“Flying a plane and building it at the same time”: Lessons learned from the dynamic implementation of mass vaccination clinics in the Region of Waterloo, Ontario, Canada

Abstract

Abstract Background Vaccination plays a critical role during pandemics, and mass vaccination clinics are often an imperative public health measure. These clinics usually consist of multi-disciplinary teams, which can pose significant coordination challenges, yet also presents an opportunity for collectively contributing toward mitigating the impact of infection within communities. This study explores the coordination dynamics of the Region of Waterloo’s Coronavirus disease of 2019 (COVID-19) mass vaccination clinics in Ontario, Canada, between July 2021 to April 2022. Methods This qualitative study included sixteen purposively selected participants working in mass vaccination clinics. Participants were individually interviewed for 40–60 minutes. An inductive and iterative thematic analysis was undertaken, including open coding, grouping, labelling, regrouping, and making sense of the themes. Results Three interrelated themes were created: (1) Unpredictable Work Environment, which comprised of changing clinic processes and the impact of clinic adjustments to the running of the clinics, (2) Clinic Cohesion Challenges, which included staff role disparities, limited job preparation and clinic system silos, and (3) Adaptable and Supportive Work Environment, which comprised of staff adaptability, dispositional flexibility, and a supportive work environment. While the first two themes created a precarious situation in the clinics, the third countered it, leading to a largely successful clinic implementation. Conclusions The rapid evolution and high transmissibility of COVID-19 in communities required a public health response that felt like flying and building a plane simultaneously—a seemingly impossible yet necessary task. However, an adaptable and supportive work environment was critical for establishing an atmosphere that can overcome challenges from a constantly changing pandemic and the guidance of public health officials. Such lessons gained from understanding the dynamic experiences in mass vaccination clinics are essential for improving the development and operation of future immunization campaigns.