to not only hold clinics at the Fischer Theatre, but to branch out to other areas including drive throughs and focusing on specific populations.  Vaccination clinics ceased at the Fischer Theatre on April 8th, 2021.    However, our highest number of vaccinations per clinic still remains at the Fischer Theatre.  We learned to fine tune our flow plans at the theatre, we developed lasting relationships with many agencies, and it was an experience that has taught us what works and definitely what does not.  Even at other locations, we have utilized the general flow plans that we used at the theatre.  While the Fischer Theatre has reopened to the public with movies, concerts, and more, we have an open invitation to come back and do clinics in the future when the need is there.