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An annual state compliance audit of the Shots For Tots program "identified irregularities respecting its appraisal of standards, policies and competencies regarding the clinic operation, patient records, vaccine storage and medication dispensing," according to a statement released by the county this weekend.
"As soon as it was brought to our attention we reacted to this finding," said Salem County Freeholder Director Julie Acton on Saturday. "Our main concern is the safety of our residents. It's sad and disturbing when something like this takes place."
In addition to the children receiving the wrong medicine, vaccines with an estimated value of $20,000 used for the Shots for Tots program were deemed unsafe after a refrigeration unit failed and they had to be destroyed.
In the wake of the revelations, Salem County agreed to pay for medical monitoring costs for the five children receiving improper immunizations "for the foreseeable future until their medical status may be determined to a reasonable degree of medical certainty."
The parents will take the children to a physician of their choice for the monitoring officials say.
Meanwhile, the clinic has been shut down. The nursing supervisor and nurse in charge of the clinic have both resigned as employees of the Salem County Department of Health, county solicitor Michael Mulligan said Saturday.
The county-run Shots for Tots clinic was held once a month at The Memorial Hospital in Mannington Township. The hospital had no medical oversight for the clinic, it only provided the space, free of charge, to the county health department to hold the clinic, a hospital spokesman said.
Once the audit revealed problems, Salem County Health Department Director Rita Shade ordered a subsequent investigation that included a complete review of the charts of the 22 patients who had received immunizations and an inventory of all vaccines.
Those patients include 20 children and two adults who visited the clinic in the past year. The clinic serves the uninsured.
In what county officials are calling "the most egregious medication dispensing case," one 2-year-old boy received an "excessive dose" of the cervical cancer prevention vaccine Gardasil.
That unidentified child's mother and pediatrician were notified on June 30 about the mistake, officials said.
County officials said "The nature, likelihood and extent of any negative health effects, if any, are not presently known other than that the child may be at risk of neurological damage."
Shade on Saturday called the incident "extremely unfortunate."
She said the five children who received wrong medications included: Two children who were injected with vaccines that had expired; one child received a flu mist dose, but was under the age recommended to receive the mist (used in place of a flu shot); one child who officials are still trying to determine what type of vaccine they received and the one boy who received the Gardasil injection.
As the for vaccines that needed to be discarded, Shade said a compressor on the refrigeration unit where the medicine was stored at the Salem County Office of Emergency Management headquarters failed on June 20.
The vaccines, when needed for the clinic, were transported from the OEM site in Mannington to Memorial Hospital.
It was decided, after consulting with the vaccine manufacturers, that the failure of the refrigeration unit had made the medicine unstable and it should be discarded, Shade said.
After learning of Shade's findings, Acton and Freeholders Bob Vanderslice and Dale Cross, members of the Administration Committee, held an emergency meeting with county Chief Financial Officer Kate Coleman and Mulligan. The freeholders, at the recommendation of Coleman and Mulligan, authorized the payment of the medical monitoring costs.
The audit which originally brought the improper dispensing of medicine to light covered the period from July 1, 2014 to June 30, 2015.
The clinic provided vaccinations of the type that are typically required to attend school.
According to the county website, the Shots for Tots program offered free immunizations for children the second Thursday of every month at Memorial Hospital.
Immunizations were offered for children 2 months to 18 years of age. Parents were required to bring an up-do-date shot record.
Shade said since another provider in the county offers the same services the Shots for Tots clinic did, the county-run clinic has been shut down for now. It will be up to the freeholders to decide whether or not to reopen the clinic.
Comment: Hard to imagine this would happen "accidentally". Perhaps done purposely to rid their inventory?