On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event.

The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis.

Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response.

The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience. (Disaster Med Public Health Preparedness. 2013;0:1-14)

Developing and implementing effective strategies to increase influenza vaccination rates among health care personnel is an ongoing challenge, especially during a pandemic. We used participatory action research (PAR) methodology to identify targeted vaccination interventions that could potentially improve vaccine uptake in a medical center.

Front-line medical center personnel were recruited to participate in 2 PAR teams (clinical and nonclinical staff). Data from a recent medical center survey on barriers and facilitators to influenza (seasonal, pandemic, and combination) vaccine uptake were reviewed, and strategies to increase vaccination rates among medical center personnel were identified.

Feasible, creative, and low-cost interventions were identified, including organizational strategies that differed from investigator-identified interventions. The recommended strategies also differed by team. The nonclinical team suggested programs focused on dispelling vaccination-related myths, and the clinical team suggested campaigns emphasizing the importance of vaccination to protect patients.

PAR methodology was useful to identify innovative and targeted recommendations for increasing vaccine uptake. By involving representative front-line workers, PAR may help medical centers improve influenza vaccination rates across all work groups. (Disaster Med Public Health Preparedness. 2013;0:1–7)

An influenza pandemic may demand that a large number of influenza immunizations be rapidly given with limited resources. This study tested the utility and practicality of self-immunization with live attenuated influenza intranasal vaccine in a mass vaccination event.

The self-immunization clinic model was evaluated in a three-tiered fashion using student, first responder, and open community events.

A single nurse was easily able to direct 89 people through the process of self-administration of the vaccine in a three-hour first-responder event and 122 people in a three-hour open community event. 96% of participants believed that they had performed the self-administration correctly, and the same percentage reported that they would like to receive influenza immunization by self-vaccination in the future.

The self-immunization clinic is a practical and potentially useful model in an influenza pandemic setting.