From the first U.S. confirmed case in January, COVID-19 has placed unprecedented strain on the U.S. healthcare system and uncovered and magnified how health issues disproportionately impact various communities every day. Now, with the spotlight firmly fixed on health disparities, public health leaders are faced with the next challenge in the COVID-19 response: vaccine distribution. Fortunately, there are tools and information available to help inform an equitable and efficient vaccine distribution plan.
On Sept. 16, the U.S. Department of Health and Human Services (HHS), in coordination with U.S. Department of Defense (DoD) and the Centers for Disease Control and Prevention (CDC), announced its COVID-19 vaccine distribution plan for state, tribal, territorial and local public health programs and their partners. The National Academies of Sciences, Engineering and Medicine (NAS) released a subsequent consensus study, Framework for Equitable Allocation of COVID-19 Vaccine on Oct. 2 that will guide the allocation of an initially limited supply of vaccine against SARS-CoV-2.
The report recommends coordination across existing health systems to support equitable distribution, administration and access to the vaccine; community engagement and risk communication and strategies to promote uptake.
This will be the single largest vaccine distribution effort in history. We can’t overlook the fact that GIS has been a proven tool to support improved vaccination coverage and will be crucial for scenario planning and distribution. So how will it work?
1. Identify Distribution Facilities
Vaccines are fragile and must be stored properly from the time they are manufactured to the time they are administered. Leading candidates for the COVID-19 vaccine not only require ultra-cold storage facilities (-4 to -94 degrees Fahrenheit) but ideal facilities must also be equipped with ample parking, capacity and proximity to production facilities and vulnerable populations. Evaluating these factors and mapping their potential reach is an essential first step to ensuring coverage.
2. Prioritize Populations
As more doses of the vaccine become available, the NAS Framework for Equitable Allocation of COVID-19 Vaccine recommends an allocation methodology that prioritizes populations according to Phases: healthcare personnel and essential workers (non-healthcare) first, followed by those with high-risk medical conditions and groups living in congregate environments, and finally vulnerable communities at increased risk of contracting and transmitting the virus e.g. college students, homeless individuals, minority communities etc. Density maps can help identify who these communities are and where they are located to inform strategies to overcome language and transportation barriers.
3. Identify Gaps and Solutions in Access to Care
Once population coverage is determined and mapped for each phase, situational awareness applications can help decision-makers by identifying which communities exist outside of a certain drive-time or walk-time to a vaccination venue. Solutions may include engaging with new partners to site new Points of Dispensing or sending mobile clinics directly into these communities. GIS will be critical in both scenarios for site selection based on population makeup and optimizing routes to locations that can most efficiently serve a larger population.
4. Vaccine Inventory Management
Current vaccine candidates require two doses for protection against COVID-19, making it critical to capture patient’s dosage information along with information identifying the carton and/or vial. This requires a system that can move fast and support vaccine, administration kits and PPE inventory tracking, as well as monitoring adverse events to ensure safe administration. Digital survey tools like ArcGIS Survey123 allow workers to quickly collect data on their smartphones or tablets, automatically updating dashboards that can give leaders real-time situational awareness.
5. Accurate Communication and Public Outreach
The COVID-19 pandemic has demonstrated the need for transparency to inspire the public’s trust. Providing communities with accurate and timely information about the importance of vaccination, where to vaccinate and the current status of vaccination efforts all contribute to this effort. Targeted messaging and culturally competent interventions are key to reaching specific populations. Montgomery County, Texas’ ArcGIS Hub site is a great example for sharing COVID-19 information with the public and includes a language translation feature to help engage with their diverse communities. Once vaccination venues are identified, counties can also share these locations on their ArcGIS Hub site by embedding an application similar to the State of California’s testing site locators.
As local health departments begin to update plans for emergency distribution for an eventual COVID-19 vaccine, NACo’s Brief for Key Considerations in COVID-19 Vaccination Distribution Plans serves as a key reference that underscores a county’s role as a key stakeholders in the strategy and planning process.
By leveraging a GIS technology platform, counties can continue to serve as a trusted resource, coupling local expertise and partnerships with the best current data to develop more equitable and transparent distribution strategies to ensure a safer, more efficient response. To assist counties with their response, Esri has developed several COVID-19 Vaccine Distribution Tools that can be used to do things like evaluate population phases, select distribution sites and select new sites. This site will continue to be updated as tools to support vaccine distribution are added.