H1N1

FLU

A Guide For Community

-andFaith-Based Organizations

This document was produced by the 

Center for Faith-based and Neighborhood Partnerships at the 

U.S. Department of Health and Human Services with support from the Centers for Disease Control and Prevention
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 iii

INTRODUCTION.................................................................................... v

SECTION A: Community and

Faith-based Involvement............................................................1

What can CFBOs do to help people stay healthy 

during the 2009-2010 flu season?.........................................................1

How can my organization create effective partnerships 

for the 2009-2010 flu season?.................................................................2

SECTION B: Vaccine Distribution.............................................3

When will the 2009 H1N1 flu vaccine be available?................. 3

Do I need both the seasonal flu vaccine and the 

2009 H1N1 flu vaccine? ............................................................................3

Who should get the seasonal flu vaccine?....................................... 3

What are the target groups for the 

2009 H1N1 flu vaccine?..............................................................................4

Should senior citizens be vaccinated for 2009 H1N1 flu? ..... 4

Where will the 2009 H1N1 flu vaccine be available?............... 4

What about the use of antivirals to treat flu?................................ 5

How can my organization support 2009 H1N1 flu vaccine 

distribution efforts?.........................................................................................5

SECTION C: Communication .....................................................7

How can my organization communicate 

effectively about flu?.......................................................................................7

SECTION D: Vulnerable and Hard-to-Reach 

Populations.........................................................................................9

What special challenges do vulnerable and hard-to-reach 

populations face?..............................................................................................9

What can my organization do to help vulnerable and 

hard-to-reach people in my community?....................................... 10

My organization supports homeless and emergency shelters. 

How can we protect the health of our clients, staff, and 

volunteers?........................................................................................................ 10

SECTION E: Participation in Community Response....11

How can my organization support increased 

needs for medical personnel? ............................................................... 11

How can my organization’s facility be used 

during the 2009 H1N1 flu response?.............................................. 11

SECTION F: Meetings and Gatherings ................................13

What steps can leaders of religious services or 

community meetings take if there is an outbreak of flu 

in my community? ........................................................................................ 13

Should people travel during the 2009-2010 flu season?...... 14

SECTION G: Mental Health and Stigma ............................15

How can my organization provide emotional comfort 

and support to my community during the 2009-2010 

flu season? ....................................................................................................... 15

How can my organization prevent and stop 

the spread of stigma around 2009 H1N1 flu?............................ 15

SECTION H: Childcare Organizations

andYouth Programs..................................................................17

Will schools be dismissed during the 2009-2010 

flu season?......................................................................................................... 17

How can my organization support efforts to prevent 

flu transmission in schools?..................................................................... 17

How can my childcare or after-school program 

support the 2009 H1N1 flu response? ....................................... 18

SECTION I:Work Environments ............................................19

How should my organization’s work environment change 

during the 2009-2010 flu season?...................................................... 19

APPENDICES:..........................................................................................21

Appendix A:About Flu.............................................................................. 22

Appendix B: Resources............................................................................. 23

Appendix C: Lessons Learned from the Minnesota 

Immunization Networking Initiative (MINI): Delivering Flu 

Vaccine in Non-traditional Settings................................................... 24

Table of Contents
iv H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

Letter from Secretary Sebelius

September 24, 2009

Dear Friends,

Thank you for your leadership and the compassionate service you provide to your 

communities. People often turn to community and faith-based organizations to get 

the most up-to-date information on health and other important community issues. 

You have a unique ability to reach deeply into your community and connect people 

with the information and resources they need to help stay healthy. 

My colleagues at HHS and I will continue to do everything in our power to help keep 

Americans healthy and safe this flu season. But government cannot respond alone. 

That is why I am pleased to present “H1N1 Flu: A Guide for Community and FaithBased Organizations.” Inside, you’ll find information about how your community or 

faith-based organization can:

•	 Ensure information is communicated effectively, accurately, and with 

cultural sensitivity to community members,

•	 Help those who are most vulnerable and hard-to-reach,

•	 Partner with local governments to assist in vaccine distribution, and

•	 Adjust activities in ways that will help protect your community from flu. 

This flu season, you will play a vital role in our country’s national preparedness and 

response efforts. Thank you for your partnership as we work together this fall to help 

keep our communities healthy.

Sincerely,

Kathleen Sebelius

Secretary

Department of Health and Human Services
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 v

To help keep communities healthy during the upcoming flu season, it will take all of us— community 

and faith-based organizations, government, businesses, and schools—working together. The federal 

government alone cannot prepare for or respond to the challenge of the 2009-2010 flu season. 

Leaders and members of community and faith-based organizations (CFBOs), people like you, know 

their communities well. As trusted leaders, you can communicate important health information 

in an effective and motivating manner. You know the people in your community who are most 

vulnerable and hard-to-reach. Organizations like yours are uniquely positioned to help keep people 

healthy during the 2009-2010 flu season. 

In addition to providing information about 2009 H1N1 flu and current response activities, this guide 

provides specific action steps you can take to help keep your community healthy by:

•	Communicating health information effectively; 

•	Supporting vaccination efforts; 

•	Linking vulnerable and hard-to-reach populations to vital information and resources; and 

•	Expanding and adjusting organizational activities to help people stay healthy. 

Since there is a great deal of variation among CFBOs, different parts of this document will be more 

relevant to your organization than others. Use this guide to help inform your response to both 

2009-2010 seasonal and 2009 H1N1 flu. Remember to be creative as you design a response plan 

that is relevant and useful to the people you serve.

INTRODUCTION
vi H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

Box 1: 2009 H1N1 Vaccine Target Groups

•	 Pregnant women

•	 Household contacts and caregivers for children younger than 6 months old

•	 Healthcare and emergency medical services personnel

•	 All people from 6 months through 24 years of age

•	 People aged 25 through 64 years with chronic health conditions (including 

asthma, heart disease, diabetes, HIV, and other disorders)
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 1

What can CFBOs do to help people stay healthy during the 2009-2010 flu season?

•	Spread the word about what individuals can do to prepare for and stay healthy during the 

2009-2010 flu season. Check http://www.flu.gov for the most up-to-date information on 

current recommendations. (See Appendix A for more details.)

•	Work closely with your local or state health department to educate community members 

on flu. For example, your organization could: 

– Institute a “Healthy Habits” or “Flu Facts” section in your newsletter; 

– Sponsor a community lecture series on preventing and treating flu; or

– Develop a “buddy” system to help ensure vulnerable and hard-to-reach community 

members stay connected to flu-related news and services.

•	Support state and local health departments’ vaccination efforts by:

– Encouraging community members to get vaccinated for seasonal flu; 

– Helping people to understand the initial target groups for 2009 H1N1 flu (see Box 1);

– Encouraging these groups to get the 2009 H1N1 flu vaccination;

– Providing facilities as vaccination sites in partnership with your state or local health 

department;

– Providing information about where vaccine is available; and 

– Tailoring health department information on vaccinations to meet the specific cultural or 

religious needs of your community. 

Note: See Section B on vaccine distribution for more information. 

Community and Faith-based 

Involvement

SECTION A:
2 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

•	Encourage individuals and families to be prepared 

for 2009 H1N1 flu by: 

– Practicing Healthy Habits (see Box 2);

– Staying up-to-date on immunizations, including 

getting the seasonal flu vaccine and the 2009 

H1N1 flu vaccine, if recommended; 

– Keeping a current list of medical conditions and 

medications; 

– Checking and refilling supplies of regular 

prescription and over-the-counter drugs 

periodically to ensure an adequate supply; and 

– Maintaining a two-week supply of food and 

other necessities to avoid the need to shop 

while you are sick or if local businesses are 

closed because illness is widespread in your 

community. See http://www.flu.gov/plan/

individual/checklist.html for a checklist. 

How can my organization create effective partnerships 

for the 2009-2010 flu season?

Your organization does not need to do everything on its 

own. Here are a few steps your organization can take to 

help ensure a coordinated response: 

•	Work with your state, local, tribal, or territorial 

government to coordinate with other national and 

local response efforts in your community.

•	Partner with organizations within your existing 

associations and networks.

Box 2: Practice Healthy Habits 

During Flu Season

•	Cover your nose and mouth with a tissue 

when you cough or sneeze. Throw the 

tissue in the trash after you use it. If a tissue 

is unavailable, cough or sneeze into your 

shoulder or elbow instead of your hands. 

•	Wash your hands often or use hand sanitizer. 

•	Avoid touching your eyes, nose, or mouth. 

•	Get the seasonal flu vaccine and/or the 

2009 H1N1 flu vaccine, if recommended 

(see Section B for more information on 

vaccine recommendations).

•	Try to avoid close contact with sick people. 

•	Keep sick children at home. 

•	If you have flu-like symptoms (fever with 

cough or sore throat), stay home for 

at least 24 hours after you are free of 

fever without the use of fever-reducing 

medications. 
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 3

SECTION B:

Vaccine Distribution

When will the 2009 H1N1 flu vaccine be available?

The 2009 H1N1 flu vaccine is expected to be available in October. 

Do I need both the seasonal flu vaccine and the 2009 H1N1 flu vaccine? 

Yes, especially if you are in one of the target groups for the 2009 H1N1 flu vaccine. 

Who should get the seasonal flu vaccine?

The seasonal flu vaccine is recommended for anyone who wants to reduce their risk of becoming ill 

with flu. It is particularly important for persons at increased risk of severe illness or for spreading the 

infection to persons who are at high risk. These people include:

•	People aged 6 months through 18 years or age 50 years or older;

•	People with underlying medical conditions, such as chronic heart or lung diseases or 

diabetes (see Appendix A for a full list of these conditions);

•	Pregnant women;

•	Healthcare providers;

•	People who live with or care for infants younger than 6 months of age; and

•	Residents of long-term care facilities. 

If you are unsure about whether you should receive the seasonal flu vaccine, contact your 

healthcare provider. 
4 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

What are the target groups for the 2009 H1N1 flu vaccine?

When the vaccine first becomes available, the groups of 

people who will be in greatest need for protection by 

vaccination with the 2009 H1N1 flu vaccine are:

•	Pregnant women;

•	Household contacts and caregivers for children 

younger than 6 months old;

•	Healthcare and emergency medical services (EMS) 

personnel;

•	All people aged 6 months to 24 years; and

•	People aged 25 through 64 years with chronic 

health conditions (see Appendix A for a list of 

these medical conditions). 

Healthcare and EMS personnel have been targeted for 

vaccination to keep them healthy, able to work, and less 

likely to infect their patients on the job. Other persons have 

been targeted for vaccination to protect them from medical 

complications if they get 2009 H1N1 flu. 

Once the demand for vaccine in target groups has been met 

at the local level, programs and providers should also begin 

vaccinating everyone from the ages of 25 through 64 years. 

Should senior citizens be vaccinated for 2009 H1N1 flu?

Based on what we know about 2009 H1N1 flu, people age 

65 or older have a lower risk of being infected with 2009 

H1N1 flu than younger people. However, the small minority 

of people over 65 who do become infected with H1N1 are 

at higher risk of complications. Therefore, any person over 

65 who becomes ill with flu-like symptoms should contact 

his or her physician right away to determine whether 

treatment with antivirals is needed. Also, seniors should 

consider getting the 2009 H1N1 flu vaccine once the target 

groups mentioned above have been offered vaccine.

Where will the 2009 H1N1 flu vaccine be available?

Vaccine will likely be available in healthcare provider offices, 

health departments, schools, and other settings, including 

pharmacies, workplaces, and community centers. Every state 

is developing a vaccine delivery plan. For more information 

about obtaining the flu vaccine, contact your doctor or local 

health department. To find a clinic near you, visit http://www.

flu.gov/individualfamily/vaccination/locator.html.

Box 3: Promising Partnership—

MINI Project

The Minnesota Immunization 

Networking Initiative (MINI) 

Project works to increase annual 

seasonal flu immunizations in the 

Twin Cities area, specifically among 

minority, immigrant, and uninsured 

populations. A collaborative effort 

between non-profit and for-profit 

organizations and corporations, 

government agencies, and faith 

communities, the MINI project 

has provided a total of 16,000 

free immunizations at 52 multicultural clinic sites since the 

program’s inception in 2006. The 

immunizations are administered 

by healthcare workers at nontraditional clinic sites, such as 

churches, mosques, and community 

centers, at times when people are 

present for other activities. See 

Appendix C if you are interested in 

setting up a similar partnership.
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 5

What about the use of antivirals to treat flu?

Antiviral drugs are prescription medicines (pills, liquid, or 

an inhaled powder) that help your body fight flu (both 

seasonal and 2009 H1N1). If you get sick with flu, antiviral 

drugs may make your illness milder and make you feel 

better faster. If people at risk of medical complications 

from flu develop flu-like symptoms, they should seek 

treatment from a healthcare provider within 48 hours, 

including antiviral treatment. For updated information 

on using antivirals during the 2009-2010 flu season, visit: 

http://www.cdc.gov/h1n1flu/antiviral.htm.

How can my organization support 2009 H1N1 flu 

vaccine distribution efforts?

•	Encourage community members to get vaccinated 

for seasonal and 2009 H1N1 flu according to 

Centers for Disease Control and Prevention (CDC) 

recommendations. Here are a few ideas: 

– Include reminders to get vaccinated in regular 

communications and gatherings.

– Hold an information session on flu vaccination 

for people in your community. Ask a health 

professional in your community or organization 

to give a presentation.

– Provide community members with information 

on where and when they can go to get flu 

vaccinations. Check with your local health 

department to get this information. 

– Organize rides to vaccination clinics and/or set 

up vaccination appointments.

– Help people understand vaccination target groups.

•	Follow up with community members to help 

ensure that they receive all necessary vaccinations 

and see their doctor for treatment.

•	 Offer your building or facilities as vaccination 

sites. Work with your local health department to 

organize this effort. See Box 3 as an example of such 

a partnership.
6 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

By: Jonathan Sherrill
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 7

How can my organization communicate effectively about flu?

Your organization can play a vital role in ensuring that accurate public health information 

is communicated effectively. When information is shared by trusted messengers, people 

are more likely to respond and change their behavior. We also need your help to deliver 

these public health messages to hard-to-reach people. 

Here are some strategies for sharing messages:

•	Check http://www.flu.gov for the most up-to-date information, and share what 

you learn with your faith community or organization. 

•	Provide timely and accurate information. You are uniquely positioned to share 

information with community members in both culturally appropriate and easy-tounderstand ways. 

•	Communicate and create linkages to populations that are vulnerable or hardto-reach, including people who are homeless, shut-in, low-income, non-Englishspeaking, unconnected to mainstream media, or are migrant workers, immigrants, 

or refugees. See Section D on vulnerable and hard-to-reach populations for more 

information. 

•	Make sure that people can access your organization in alternate ways. You might 

consider:

– Organizing a phone tree; 

– Maintaining up-to-date websites; 

– Creating an e-mail listserv; 

– Pre-recording messages on a designated call-in phone number; or

– Posting notices in frequently accessed places. Posters can be found at: http://

www.cdc.gov/germstopper/materials.htm.

•	Assist people with physical, sensory, intellectual, or communication disabilities by 

using alternative communication strategies. For example, provide links to the CDC 

Resources for the Deaf and Hard of Hearing at: http://www.cdc.gov/h1n1flu/deaf.htm. 

Communication 

SECTION C:
8 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 9

Some people have a higher risk of medical complications from seasonal and 2009 H1N1 flu, and 

CDC has prioritized these groups for vaccination. Many people, both targeted and not targeted for 

vaccination, face additional challenges during the 2009-2010 flu season because of their economic, 

social, or medical situations. 

People in vulnerable and hard-to-reach populations may never receive important health messages 

because they are not connected to mainstream communication networks or because they cannot 

understand English. Others may be unable to afford healthcare or to access the services they need 

to stay healthy. Although vulnerable and hard-to-reach populations may vary from community to 

community, they may include:

•	Low-income individuals and families; 

•	Non-English speakers;

•	Homeless individuals and families;

•	Shut-in or home-bound individuals.

•	Migrant workers, immigrants, and refugees; and

•	People with physical, sensory, mental health, intellectual, and cognitive disabilities; 

What special challenges do vulnerable and hard-to-reach populations face?

•	Barriers to communication. Inability to understand English, hear oral announcements, see 

directional signs, read written information, or access traditional forms of communication.

•	Specialized medical care. Unstable, terminal, or contagious conditions requiring specialized care.

•	Requirements for independence in daily activities. Need for consumable medical supplies 

(formula, bandages, etc.), medical equipment (wheelchairs, oxygen, etc.), and/or caregivers. 

•	Supervision needs. Eldercare or care for adults suffering from dementia, Alzheimer’s disease, 

severe anxiety, etc.

•	Transportation barriers. Inability to drive, limited or no access to a private vehicle, or 

requirements for accessible vehicles. 

•	Economic or social dislocation. Lack of economic resources and/or limited access to social 

support and mainstream communication networks. 

Vulnerable and 

Hard-to-Reach Populations

SECTION D:
10 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

What can my organization do to help vulnerable and 

hard-to-reach people in my community?

Your organization can provide programs and services 

critical to helping vulnerable and hard-to-reach individuals 

and families. Here are some suggestions: 

•	Identify which members of your community might 

need extra assistance.

•	Translate documents and health materials into 

languages spoken by members of your community.

•	Ensure that messages are simple and clear for lowliteracy audiences.

•	Develop a “necessities bank” to provide needed 

items to individuals who cannot afford them.

•	Provide transportation for community 

members who can’t drive or who rely on public 

transportation systems. 

•	Organize services for members needing assistance 

picking up medication, equipment, or supplies. 

•	Read Appendix C for an overview of an effective 

partnership to provide vaccine to vulnerable and 

hard-to-reach populations.

My organization supports homeless and emergency 

shelters. How can we protect the health of our clients, 

staff, and volunteers?

CDC has released specific guidance for homeless 

and emergency shelters, available at: http://www.

cdc.gov/h1n1flu/guidance/homeless.htm. Some 

recommendations include: 

•	Minimizing contact between sick people and 

well people;

•	Providing hand sanitizers and access to handwashing facilities; and

•	Staying informed about current guidance from 

CDC and your state or local health department. 

Box 4: Parish nurses can play an important 

role in the flu response by: 

•	Organizing flu vaccination campaigns in 

their congregations; 

•	Helping people understand the vaccination 

target groups and encouraging those 

groups to get vaccinated;

•	Providing information to community members 

on hygiene and healthy practices;

•	Supporting individuals as they safely care 

for sick family members; and

•	Caring for patients who require home 

care, especially those recently discharged 

by the hospital.
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 11

How can my organization support increased needs for medical personnel?

During the 2009-2010 flu season, hospital staff may be overextended. Here are some steps that 

your organization can take to help meet the demand for medical personnel: 

•	Check with your local hospital system and health department to see whether there are nonmedical needs that volunteers from your organization can fill. Many community members—

interpreters, chaplains, office workers, legal advisors, and others—can fill key support positions.

•	Connect with the Medical Reserve Corps in your community. Community-based Medical 

Reserve Corps (MRC) units work locally to organize volunteers (including physicians, nurses, 

pharmacists, and dentists) who donate their time and expertise to prepare for and respond to 

emergencies. MRC volunteers supplement existing emergency and public health resources. For 

more information, go to: http://www.medicalreservecorps.gov. 

•	Engage parish nurses in flu response efforts (see Box 4).

How can my organization’s facility be used during the 2009 H1N1 flu response?

Talk with your local health department now to determine ways in which your volunteers and facilities 

might be useful during the response to 2009 H1N1 flu. For more information on using your building 

for vaccine distribution, see Section B. 

SECTION E:

Participation in 

Community Response
12 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 13

Many faith-based and community groups hold services or meetings that bring people together. If the 

flu is causing more severe disease, CDC and your local health department may suggest that people 

avoid close contact with others and avoid attending large gatherings, a practice often called social 

distancing. These measures are intended to slow the spread of flu. Religious traditions and obligations 

may make it difficult to implement social distancing measures. However, faith-based and other 

community groups can do some specific things to help keep their members healthy. 

What steps can leaders of religious services or community meetings take if there is an outbreak 

of flu in my community?

•	To the extent possible, make decisions in accordance with your state and local health 

departments about community gatherings and religious services during widespread flu illness 

in your community. People should not be discouraged from gathering unless advised by public 

health officials. 

•	Encourage people to wash hands often with soap and water. If soap and water are not 

available, use an alcohol-based hand rub. If soap and water are not available and alcohol-based 

products are not allowed, other hand sanitizers that do not contain alcohol may be useful.

•	Remind people to cover their mouth and nose with a tissue when coughing or sneezing. It 

may prevent those around them from getting sick.

•	Reduce crowding as much as possible. 

•	Identify which activities may increase the chance of spreading flu. Work with your local health 

department to make decisions about changing or limiting these activities in order to help keep 

people healthy.

– People gathering in close proximity may increase the risk of flu transmission. 

– Many religious services and community meetings involve a time of greeting or recognition 

by shaking hands or hugging. Encouraging interaction without physical contact and 

implementing social distancing measures may reduce the spread of flu in your community. 

– Some religious traditions and rituals emphasize eating and drinking from communal dishes 

and vessels. Flu transmission may be possible in these circumstances. If flu is circulating 

widely in your community, faith and community leaders may consider adjusting such 

practices in order to reduce the spread of flu. Check with your local or state health 

department and http://www.flu.gov. 

Meetings and Gatherings

SECTION F:
14 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

•	Encourage people with flu-like illness to stay home. The spread of flu may be decreased if 

people with flu-like illness stay home for at least 24 hours after they are free of fever without 

the use of fever-reducing medications. 

•	If there is widespread flu illness in your community, discuss the risks of attending gatherings 

for those at high risk of medical complications from flu. By avoiding gatherings, these 

individuals may reduce their risk of becoming ill with flu. 

•	Provide alternative options and venues for participation whenever possible for individuals 

who are ill, home-bound, or have a high risk of flu complications and will not be able to attend 

gatherings. See Section C on communication for more information. 

•	Check http://www.cdc.gov/h1n1flu/guidance/public_gatherings.htm for additional guidance on 

holding public gatherings, including religious services.

Should people travel during the 2009-2010 flu season?

Individuals and groups preparing for travel (including religious pilgrimages, retreats, holiday 

celebrations, and missionary trips) should stay informed on the latest news and travel advisories 

from CDC and the U.S. Department of State. Find this information at: http://www.flu.

gov/individualfamily/travelers/index.html. Share this information with community members 

accordingly. Travelers who wish to minimize the transmission of flu should: 

•	Follow local health recommendations, including movement restrictions;

•	Practice healthy habits to help stop the spread of flu; and

•	Follow these recommendations if the traveler becomes ill:

– Stay home or in a hotel room for at least 24 hours after becoming free of fever without 

the use of fever-reducing medicines.

– Seek medical care if the traveler has severe illness or is at high risk of medical complications. 

Contact the U.S. Embassy or Consulate for help obtaining medical care. 

– Closely monitor the traveler’s health after the traveler returns to the United States. 
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 15

How can my organization provide emotional comfort and support to my community during the 

2009-2010 flu season? 

•	Provide community members with support and stress relief activities. 

•	Utilize existing mental health materials and resources, especially those focused on coping 

with 2009 H1N1 flu. See Appendix B for some resources. 

•	Encourage clergy, lay counselors, staff, and volunteers to maintain their own psychological, 

emotional, and spiritual well-being. Also, encourage them to seek help when needed. 

•	Connect community members to existing mental health and counseling services in the 

community. Check http://mentalhealth.samhsa.gov/databases/ for information on mental health 

services in your community.

How can my organization prevent and stop the spread of stigma around 2009 H1N1 flu?

Your organization plays an important role in reducing stigma. Stigma during the spring 2009 H1N1 flu 

outbreaks placed blame on certain people who contracted the disease and misrepresented how 

the disease was spread. Your organization can help to avoid stigma and blame while meeting people’s 

real desire to avoid infection by: 

•	Delivering public health messages that address people’s concerns; 

•	Dispelling rumors, misinformation, fear, and anxiety present in your community; and

•	Modeling respectful and compassionate behavior when interacting with members of 

communities that are being stigmatized. 

SECTION G:

Mental Health and Stigma
16 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 17

Will schools be dismissed during the 2009-2010 flu season?

The decision to dismiss students will be made locally. Find more information on schools and flu in the 

Communication Toolkit for Schools, available at: http://www.flu.gov/plan/school/toolkit.html. 

How can my organization support efforts to prevent flu transmission in schools?

As part of your community’s response, your organization can support schools as they endeavor to 

balance the risks of illness among students and staff with the benefits of keeping students in school. 

Your organization can encourage community members to plan to keep students home in the case 

of illness or a school dismissal. If it is not possible for parents to miss work or other commitments, 

your organization can organize emergency childcare options for these community members by 

matching these community members with a feasible childcare alternative. 

Here are some steps your organization can take if school and public health officials make the local 

decision to dismiss schools:

•	Encourage children and teenagers to refrain from gathering in large groups outside of 

school (for example, at shopping malls and other public places). 

•	Make sure that children and youth can continue learning while out of school. For example, 

your organization could: 

– Prepare learning materials, equipment, or books that could be useful for teaching and caring for 

children at home. Think about using local expertise and resources, like your organization’s library 

or community members who are trained in education. See http://free.ed.gov for more information.

– Make sure students have all that they need. Transport books, assignments, and completed 

work to and from the classroom and an ill child’s home. 

•	Provide nutritious meals to children normally receiving school lunches. A good resource for 

creating healthy meals for infants, children, and adults is available at: http://www.fns.usda.gov/

CND/Care/ProgramBasics/Meals/Meal_Patterns.htm. 

Childcare Organizations 

and Youth Programs

SECTION H:
18 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

How can my childcare or after-school program support 

the 2009 H1N1 flu response? 

Childcare and youth programs will be essential partners 

in protecting the public’s health during the 2009-2010 flu 

season. CDC has developed specific guidance for Child 

Care and Early Childhood Programs during the 2009-2010 

flu season. The guidance is available at: http://www.cdc.gov/

h1n1flu/childcare/guidance.htm. Here are some steps you 

can take to help keep the children you serve healthy: 

•	Stay home when sick. Those with flu-like illness 

should stay home for at least 24 hours after they no 

longer have a fever or signs of a fever without the use 

of fever-reducing medicines. They should stay home 

even if they are using antiviral drugs. Early childhood 

programs, parents, or state and local health officials 

may elect to require longer periods of exclusion.

•	Separate ill students and staff. Children and staff 

who appear to have flu-like illness should be sent to 

a room separate from others until they can be sent 

home. They should wear a surgical mask, if possible. 

Those caring for ill students should also wear 

protective gear. 

•	Educate and encourage students to cover their 

mouth and nose with a tissue when they cough 

or sneeze. Provide them with easy access to tissues.

Remind them to cover coughs or sneezes using their 

elbow or shoulder instead of their hand when a 

tissue is not available.

•	Remind students to practice good hand hygiene.

Provide the time and supplies (easy access to running 

water and soap or hand sanitizers) for them to wash 

their hands as often as necessary.

•	Do routine cleaning. Staff or volunteers should 

routinely clean areas that students and staff touch 

often. Special cleaning with bleach and other nondetergent-based cleaners is not necessary. 

•	Increase distance between people. Try developing 

innovative ways to separate students. These can be as 

simple as moving desks or workspaces farther apart 

or using larger rooms when available.

•	Get vaccinated against the flu. All children and 

many staff in early childhood settings will fall within 

the target groups for the 2009 H1N1 flu vaccine.

•	Conduct daily health checks. Early childhood 

providers observe all children for signs of illness 

and should talk with each child’s parent or guardian.

•	Encourage early treatment for children and staff 

at high risk for flu complications. Parents and staff 

should be encouraged to talk with their health care 

provider to determine whether they, or a member 

of their family, are at high risk for flu complications. 

•	Consider selective early childhood program closures.

Work closely with your local health department to 

determine whether your early childhood program 

should be temporarily closed. 
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 19

How should my organization’s work environment change during the 2009-2010 flu season?

Your organization should be prepared for staff and volunteer absence during the upcoming flu 

season. Many members of your organization may need to stay home because they or their family 

members are sick or because schools and childcare centers are closed. 

Here are some steps you can take to ensure that your organization continues to operate effectively:

•	Encourage sick staff and volunteers to stay home and away from the workplace, and provide 

flexible leave or telework policies. 

•	Encourage all employees and staff who are in target groups for 2009 H1N1 flu to get 

vaccinated. 

•	Encourage staff and volunteers to get the seasonal flu vaccine in accordance with CDC 

recommendations. 

•	Encourage early treatment for staff at high risk for flu complications. Staff and volunteers at 

high risk for flu complications and parents of children younger than age 5 who become ill with 

flu-like illness should call their healthcare provider as soon as possible to determine whether they 

need antiviral treatment. 

•	Display posters that remind employees about proper hand washing and covering coughs 

and sneezes. These posters can be found on the following CDC website: http://www.cdc.gov/

germstopper/materials.htm. 

•	Provide facilities for hand washing and/or hand sanitizers in common areas, like lobbies, 

corridors, and restrooms. 

•	Routinely clean surfaces and items that are touched frequently. Additional disinfection 

beyond routine cleaning is not necessary. 

•	Prepare for staff and volunteers to stay home and plan ways for essential business 

functions to continue. Cross-train staff to perform essential functions so that your 

organization can continue operating. 

Work Environments

SECTION I:
20 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

•	Plan for financial impacts associated with 2009 

H1N1 flu. 

– Budget: Consider the impact of 2009 H1N1 flu 

response and other unforeseen emergencies 

that can lead to a shortage of funds. 

– Charitable development strategies: Since many 

non-profit organizations rely on community 

giving to support their activities, they may 

want to use alternative means of receiving 

contributions, for example, by mail or internet.

•	Check CDC’s Toolkit for Businesses and Employers

for more information on things you can do in the 

workplace to help keep your organization functioning 

and your employees healthy: http://www.flu.gov/plan/

workplaceplanning/toolkit.html. 
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 21

APPENDICES:

Appendix A: About Flu

Appendix B: Resources

Appendix C: Lessons Learned from the Minnesota 

Immunization Networking Initiative (MINI): 

Delivering Flu Vaccine in Non-traditional Settings
22 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

How do I know the difference between 2009 H1N1 flu or seasonal flu?

It will be very hard to tell whether someone who is sick has 

2009 H1N1 flu or seasonal flu. Public health officials and medical 

authorities do not recommend laboratory testing except in specific 

circumstances. Anyone who has flu-like symptoms should stay home 

and not go to work or school.

Symptoms of flu include fever or chills and cough or sore throat. 

Other possible symptoms include runny nose, body aches, headache, 

tiredness, diarrhea, or vomiting.

How do I recognize a fever or signs of a fever?

A fever is a temperature taken with a thermometer that is equal to 

or greater than 100 degrees Fahrenheit (38 degrees Celsius). If a sick 

person’s temperature cannot be taken, look to see whether the person 

feels very warm, has a flushed appearance, is sweating, or is shivering.

Will there be a 2009 H1N1 flu vaccine?

Yes. The 2009 H1N1 flu vaccine is expected to be available for the 

public in October 2009. The seasonal flu vaccine will be available from 

early September 2009 onward. 

Who is at high risk for medical complications from flu?

Anyone can get flu and can have serious problems from flu, though 

some groups are at higher risk for complications from seasonal or 

2009 H1N1 flu. These include children younger than 5 years of age, 

pregnant women, people of any age with chronic health conditions, 

and people 65 years of age and older.

Medical conditions associated with a higher risk of flu-related 

complications include: chronic pulmonary (including asthma), 

cardiovascular (except hypertension), renal, hepatic, cognitive, 

neurologic/neuromuscular, hematologic, or metabolic disorders 

(including diabetes mellitus) and immunosuppression (including HIV 

and immunosuppression caused by medications). 

Individuals should talk with their healthcare provider to determine 

whether they are at higher risk for flu complications, especially if they have 

been in close contact with others who are sick with flu or flu-like illness.

If people in these groups get flu-like symptoms, they should seek 

treatment—including antiviral treatment—from a healthcare provider 

within 48 hours.

What can I do to protect myself and others from getting sick?

There are some key things that you can do right now to help keep 

you and your family healthy. 

Everyday steps to protect your health:

•	 Cover your nose and mouth with a tissue when you cough or 

sneeze. Throw the tissue in the trash after you use it. If a tissue 

is unavailable, cough or sneeze into your shoulder or elbow 

instead of your hands. 

•	 Wash your hands often with soap and warm water for at least 

20 seconds, especially after you cough or sneeze. You can also 

use alcohol-based hand sanitizers. 

•	 Avoid touching your eyes, nose, or mouth. Germs spread this way. 

•	 Try to avoid close contact with sick people. 

•	 Keep sick children at home. 

•	 If you have flu-like symptoms (fever with cough or sore throat), stay 

home for at least 24 hours after you are free of fever without the 

use of fever-reducing medications like Tylenol®. This step is to help 

stop spreading the virus to others. 

Some other important actions during the 2009-2010 flu season:

•	 Get the seasonal flu vaccine if recommended by CDC or if you 

want to reduce your chance of getting the flu. 

•	 Get vaccinated for 2009 H1N1 flu if you are in one of the 

target groups. Others may be able to get the vaccine after local 

demand among target groups has been met. 

•	 Follow public health advice and guidance. For example, avoid 

close contact with others attending large gatherings of people 

(often called social distancing measures).

•	 Be prepared in case you get sick and need to stay home for 

a week or so. Keep a supply of over-the-counter medicines, 

alcohol-based hand sanitizers, tissues, and other related items so 

that you do not need to make trips outside your home while 

you are sick and contagious.

•	 Stay informed by checking with your local health department or 

http://www.flu.gov for updates related to staying healthy. 

Appendix A:

About Flu
H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009 23

Appendix B:

1. The most up-to-date, comprehensive information on 2009 H1N1 flu: 

www.flu.gov

or

www.cdc.gov/H1N1flu

2. The Centers for Disease Control and Prevention (CDC) Hotline: 

1-800-CDC-INFO (1-800-232-4636)

Available in English and Spanish, 24 hours a day, 7 days a week. 

TTY: 1-888-232-6348. 

Email questions to: cdcinfo@cdc.gov. 

3. HHS Center for Faith-based and Neighborhood Partnerships: 

http://www.hhs.gov/partnership

200 Independence Avenue, S.W.

Washington, DC 20201

Phone: (202) 358-3595 Fax: (202) 401-3463

4. World Health Organization (WHO) Influenza Website:

http://www.who.int/csr/disease/swineflu/en/index.html

5. To contact your state or local health department, call 311 or visit: http://www.apha.org/about/

Public+Health+Links/LinksStateandLocalHealthDepartments.htm 

6. The Faith-Based & Community Organizations Pandemic Influenza Preparedness Checklist (a checklist 

for pandemic planning): http://www.pandemicflu.gov/plan/community/faithcomchecklist.html) 

7. National Voluntary Organizations Active in Disaster: 

http://www.nvoad.org

8. The American Red Cross (a resource on coping and emotional health during H1N1): http://www.

redcross.org/www-files/Documents/pdf/Preparedness/SwineH1N1FluCopingFactSheet.

pdf?utm_source=BRCR&utm_medium=PDF&utm_campaign=Flu_CopingTips

9. National Institute of Mental Health http://www.nimh.nih.gov/health/publications/index.shtml

Resources
24 H1N1 FLU: A Guide for Community and Faith-Based Organizations: september 2009

Why should local or state health departments build vaccination 

partnerships with community and faith-based organizations (CFBOs)?

•	 Faith communities and grassroots community organizations have 

established credibility in their respective communities, trusted 

leadership, and knowledge of and relationships with hard-toreach populations, such as vulnerable adults, immigrants, and 

special needs persons.

•	 Many CFBOs have an existing infrastructure of health promotion 

through the work of a faith community registered nurse or a health 

cabinet/committee. 

Why should CFBOs collaborate with public health or state 

departments of health?

•	 By providing a facility site for vaccinations, faith communities 

and other community organizations can fulfill a mission to serve 

people in need.

•	 Faith communities can model commitment to wellness for the whole 

person by hosting flu vaccinations. They can demonstrate that caring 

for the physical body is an honorable part of their faith tradition. 

Getting Started: Influenza vaccinations in non-traditional settings

Community needs/strengths assessment: Contact the local public 

health department, the immunizations department at your local or 

state health department, and the local Immunization Action Coalition. 

Look at health disparities data in your region, including numbers of 

uninsured, underserved, and those without a medical home. Gather facts, 

information, and advice. Find out who is currently providing vaccinations 

in your locale (health departments, visiting nurses, and healthcare 

companies that contract with businesses for employee vaccination).

Build the collaboration: Identify and invite potential partners to an 

organizational meeting, including representatives from state and local 

public health agencies, faith communities, service providers, non-profit 

collaborations, local coalitions, and networks. Present information that 

documents the need for vaccine provision through non-traditional sites. 

Locate an organization or agency that could provide healthcare professionals 

and vaccine. Discuss roles and responsibilities for the different members of 

the collaboration, including a clear leadership structure. 

Vaccine delivery requirements: A licensed healthcare provider with a 

doctor’s orders (standing orders); liability insurance; licensed healthcare 

professionals (nurses and medical assistants); vaccine (multi-dose vials, 

individual syringes, or intranasal) and supplies (syringes, gauze, and 

bandages); and printed materials such as consent forms, Vaccination 

Information Statements (VIS), and privacy statements. Find CDC’s 

protocol for delivery of vaccinations in non-traditional settings at: 

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4901a1.htm and 

information on the Public Readiness and Emergency Preparedness 

Act at: http://www.hhs.gov/disasters/emergency/manmadedisasters/

bioterorism/medication-vaccine-qa.html 

Roles/responsibilities: The program manager will coordinate meetings 

(planning, coordination, and evaluation); act as liaison to public health/

state department of health and the healthcare provider(s); solicit 

financial support through grant applications; and if necessary, solicit 

donations of vaccine (excess vaccine is typically available in December 

from pharmaceutical companies, clinics, drug stores, etc.). Appoint a 

site coordinator for each participating community partner organization 

who will coordinate with the program manager to schedule sites and 

arrange for facility use. Each host site will be responsible for necessary 

interpreters, volunteers, and publicity. 

Appendix C was authored by Patricia Peterson, Faith Community Outreach 

Manager, Fairview Health Services, Minneapolis, MN. If you would like to 

obtain more information, please contact her by phone at (612) 672-2807 

or email (ppeters1@fairview.org). 

Appendix c:

Lessons Learned from the Minnesota Immunization 

Networking Initiative (MINI): Delivering Flu Vaccine 

in Non-traditional Settings