Key Considerations for Counties in COVID-19 Vaccine Distribution Plans

  • Key Considerations for Counties in COVID-19 Vaccine Distribution Plans

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    Key Considerations for Counties in COVID-19 Vaccine Distribution Plans

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    • Background & Resources
    • County Examples

    Counties invest heavily in local residents' health and well-being and have been on the front lines of our nation’s response to the coronavirus pandemic. Counties support over 900 hospitals, 824 long-term care facilities and 1,943 local health departments- entities that will play an integral role in the distribution of a COVID-19 vaccine. This toolkit is aimed at providing counties the information and resources needed to plan for and equitably distribute the COVID-19 vaccine at the local level.

    Track: COVID Vaccine Administration

    • Doses administered per 100k residents
    • Doses distributed per 100k residents
    • Doses distributed
    • People with at least one dose

    Background and Resources 

    About the Vaccines

    COVID-19 Vaccine Tracker

    Vaccine Manufacturer Vaccine Type Development Stage Preliminary Effectiveness Estimated Start of Distribution Dosage Requirement Estimated Storage Requirement Amount Available

    BioNTech SE/ Pfizer

    mRNA Received FDA Approval on 12/11 95% final efficacy analysis

    In progress

    Two-dose Approx. -70 ° C/ -94° F

    200 million doses by end of year

     

    Moderna

    mRNA Received FDA Approval on 12/18 94.5% final efficacy analysis In progress Two-dose -20° C/ -4° F 15 million doses by end of year
    AstraZeneca/Oxford

    Viral vector

    Phase 3 (Started in August) 70% average in interim efficacy analysis Mid 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD
    Janssen Pharmaceuticals (Johnson & Johnson) Viral vector 

    Phase 3

    (Started in September)
    72% average in interim efficacy analysis in US  Mid 2021  Single-dose 2°C - 8°C/36°F to 46° F TBD
    Novavax

    Protein adjuvant

    Phase 3

    (started in September) 
    N/A Mid 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD
    Sanofi/GlaxoSmithKline

    Protein adjuvant

    Phase 2 (Phase 3 set to start in December)  N/A Mid-late 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD

     

    County Role in Vaccine Distribution

    As gatekeepers of the local health and human service safety net, counties will play an essential role in the development and implementation of vaccination programs. 

    The County Role in Vaccination Program Implementation

    1. Leveraging Local Expertise. According to profile data from the National Association of County and City Health Officials (NACCHO), most local health departments provide direct immunization services; 90 percent offer adult immunizations and 88 percent offer childhood immunizations. These departments therefore have a solid foundation of expertise in planning and administering vaccine and immunization programs. Counties must advocate that states leverage this experience and expertise to ensure COVID-19 vaccination planning efforts make best use of established practices and resources for implementation.

    2. Increasing Vaccine Confidence. Vaccine confidence is defined as the trust that parents, patients, or providers have in recommended vaccines, the providers administering those vaccines, and the processes and policies that lead to the development, licensure, manufacturing and recommendations for use.[1] County officials and local public health agencies must work directly with individuals in their communities to address vaccine hesitancy, combat vaccine misinformation, and increase vaccine confidence.

    3. Advocating for Necessary Resources. A survey conducted in June of 2020 by NACCHO revealed that immunization programs in local health departments were the most impacted by COVID-19 through the redirection of funding and the loss of staff. The findings also suggested that while the majority of local health departments (71%) are prepared to give COVID vaccines, they will need additional resources to do so.

    [1] National Association of County and City Health Officials (2020). Local public health: an integral partner for increasing vaccine confidence. Retrieved September 22, 2020 from https://www.naccho.org/uploads/full-width-images/factsheet_Local-Public-Health-Increasing-Vaccine-Confidence_july-2020.pdf

    Priority Populations

    The CDC has convened a group of professional organizations which include the National Institutes of Health (NIH) and the National Academies of Sciences, Engineering, and Medicine (NASEM), to determine which populations should be prioritized for COVID-19 vaccinations and ensure that there is equitable access to COVID-19 vaccination availability across the U.S.

    The working group will decide on priority populations through the continuous review of evidence on COVID-19 epidemiology and burden as well as COVID-19 vaccine safety, efficacy, evidence, quality and implementation findings.

    In addition to priority populations, the CDC is encouraging jurisdictions to include a plan to expand vaccine availability beyond priority populations to specific, “critical” populations that jurisdictions are encouraged to consider in their planning efforts:

    • Critical Infrastructure workforce: frontline healthcare personnel, vaccinators, school nurses EMS personal etc.
    • People at increased risk for severe COVID-19 illness: nursing home and skilled nursing facility residents, people with underlying medical conditions, people aged 65+
    • People at increased risk of acquiring or transmitting COVID: racial and ethnic minorities, tribal communities, people incarcerated or detained in correctional facilities, people experiencing homelessness or living in shelters, colleges or universities, people living or working in congregate settings
    • People with limited access to routine vaccination services: people in rural communities, individuals with disabilities, the uninsured and underinsured. 

    Key consideration for counties:

    • Counties officials are trusted public servants in their communities, with the ability to leverage existing partnerships with a variety of stakeholders to rapidly disseminate information through a range of channels.
    • County officials should leverage stakeholder partnerships to help identify and communicate with critical populations to ensure equitable vaccine distribution.

    County Communication Plans

    As the nation endeavors to take on an unprecedented rollout of the COVID-19 vaccine, counties will play a critical role in both planning vaccine distribution efforts, and ensuring residents get vaccinated.

    Research findings indicate that nearly a third of the U.S. population is hesitant to get the COVID-19 vaccine, and rates of hesitancy are even higher amongst minority groups.

    Additionally, vaccine disinformation and misinformation that has continued to plague local communities and contribute to hesitancy and distrust and will jeopardize rates of inoculation, and efforts to end the current public health emergency. The daunting task of overcoming these challenges and building public confidence in the COVID-19 vaccine, lays primarily on local government officials- who must develop effective communication strategies that reach all segments of their resident populations.

    County elected and appointed officials are trusted public servants in their communities, with the ability to leverage existing partnerships with a variety of stakeholders to rapidly disseminate information through a range of channels. Never has this responsibility been as important as it is now, as the need for effective communication to combat vaccine hesitancy and distrust is essential for the success of this operation.

    View the NACo Brief: County COVID-19 Vaccine Communication Plans

    KEY COMPONENTS

    Communication toolkits developed by federal agencies like the Centers for Disease Control and Prevention, alongside scientists and researchers have outlined several distinct elements of vaccine communication strategies that may assist with improving vaccine confidence in local communities:

    1. Identify appropriate messengers and vaccine champions that have a trusted voice in the community.
    2. Tailor messages for a variety of different audiences and produce targeted messaging for vulnerable populations.
    3. Lead with facts and transparency to increase public trust.
    4. Listen to concerns and adjust messaging as necessary to address the feedback.

    Many counties have incorporated these strategies into their COVID-19 communication plans for residents. The following sections summarize components of several county plans that have been implemented across the U.S. thus far.

    HENNEPIN COUNTY, MINN.

     

    Hennepin County has created a comprehensive communications plan to build vaccine confidence. To do so, the county has first focused on essential workers and those in congregate care settings. Given the existing vaccine confidence in many of these individuals, the county intends to reinforce messaging from state and federal officials and focus its efforts on advertising vaccination Points of Dispensing (PODs). In late spring, the county will turn its attention towards older adults, individuals with preexisting medical conditions, underserved communities, and uninsured/underinsured persons.  

    To reinforce and reframe confidence in the vaccine, the county plans to rely on the following “key messages”: 

    Three principles will guide vaccine distribution:  

    1. Maximize immediate health benefits and minimize serious illnesses, deaths and harm created by COVID-19. 
    2. Equitable distribution and access 
    3. (ransparency and speedy information sharing with residents 

    Minnesota is taking a regional approach to vaccine distribution through the creation of 25 “hub” sites that directly receive federal vaccine deliveries. 

    Not every factor of vaccine distribution is within Minnesota’s control 

    Until vaccines are available for everyone, we all need to continue to adhere to public health guidelines to protect ourselves and our communities.   

    To reach each audience, the county plans to share the messages listed above through diverse media outlets as well as influential leaders and organizations in underserved communities. It also intends to circulate footage of residents receiving vaccinations and leverage vaccine confidence programs of national, state and local partners within the community. This includes PR campaigns of public sector (e.g. CDC, NIH or the Governor’s Office) and private sector groups, such as The Ad Council, AMA, state health care associations and local hospitals.    

     

    COCONINO COUNTY, ARIZ.

     

    The vaccine communications campaign established by Coconino County first targets frontline healthcare workers and long-term care facilities and residents followed by a focus on the general public. Coconino County has structured its campaign into three phases: 

    • Pre-distribution of vaccine (RUN 1) 
    • Vaccine distribution launch (RUN 2) 
    • During Vaccine distribution (RUN 3) 

    During RUN 1, the county aims to build trust in the vaccine, generate excitement around returning to “normalcy” and emphasize personal responsibility to protect oneself and their communities. This phase of the campaign will target both high-priority groups and county residents with messages on the safety and efficacy of the vaccine. 

    RUN 2 will aim to educate high-priority groups and the general public on details related to the vaccine. This includes information on vaccine eligibility and timelines, side effects, the need for two doses and vaccination sites. The county will also roll out a “#SleeveUp #MaskUp #WashUp” social media campaign during RUN

    During its final “RUN 3” phase, the county will continue to educate its residents on vaccine-related information and introduce a “Conquer COVID” campaign that emphasizes the need for two doses and to bring insurance cards when being vaccinated although the vaccine is cost-free.  

    To facilitate this campaign and amplify its message across the county, Coconino County will utilize social media platforms (e.g. Facebook, Twitter, Instagram), produced and live videos, traditional media and the county website. The county began its communications campaign on December 15 and will continue to run this program through 2021.  

    MECKLENBURG COUNTY, N.C.

     

    Aimed at providing education on COVID-19 prevention and vaccination, Mecklenburg County’s vaccination communication plan targets the entire county population with a focus on priority groups and diverse communities. To execute its campaign, Mecklenburg County has divided its efforts between two audiences: (1) the general population and (2) populations that are historically vaccine resistant, hesitant and hard to reach.  

    By using county channels, radio, print media, news media, social media and web and digital platforms, the County intends to amplify four key messages: 

    1. You can protect yourself and others by wearing masks, washing your hands and staying home; 
    2. Prioritize vaccines; 
    3. The vaccine is safe and reliable; 
    4. Where and how residents can get vaccinated 

    Mecklenburg County has structured its outreach in two stages. First, it will conduct grassroots outreach and mass paid outreach by working with faith groups, community organizations and nontraditional communications tools (e.g. clean graffiti, door hangers, community workshops, etc.). In Stage 2, the county will turn to radio, print, digital and social media to promote vaccine safety and efficacy. County officials will identify “community influencers” to participate in vaccine promotional content through videos and interviews. 

    Internally, the county intends to facilitate its campaign through its Joint Information Center, Emergency Operations Center, Public Health Department and Public Information Department. The county will also partner with local entities, such as hospitals, EMS and neighboring municipalities and cities. 

    RESOURCES

    Federal Resources

    • Centers for Disease Control and Prevention’s How to Build Confidence in COVID-19 Vaccines: A Short Guide for Immunization Coordinators in Medical Centers and Clinics

    Partner Resources

    • American Hospital Association’s COVID-19 Vaccine Communications Toolkit
    • de Beaumont Foundation’s Changing the COVID Conversation Communications Cheat Sheet
    • ZenCity’sReady, Set, Vaccinate: A Guide for Local Governments on How to Take Control of the COVID-19 Vaccine Narrative in Your Community

    Vaccine Allocation, Ordering, Distribution & Inventory

    Allocation

    Each jurisdiction will be allocated a certain amount of the COVID-19 vaccine by the federal government, which will be managed by the jurisdiction’s immunization program. The allotted amount will change over time based on availability and population priority.

    Each week on Tuesday, states and jurisdictions will be provided allocations that are available to ship the following week. 

    • Click here to view allocations for the Pfizer vaccine by jurisdiction
    • Click here to view allocations for the Moderna vaccine by jurisdiction 

    Ordering

    Local distribution sites and enrolled providers will order the COVID-19 vaccine by the jurisdiction’s immunization program. The playbook specifies that jurisdictions may use existing IT systems and procedures in place for routine ordering of publicly funded vaccines (e.g., IIS/ExIS upload to CDC’s VTrckS for provider direct order entry). Jurisdictions will also use these systems to communicate with CDC about vaccine supply and allocations. Alongside vaccine allocations there will be ancillary supplies sent to jurisdictions which include needles, syringes, and PPE.

    States and jurisdictions will order based on their allocated amounts for that week and direct Operation Warp Speed to where shipments of the vaccine should be delivered. 

    Distribution

    COVID-19 vaccine allotments and ancillary supplies will be provided by the federal government at no cost to vaccination providers. The vaccines will be shipped to provider sites that enrolled in the jurisdiction’s immunization program within 48 hours of order approval. Because of vaccine storage requirements, ancillary supplies will ship separately from the vaccine.

    The federal government has a contract with McKesson Corp. to be a centralized distributor of Covid-19 vaccines, with the exception of Pfizer’s, which has set up its own distribution network. 

    Inventory

    The playbook advises that COVID-19 vaccination provider sites will be required to report inventory of COVID-19 vaccines, and jurisdictions will have to ensure this inventory information is submitted with each new order. Vaccines that are authorized under an Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) will vary slightly from product that receive an approval from the FDA, which has implications for the expiration date of the product.

    Key consideration for counties:

    • Determine the entity in your jurisdiction responsible for managing vaccine allotments and orders.
    • Ensure that eligible vaccine provider sites in your county (local health departments, clinics, community health centers, etc.) are enrolled in your state’s immunization program so that they may receive vaccine allotments.
    • Take inventory of existing IT systems used for publicly funded vaccines and ensure all local vaccine provider sites have access to these systems for vaccine ordering and inventory purposes.

    Vaccine Administration, Documentation & Reporting

    The playbook specifies that each vaccination provider site is required to report certain data elements for each dose administered and within 24 hours of the administration. Required data elements include detailed information about the vaccine administration site, as well as information about the vaccine recipient (see page 53 of the playbook for full list of discreet data elements). 

    While provider sites may use approved Immunization Information Systems (IIS) or other external systems for tracking, all vaccine administration data must be reported to the CDC’s Immunization Data Lake. The CDC recommends that jurisdictions assess the capability of COVID-19 vaccination providers to meet federal and jurisdiction-specific reporting requirements before or upon enrollment, which includes ensuring that sites have trained staff, necessary equipment, and internet access.

    In addition to reporting vaccine administration, vaccination sites and jurisdictions must implement processes to track first and second vaccine dosages for those vaccines requiring boosters. The information systems being used to track the vaccine administration must also be able to exchange data with other jurisdiction’s systems and/or the CDC ‘s Immunization Data Lake to obtain immunization history, if applicable.

    Key consideration for counties:

    • Assess the vaccine provider site’s ability (staff capacity, necessary equipment, and internet access) to adhere to CDC’s data reporting requirements. Report resource needs to your jurisdiction project manager. 

    Policy Priorities & Call to Action

    Counties are critical to any national vaccination effort. In order to be best positioned for success in our efforts to get residents vaccinated we will continue to work with Congress and the administration to obtain the following:

    1. Strong intergovernmental partnerships at the federal, state and local level that allows for clear communication and distribution of responsibility;
    2. Direct and flexible federal assistance to counties—which includes direct allocation of vaccine doses; and
    3. Shared communication messages on vaccine accessibility and safety at all levels of government.
    Reach Out to Your Congressional Representative

    To assist with our efforts to get direct and flexible aid to counties for vaccines and other COVID-19 mitigation efforts we are asking that you contact your congressional representatives and request their support.

    • CONTACT YOUR HOUSE REPRESENTATIVE
    • CONTACT YOUR SENATORS

    Resources

    Partner Organizations

    • Local Public Health: An Integral Partner for Increasing Vaccine Confidence (NACCHO)
    • NACCHO Infographic: The Impact of COVID-19 Response on Local Health Department Immunization Programs
    • Preliminary Framework for Equitable Allocation of COVID-19 Vaccine (NASEM)

    Department of Health and Human Services

    • COVID-19 Vaccine Resource Page
    • Fact Sheet: Explaining Operation Warp Speed
    • From the Factory to the Frontlines: The Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine

    Centers for Disease Control and Prevention

    • COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations
    • Vaccine Storage and Handling Toolkit
    • COVID-19 Vaccine Training Module for Healthcare Providers
    • CDC Vaccination Communication Toolkit for Health Care Professionals
    • Vaccination Guidance During a Pandemic
    • Frequently Asked Questions about COVID-19 Vaccination
    • Ensuring the Safety of COVID-19 Vaccines
    • How CDC Is Making COVID-19 Vaccine Recommendations
    • 8 Things to Know about Vaccine Planning

    Food and Drug Administration

    • Vaccine Development 101
    • Emergency Use Authorizations (EUAs) Explained
    • Development and Licensure of Vaccines to Prevent COVID-19

    EXAMPLES OF CORONAVIRUS RELIEF FUNDS (CRF) USES FOR VACCINE DISTRIBUTION

    Find more information and examples on county CRF uses here. 

    Sacramento County, California 

    Population: 1,552,058 

    CRF allocation: $181,198,725 

    Plan Overview: Sacramento County plans to allocate $3 million in CRF funds to purchase supplies and resources necessary to effectively distribute a COVID-19 vaccine when it is approved and made publicly available. These expenses include the purchase of “syringes, refrigeration bags, trucks and trailers”. As of October 22, the county has already approved $250,000 in CRF dollars to purchase two trucks and two trailers “to transport supplies to medical points of dispensing sites called MPODs”. The county described these MPOD sites as “pop-up clinics…designed to quickly distribute the vaccine to massive amounts of people”. For more information, click here.

    Pima County, Arizona 

    Population: 1,047,279 

    CRF allocation: $87,107,597 

    Plan Overview: Pima County spent $3.4 million to purchase a 43,500-square-foot warehouse to store PPE and eventually a COVID-19 vaccine. Although CRF dollars were not directly used for the purchase, County Administrator Chuck Huckleberry said “that it was made possible by dollars freed up by the CARES Act and other federal funding”. For more information, click here. 

    Tippecanoe County, Indiana 

    Population: 195,732 

    CRF allocation: $6,263,207.00 

    Plan Overview: Tippecanoe County allocated over $120,000 of its CRF sub-allocation from the state to cover expenses related to its COVID-19 vaccine clinic. For more information, click here. 

    This toolkit is aimed at providing counties the information and resources needed to plan for and equitably distribute the COVID-19 vaccine at the local level.
    2020-10-21
    Basic page
    2021-02-23
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Counties invest heavily in local residents' health and well-being and have been on the front lines of our nation’s response to the coronavirus pandemic. Counties support over 900 hospitals, 824 long-term care facilities and 1,943 local health departments- entities that will play an integral role in the distribution of a COVID-19 vaccine. This toolkit is aimed at providing counties the information and resources needed to plan for and equitably distribute the COVID-19 vaccine at the local level.

Track: COVID Vaccine Administration

Background and Resources 

About the Vaccines

COVID-19 Vaccine Tracker

Vaccine Manufacturer Vaccine Type Development Stage Preliminary Effectiveness Estimated Start of Distribution Dosage Requirement Estimated Storage Requirement Amount Available

BioNTech SE/ Pfizer

mRNA Received FDA Approval on 12/11 95% final efficacy analysis

In progress

Two-dose Approx. -70 ° C/ -94° F

200 million doses by end of year

 

Moderna

mRNA Received FDA Approval on 12/18 94.5% final efficacy analysis In progress Two-dose -20° C/ -4° F 15 million doses by end of year
AstraZeneca/Oxford

Viral vector

Phase 3 (Started in August) 70% average in interim efficacy analysis Mid 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD
Janssen Pharmaceuticals (Johnson & Johnson) Viral vector 

Phase 3

(Started in September)
72% average in interim efficacy analysis in US  Mid 2021  Single-dose 2°C - 8°C/36°F to 46° F TBD
Novavax

Protein adjuvant

Phase 3

(started in September) 
N/A Mid 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD
Sanofi/GlaxoSmithKline

Protein adjuvant

Phase 2 (Phase 3 set to start in December)  N/A Mid-late 2021 Two-dose 2°C - 8°C/36°F to 46° F TBD

 

County Role in Vaccine Distribution

As gatekeepers of the local health and human service safety net, counties will play an essential role in the development and implementation of vaccination programs. 

The County Role in Vaccination Program Implementation

1. Leveraging Local Expertise. According to profile data from the National Association of County and City Health Officials (NACCHO), most local health departments provide direct immunization services; 90 percent offer adult immunizations and 88 percent offer childhood immunizations. These departments therefore have a solid foundation of expertise in planning and administering vaccine and immunization programs. Counties must advocate that states leverage this experience and expertise to ensure COVID-19 vaccination planning efforts make best use of established practices and resources for implementation.

2. Increasing Vaccine Confidence. Vaccine confidence is defined as the trust that parents, patients, or providers have in recommended vaccines, the providers administering those vaccines, and the processes and policies that lead to the development, licensure, manufacturing and recommendations for use.[1] County officials and local public health agencies must work directly with individuals in their communities to address vaccine hesitancy, combat vaccine misinformation, and increase vaccine confidence.

3. Advocating for Necessary Resources. A survey conducted in June of 2020 by NACCHO revealed that immunization programs in local health departments were the most impacted by COVID-19 through the redirection of funding and the loss of staff. The findings also suggested that while the majority of local health departments (71%) are prepared to give COVID vaccines, they will need additional resources to do so.


[1] National Association of County and City Health Officials (2020). Local public health: an integral partner for increasing vaccine confidence. Retrieved September 22, 2020 from https://www.naccho.org/uploads/full-width-images/factsheet_Local-Public-Health-Increasing-Vaccine-Confidence_july-2020.pdf

Priority Populations

The CDC has convened a group of professional organizations which include the National Institutes of Health (NIH) and the National Academies of Sciences, Engineering, and Medicine (NASEM), to determine which populations should be prioritized for COVID-19 vaccinations and ensure that there is equitable access to COVID-19 vaccination availability across the U.S.

The working group will decide on priority populations through the continuous review of evidence on COVID-19 epidemiology and burden as well as COVID-19 vaccine safety, efficacy, evidence, quality and implementation findings.

In addition to priority populations, the CDC is encouraging jurisdictions to include a plan to expand vaccine availability beyond priority populations to specific, “critical” populations that jurisdictions are encouraged to consider in their planning efforts:

  • Critical Infrastructure workforce: frontline healthcare personnel, vaccinators, school nurses EMS personal etc.
  • People at increased risk for severe COVID-19 illness: nursing home and skilled nursing facility residents, people with underlying medical conditions, people aged 65+
  • People at increased risk of acquiring or transmitting COVID: racial and ethnic minorities, tribal communities, people incarcerated or detained in correctional facilities, people experiencing homelessness or living in shelters, colleges or universities, people living or working in congregate settings
  • People with limited access to routine vaccination services: people in rural communities, individuals with disabilities, the uninsured and underinsured. 

Key consideration for counties:

  • Counties officials are trusted public servants in their communities, with the ability to leverage existing partnerships with a variety of stakeholders to rapidly disseminate information through a range of channels.
  • County officials should leverage stakeholder partnerships to help identify and communicate with critical populations to ensure equitable vaccine distribution.

County Communication Plans

As the nation endeavors to take on an unprecedented rollout of the COVID-19 vaccine, counties will play a critical role in both planning vaccine distribution efforts, and ensuring residents get vaccinated.

Research findings indicate that nearly a third of the U.S. population is hesitant to get the COVID-19 vaccine, and rates of hesitancy are even higher amongst minority groups.

Additionally, vaccine disinformation and misinformation that has continued to plague local communities and contribute to hesitancy and distrust and will jeopardize rates of inoculation, and efforts to end the current public health emergency. The daunting task of overcoming these challenges and building public confidence in the COVID-19 vaccine, lays primarily on local government officials- who must develop effective communication strategies that reach all segments of their resident populations.

County elected and appointed officials are trusted public servants in their communities, with the ability to leverage existing partnerships with a variety of stakeholders to rapidly disseminate information through a range of channels. Never has this responsibility been as important as it is now, as the need for effective communication to combat vaccine hesitancy and distrust is essential for the success of this operation.

View the NACo Brief: County COVID-19 Vaccine Communication Plans

KEY COMPONENTS

Communication toolkits developed by federal agencies like the Centers for Disease Control and Prevention, alongside scientists and researchers have outlined several distinct elements of vaccine communication strategies that may assist with improving vaccine confidence in local communities:

  1. Identify appropriate messengers and vaccine champions that have a trusted voice in the community.
  2. Tailor messages for a variety of different audiences and produce targeted messaging for vulnerable populations.
  3. Lead with facts and transparency to increase public trust.
  4. Listen to concerns and adjust messaging as necessary to address the feedback.

Many counties have incorporated these strategies into their COVID-19 communication plans for residents. The following sections summarize components of several county plans that have been implemented across the U.S. thus far.

HENNEPIN COUNTY, MINN.

 

Hennepin County has created a comprehensive communications plan to build vaccine confidence. To do so, the county has first focused on essential workers and those in congregate care settings. Given the existing vaccine confidence in many of these individuals, the county intends to reinforce messaging from state and federal officials and focus its efforts on advertising vaccination Points of Dispensing (PODs). In late spring, the county will turn its attention towards older adults, individuals with preexisting medical conditions, underserved communities, and uninsured/underinsured persons.  

To reinforce and reframe confidence in the vaccine, the county plans to rely on the following “key messages”: 

Three principles will guide vaccine distribution:  

  1. Maximize immediate health benefits and minimize serious illnesses, deaths and harm created by COVID-19. 
  2. Equitable distribution and access 
  3. (ransparency and speedy information sharing with residents 

Minnesota is taking a regional approach to vaccine distribution through the creation of 25 “hub” sites that directly receive federal vaccine deliveries. 

Not every factor of vaccine distribution is within Minnesota’s control 

Until vaccines are available for everyone, we all need to continue to adhere to public health guidelines to protect ourselves and our communities.   

To reach each audience, the county plans to share the messages listed above through diverse media outlets as well as influential leaders and organizations in underserved communities. It also intends to circulate footage of residents receiving vaccinations and leverage vaccine confidence programs of national, state and local partners within the community. This includes PR campaigns of public sector (e.g. CDC, NIH or the Governor’s Office) and private sector groups, such as The Ad Council, AMA, state health care associations and local hospitals.    

 

COCONINO COUNTY, ARIZ.

 

The vaccine communications campaign established by Coconino County first targets frontline healthcare workers and long-term care facilities and residents followed by a focus on the general public. Coconino County has structured its campaign into three phases: 

  • Pre-distribution of vaccine (RUN 1) 
  • Vaccine distribution launch (RUN 2) 
  • During Vaccine distribution (RUN 3) 

During RUN 1, the county aims to build trust in the vaccine, generate excitement around returning to “normalcy” and emphasize personal responsibility to protect oneself and their communities. This phase of the campaign will target both high-priority groups and county residents with messages on the safety and efficacy of the vaccine. 

RUN 2 will aim to educate high-priority groups and the general public on details related to the vaccine. This includes information on vaccine eligibility and timelines, side effects, the need for two doses and vaccination sites. The county will also roll out a “#SleeveUp #MaskUp #WashUp” social media campaign during RUN

During its final “RUN 3” phase, the county will continue to educate its residents on vaccine-related information and introduce a “Conquer COVID” campaign that emphasizes the need for two doses and to bring insurance cards when being vaccinated although the vaccine is cost-free.  

To facilitate this campaign and amplify its message across the county, Coconino County will utilize social media platforms (e.g. Facebook, Twitter, Instagram), produced and live videos, traditional media and the county website. The county began its communications campaign on December 15 and will continue to run this program through 2021.  

MECKLENBURG COUNTY, N.C.

 

Aimed at providing education on COVID-19 prevention and vaccination, Mecklenburg County’s vaccination communication plan targets the entire county population with a focus on priority groups and diverse communities. To execute its campaign, Mecklenburg County has divided its efforts between two audiences: (1) the general population and (2) populations that are historically vaccine resistant, hesitant and hard to reach.  

By using county channels, radio, print media, news media, social media and web and digital platforms, the County intends to amplify four key messages: 

  1. You can protect yourself and others by wearing masks, washing your hands and staying home; 
  2. Prioritize vaccines; 
  3. The vaccine is safe and reliable; 
  4. Where and how residents can get vaccinated 

Mecklenburg County has structured its outreach in two stages. First, it will conduct grassroots outreach and mass paid outreach by working with faith groups, community organizations and nontraditional communications tools (e.g. clean graffiti, door hangers, community workshops, etc.). In Stage 2, the county will turn to radio, print, digital and social media to promote vaccine safety and efficacy. County officials will identify “community influencers” to participate in vaccine promotional content through videos and interviews. 

Internally, the county intends to facilitate its campaign through its Joint Information Center, Emergency Operations Center, Public Health Department and Public Information Department. The county will also partner with local entities, such as hospitals, EMS and neighboring municipalities and cities. 

RESOURCES

Federal Resources

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Vaccine Allocation, Ordering, Distribution & Inventory

Allocation

Each jurisdiction will be allocated a certain amount of the COVID-19 vaccine by the federal government, which will be managed by the jurisdiction’s immunization program. The allotted amount will change over time based on availability and population priority.

Each week on Tuesday, states and jurisdictions will be provided allocations that are available to ship the following week. 

Ordering

Local distribution sites and enrolled providers will order the COVID-19 vaccine by the jurisdiction’s immunization program. The playbook specifies that jurisdictions may use existing IT systems and procedures in place for routine ordering of publicly funded vaccines (e.g., IIS/ExIS upload to CDC’s VTrckS for provider direct order entry). Jurisdictions will also use these systems to communicate with CDC about vaccine supply and allocations. Alongside vaccine allocations there will be ancillary supplies sent to jurisdictions which include needles, syringes, and PPE.

States and jurisdictions will order based on their allocated amounts for that week and direct Operation Warp Speed to where shipments of the vaccine should be delivered. 

Distribution

COVID-19 vaccine allotments and ancillary supplies will be provided by the federal government at no cost to vaccination providers. The vaccines will be shipped to provider sites that enrolled in the jurisdiction’s immunization program within 48 hours of order approval. Because of vaccine storage requirements, ancillary supplies will ship separately from the vaccine.

The federal government has a contract with McKesson Corp. to be a centralized distributor of Covid-19 vaccines, with the exception of Pfizer’s, which has set up its own distribution network. 

Inventory

The playbook advises that COVID-19 vaccination provider sites will be required to report inventory of COVID-19 vaccines, and jurisdictions will have to ensure this inventory information is submitted with each new order. Vaccines that are authorized under an Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) will vary slightly from product that receive an approval from the FDA, which has implications for the expiration date of the product.

Key consideration for counties:

  • Determine the entity in your jurisdiction responsible for managing vaccine allotments and orders.
  • Ensure that eligible vaccine provider sites in your county (local health departments, clinics, community health centers, etc.) are enrolled in your state’s immunization program so that they may receive vaccine allotments.
  • Take inventory of existing IT systems used for publicly funded vaccines and ensure all local vaccine provider sites have access to these systems for vaccine ordering and inventory purposes.

Vaccine Administration, Documentation & Reporting

The playbook specifies that each vaccination provider site is required to report certain data elements for each dose administered and within 24 hours of the administration. Required data elements include detailed information about the vaccine administration site, as well as information about the vaccine recipient (see page 53 of the playbook for full list of discreet data elements). 

While provider sites may use approved Immunization Information Systems (IIS) or other external systems for tracking, all vaccine administration data must be reported to the CDC’s Immunization Data Lake. The CDC recommends that jurisdictions assess the capability of COVID-19 vaccination providers to meet federal and jurisdiction-specific reporting requirements before or upon enrollment, which includes ensuring that sites have trained staff, necessary equipment, and internet access.

In addition to reporting vaccine administration, vaccination sites and jurisdictions must implement processes to track first and second vaccine dosages for those vaccines requiring boosters. The information systems being used to track the vaccine administration must also be able to exchange data with other jurisdiction’s systems and/or the CDC ‘s Immunization Data Lake to obtain immunization history, if applicable.

Key consideration for counties:

  • Assess the vaccine provider site’s ability (staff capacity, necessary equipment, and internet access) to adhere to CDC’s data reporting requirements. Report resource needs to your jurisdiction project manager. 

Policy Priorities & Call to Action

Counties are critical to any national vaccination effort. In order to be best positioned for success in our efforts to get residents vaccinated we will continue to work with Congress and the administration to obtain the following:

  1. Strong intergovernmental partnerships at the federal, state and local level that allows for clear communication and distribution of responsibility;
  2. Direct and flexible federal assistance to counties—which includes direct allocation of vaccine doses; and
  3. Shared communication messages on vaccine accessibility and safety at all levels of government.
Reach Out to Your Congressional Representative

To assist with our efforts to get direct and flexible aid to counties for vaccines and other COVID-19 mitigation efforts we are asking that you contact your congressional representatives and request their support.

Resources

Partner Organizations

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

EXAMPLES OF CORONAVIRUS RELIEF FUNDS (CRF) USES FOR VACCINE DISTRIBUTION

Find more information and examples on county CRF uses here

Sacramento County, California 

Population: 1,552,058 

CRF allocation: $181,198,725 

Plan Overview: Sacramento County plans to allocate $3 million in CRF funds to purchase supplies and resources necessary to effectively distribute a COVID-19 vaccine when it is approved and made publicly available. These expenses include the purchase of “syringes, refrigeration bags, trucks and trailers”. As of October 22, the county has already approved $250,000 in CRF dollars to purchase two trucks and two trailers “to transport supplies to medical points of dispensing sites called MPODs”. The county described these MPOD sites as “pop-up clinics…designed to quickly distribute the vaccine to massive amounts of people”. For more information, click here.

Pima County, Arizona 

Population: 1,047,279 

CRF allocation: $87,107,597 

Plan Overview: Pima County spent $3.4 million to purchase a 43,500-square-foot warehouse to store PPE and eventually a COVID-19 vaccine. Although CRF dollars were not directly used for the purchase, County Administrator Chuck Huckleberry said “that it was made possible by dollars freed up by the CARES Act and other federal funding”. For more information, click here

Tippecanoe County, Indiana 

Population: 195,732 

CRF allocation: $6,263,207.00 

Plan Overview: Tippecanoe County allocated over $120,000 of its CRF sub-allocation from the state to cover expenses related to its COVID-19 vaccine clinic. For more information, click here

Contact

  • Associate Legislative Director – Health  
    (202) 942-4246

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