Key Considerations for Counties in COVID-19 Vaccine Distribution Plans

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

  • Basic page

    Key Considerations for Counties in COVID-19 Vaccine Distribution Plans

    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 begin planning for an equitable distribution of the COVID-19 vaccine at the local level.

    Jump to Section

    • State Distribution Plans
    • Background & Resources
    • County Examples
    • NACo Legislative Summary of CDC Playbook

    Explore State Distribution Plans

    Alaska

    COVID-19 Vaccination Plan - Draft
    Source: State of Alaska Department of Health and Social Services; October 16, 2020; Version 1
     

    Alaska’s COVID-19 Vaccine ECHO (Extension for Community Healthcare Outcomes) is a partnership with the State and with Alaska Native Tribal Health Consortium (ANTHC) to provide COVID-19 vaccine planning and operation updates. It uses videoconferencing technology to connect a team of interdisciplinary experts with primary care providers, other health services professionals, and community members. These videoconferences create virtual learning communities by connecting Alaska’s COVID-19 experts with specific audiences on specific topics. Additionally, to reach public and consumer audiences, the Vaccine Communication/Education Team will implement a blend of paid, earned, and owned media.

    The Alaska Native Tribal Health Consortium (ANTHC) is a non-profit Tribal health organization designed to meet the unique health needs of Tribal people living in Alaska. In partnership with the more than 180,000 Tribal people that we serve and THOs of the Tribal, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction. ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,000 employees offering an array of health services to people around the nation’s largest state.

    Alabama

    COVID-19 Vaccination Plan - Interim Draft
    Source: Alabama Department of Public Health (ADPH); November 5, 2020
     
    Vaccine Administration Documentation and Reporting
    Alabama’s lifespan registry, ImmPRINT, collects data on all vaccines administered. There are currently over 4,000 sites that utilize ImmPRINT daily. ImmPRINT is capable of real-time reporting and can produce all metrics to be shared with the ADPH’s Digital Media Branch Director for display on department’s website.
     
    Provider Recruitment and Enrollment
    Primary provider types include Local Health Departments, Hospitals/Health Care Organizations, Long Term Care Facilities, and Pharmacies of which there are 856 out of 1500 pharmacies enrolled. The ADPH Immunization Division (IMM) uses ImmPRINT for provider enrollment and management and there are currently more than 2,677 healthcare sites who are working with ImmPRINT. Providers will include external partners, like the Alabama Hospital Association, the Medical Association for the State of Alabama, and the State Committee of Public Health. In addition, ADPH continues to reach out to all the other major healthcare systems and providers, including the members of the Alabama Adolescent and Adult Vaccine Task Force.
     
    Equity in Distribution and Messaging
    Pharmacies can identify and conduct outreach to their patients who may not necessarily have a defined “medical home” and can serve the immunization needs of this population. ADPH IMM will use ImmPRINT to monitor provider locations to determine if additional recruitment is necessary for areas that are insufficiently staffed to meet the anticipated demand based on population density and any known disparity regions. IMM will monitor vaccine administration statistics by county to cover race and high-risk populations. Messaging to the public will be phase based and use existing channels. Alabama’s Health Alert Network via the Alabama Emergency Response Technology (ALERT) will be among major tools for updating the public as well. IMM has the capability to send second‐dose reminders via postcard and email but will be looking to develop more methods including radio, social media, and text alerts.
     
    Organizational Structure
    ADPH is the health agency for the state of Alabama and the State Board of Health is an advisory board to support all public health matters. ADPH consists of 6 districts, which includes 65 out of 67 county health departments. ADPH is a centralized public health system and all levels, including central office and counties, are under the authority of the SHO. The state is responsible for coordination of the pandemic influenza response within and between jurisdictions, while public health districts and county health departments (CHDs) are responsible for coordination of pandemic vaccine response with other organizations in their region. 
     
    Last modified: 11/23/2020

    Arizona

    Arizona Department of Health Services (ADHS) submitted its Draft Arizona COVID-19 Vaccination Plan but is not as of yet publicly available. According to an update on the ADHS website on October 20th:

    To inform this draft plan, ADHS has worked since April with a large and diverse group of stakeholders that includes county and tribal public health, outpatient healthcare providers and associations, inpatient healthcare providers and associations, payors, pharmacy and EMS stakeholders, and state and local emergency management agencies. This partner involvement and feedback is so critical to making sure that Arizona has the best possible plan for vaccine distribution, and also includes the development and implementation of training and exercises to inform the state’s pandemic vaccine response.

    The Draft Arizona COVID-19 Vaccination Plan highlights Arizona’s local allocator model, which designates county health departments and tribal health partners as the local authorities responsible for approving vaccine allocations to providers within each jurisdiction. It also focuses on the importance of communication, as the CDC anticipates a vaccine requiring two doses spaced three to four weeks apart.  

    The vaccination program will be led by a state advisory committee referred to as the Vaccine and Antiviral Prioritization Advisory Committee which will be comprised of a group of experts from ADHS and its partners.

    Source

    Arkansas

    COVID-19 Vaccination Plan - Interim Draft
    Source: Arkansas Department Of Health; October 16, 2020; Work in Process 
     
    Vaccine Administration Documentation and Reporting
    The ADH Immunization Information System (IIS), WebIZ, is the statewide centralized repository of immunization information and will be used to track vaccine distribution. All COVID-19 vaccination providers must be registered in the system and must submit vaccination information to WebIZ within 24 hours of vaccine administration. 
     
    Provider Recruitment and Enrollment
    ADH is recruiting new providers through the COVID-19 Prevention Workgroup, through a COVID-19 Provider Enrollment link on the ADH website and a notice and link to the WebIZ Homepage. ADH is also working with partner organizations and creating an online COVID-19 vaccination provider enrollment process.  
     
    Equity in Distribution and Messaging
    The Arkansas Vaccine Medical Advisory Committee’s subcommittee on COVID-19 vaccination will adapt and apply the ACIP and NAM recommendations to develop specific recommendations for each priority population in Arkansas.  
     
    The ADH Office of Health Communications, along with the ADH Office of Health Equity and ADH subject matter experts will coordinate messaging across multiple platforms and channels to communicate with all audiences before availability of a vaccine as well as through the different phases of the program. Emphasis will be placed on reaching groups with increased risk or with limited access to vaccination services, including Arkansas’ Hispanic and Marshallese populations. All messaging will be reviewed to ensure it is culturally appropriate, respectful, and free of stigma and/or bias and to verify that it uses plain language that is accessible by the intended audience.  
     
    Organizational Structure
    ADH has established both internal and external working groups to help guide vaccination efforts. ADH, a unified or centralized health department, is headquartered in Little Rock and has a total of 94 Local Health Units – with at least one in each of the state’s 75 counties. The open and closed Points of Distribution (POD) program can be used in all three of the suggested phases of the COVID-19 vaccination plan. The Arkansas State Strategic National Stockpile (SNS) program has historically relied on coordination and collaboration of ADH Local Health Units, businesses, community organizations and volunteers in the actions of mass distribution and redistribution of medical countermeasures.
     
    Last modified: 11/18/2020

    California

    COVID-19 Vaccination Plan - Interim Draft
    Source: California Department of Public Health; October 16, 2020; Version 1.0
     
    Vaccine Administration Documentation and Reporting
    Data from all COVID-19 vaccine doses administered by providers will be stored in California’s Immunization Registry (CAIR). CAIR supports real-time immunization record query messages (QBP) and can be accessed online to help providers and other authorized users track patient immunization records and reduce missed opportunities. 
     
    Provider Recruitment and Enrollment
    Vaccine provider recruitment and enrollment will be conducted primarily by local health departments, based on their existing partnerships with the provider community. Eligible providers will be invited to enroll in the COVID-19 Provider Enrollment and Ordering Management System. Once successfully enrolled, providers will be eligible to receive vaccine allocations. 
     
    Equity in Distribution and Messaging
    California has developed a health equity metric, which helps guide the state’s counties in their continuing efforts to fight COVID-19 more effectively. Additionally, California has established a Health Equity Technical Assistance Team that will partner with key regional collaborative and advocacy groups to develop and menu and playbook of best practices, resources and vendors with an equity focus to share and provide resources to counties. 
     
    California’s communication plan aligns with the vaccine distribution timeline and will be implemented throughout all phases. The plan includes public and stakeholder engagement with a focus on tailored messaging to key populations and vulnerable communities to ensure maximum vaccine uptake. The plan includes an expedited process to issue urgent public health communications through a rapid response crisis communication hub. 
     
    Organizational Structure
    CDPH resides within the cabinet-level California Health and Human Services Agency (CHHS) and is leading much of the state’s COVID-19 response activities. Local government entities must use the state’s Standardized Emergency Management System (SEMS) to be eligible for any reimbursement of response-related costs under the state’s disaster assistance programs.
     
    CDPH works closely with local health departments to coordinate and provide technical assistance for all the different aspects of provider enrollment, data elements and outreach. At the local level, jurisdictions have local immunization and pandemic flu coordinators that already have connections to local health care vaccine providers. 
     
    Last modified: 11/18/2020

    Colorado

    COVID-19 Vaccination Plan - Draft
    Source: Colorado Department of Public Health and Environment; October 16, 2020; Version 1.0

     

    Demonstration of proactive communication strategies for second-dose reminders

    The Colorado Department of Public Health and Environment’s (CDPHE) will work with local public health agencies (LPHA) to determine where vaccines should go within their jurisdiction. Colorado will analyze the results of an initial COVID-19 Vaccine Provider Interest Survey and coordinate with Local Public Health Agencies (LPHA) to determine the vaccination providers who will be initially enrolled in the COVID-19 Vaccination Program for Phase 1. The state will use the Colorado Immunization Information System (CIIS) to track the data.

    Second-dose reminders

    Colorado will strongly encourage COVID-19 vaccination providers to schedule a patient’s second-dose appointment when they receive their first dose as patients are more likely to present for a second dose if the appointment is already on their calendar. Whenever possible, second-dose reminders will come directly from the COVID-19 vaccination provider who first immunized the patient as patients are more receptive to receiving messages from trusted and known sources. Proactive scheduling of second-dose appointments can also assist COVID-19 vaccination providers with planning and anticipated inventory needs.

    For COVID-19 vaccination providers without existing mechanisms for performing second-dose reminders, Colorado will promote the use of the CIIS which has a reminder/recall report feature and can be run by LPHAs by county level population. This feature also has the capability to reprocess the same reminder/recall run and generate a report of those patients who have become up-to-date since the initial reminder/recall report was generated and those patients who are still not-up-to-date. The state has created a Patient Reminder/Recall training toolkit for clinics which includes training videos, best practices, guidance on reviewing the quality and accuracy of the clinic’s data before running a reminder/recall, and templates for reminder messages. The state also recently invested in a health messaging system (Teletask) that enables them to send automated phone messages, text messages. Lastly, Colorado will have a Public Portal available which provide secure access for patients to have another method by which they can stay on top of their COVID-19 vaccine schedules.

    Delaware

    The Delaware Division of Public Health submitted an executive summary for its COVID-19 vaccine plan to the Centers for Disease Control and Prevention during the week of October 26th. The plan itself is currently not publicly available.

    Source

    Florida

    While Florida’s COVID-19 Vaccination Plan is not yet publicly available, it has been reviewed and summarized by Tampa Bay’s news station, WTSP. A link to that article and video clip is available for this summary. Florida’s Department of Health is integrating a planning structure based on lessons learned from the H1N1 pandemic, such as by “increasing the inclusion of community partners to provide vaccinators.” All 67 county health departments will be directly involved in vaccination administration. The DOH will be using an “Incident Command Structure” comprised of experts and representatives from the immunization program, epidemiology, EMS, long-term care associations and others. The Department of Health will be coordinating their vaccine efforts with hospitals, pharmacies, correctional facilities, homeless shelters, community-based organizations, long-term care facilities and public safety agencies. The vaccine distribution currently considers the following groups to be priority recipients though it is subject to change at the time a vaccine actually becomes available: health care personnel, essential workers, those with medical conditions placing them at high-risk for COVID-19 complications, and adults who are 65 years of age, or older.

    Source

    Georgia

    COVID-19 Vaccination Plan - Draft
    Source: Georgia Department of Public Health; October 15, 2020; Version 1
     
    Vaccine Administration Documentation and Reporting
    Using the Georgia Registry of Immunization Transactions and Services (GRITS) to collect COVID-19 vaccine doses administered data from providers.  
     
    Provider Recruitment and Enrollment
    Public Health Districts (PHDs) will use Points of Distribution (PODs) for vaccine distribution which will include public health clinics, hospitals, long term care facilities (LTCs), emergency medical services (EMS), etc. Other potential vaccine providers will include health districts, currently enrolled Vaccines for Children (VFC) providers, and previous H1N1 mass vaccination providers. The recruitment process surveys the potential providers and then assigns them to a population tier based on providers’ ability to store, manage and distribute vaccines.
     
    Equity in Distribution and Messaging
    DPH has established a COVID-19 Health Equity Team which engages community-based organizations (CBOs) to address health inequities exacerbated by COVID-19. The Department of Public Health (DPH) will utilize the current partnerships created by this team to collect estimates on critical populations and locate them. Coordination of communication efforts about vaccine development and availability will be led by the state DPH Division of Communications. The public will receive this information from the state DPH website, social media, media reports and additional marketing campaigns as funding allows. Healthcare providers will be informed through the Regional Coordinating Hospital System and through the DPH constant contact list-serve. Partner agencies will be updated and informed through the Joint Information Center (JIC) operations, and redundantly through communications with the 18 Public Health districts and their communicators. Second-dose reminders will be completed through provider built-in systems and a statewide reminder recall program as a backup. 
     
    Organizational Structure
    Georgia’s 18 Health Districts and local public health departments work with local community partners, healthcare organizations, long-term care facilities, businesses, industries, and professional organizations. Each district will be required to establish points of contact for key critical populations to a) identify and locate critical populations in their geographic area and b) communicate timely and effective COVID-19 vaccination messaging. 
     
    Last modified: 11/17/2020

    Hawaii

    News Release from State of Hawaii, Department of Health
    Vaccination Plan Executive Summary 
    Plan Status and Source: No full plan for public access.
     
    Hawaii does not as of yet have their full plan documented online for public access. However, their Department of Health posted a summary on October 22nd. Lt. Gov. Josh Green made the following statement: 
     
    “This has to be a coordinated effort between the state and counties. It will also require extensive outreach and education to healthcare providers and their patients. Everyone’s kokua is critical to the success of the vaccination plan, so we must make sure everyone’s roles and responsibilities are clearly defined.” 
     
    Vaccine Administration
    During the initial phase of vaccine distribution, Hawaii Department of Health will prioritize high-risk healthcare employees at hospitals and others involved with direct patient care, first responders who have high risk for COVID-19 exposure, and Hawaii residents of all ages who have underlying health conditions, including those 65 and older who live in congregate settings 
     
    Documentation and Reporting
    Hawaii will use the Hawaii Immunization Registry (HIR) system for data tracking and for provider enrollment. 
     
    Organizational Structure
    The Hawaii Department of Health (HDOH), as the lead state health agency and lead state agency for State Emergency Support Function 8 (SESF #8) Public Health and Medical Services, formed a Core Planning Team with representatives from local, state, and federal levels as well as private sector partners under the leadership of the Disease Outbreak Control Division (DOCD) Immunization Branch (IMB) to develop the state's COVID‐19 Vaccination Plan. HDOH will use two primary coordinating bodies, a Vaccination Core Planning Team and a Vaccination Program Implementation Committee, as well as standing and ad hoc working groups to support the COVID‐19 vaccination program 
     
    Last modified: 11/17/2020

    Idaho

    COVID-19 Vaccination Plan - Interim Draft
    Source: Idaho Department of Health and Welfare; October 16, 2020; Version 1
     
    Vaccine Administration Documentation and Reporting
    The Idaho Immunization Program (IIP) will use PrepMod to collect COVID-19 vaccination administration data from vaccine providers. IIP will set targets for successful implementation which includes monitoring staffing, budgets, and supplies. Idaho Resource Tracking System will be used by IIP and the Public Health Preparedness and Response Program to monitor vaccine supplies. 
     
    Provider Recruitment and Enrollment
    The Idaho Immunization Program (IIP) will initially focus on recruiting local public health districts, hospitals, and FQHCs as vaccine providers. Pharmacies could also be enrolled to conduct mass vaccination clinics in areas of need. A public Idaho COVID-19 Vaccine Provider Toolkit will be developed as a reference guide for vaccine providers. Provider recruitment/enrollment will match the 3-phased approach to COVID-19 vaccination, and the DPH and state medical actors will work closely with the directors of the local public health districts to coordinate the vaccine delivery. 
     
    Equity in Distribution and Messaging
    DHW is engaging with partners and the Idaho COVID-19 Vaccine Advisory Committee to prioritize subgroups and ensure equity and transparency in vaccine distribution and administration. DHW has also convened a COVID-19 Communications Task Force that will lead vaccination communications. Communication will include targeted messaging to essential agents like providers and priority populations with information on vaccine availability and safety. Channels will include social media, websites, blog platforms, as well as other government partners, and DHW’s media and marketing contractor. The COVID-19 Vaccine Advisory Committee (CVAC) will rely on input from disparate populations in order to assure equitable access to a vaccine. Second-dose reminders will be sent through Prepmod’s reminder feature and the reminder feature within Idaho’s IIS, IRIS (Immunization Reminder Information System). 
     
    Organizational Structure
    Idaho has a decentralized public health structure. At the highest level, Idaho’s State Health Officer (SHO) is in regular communication with the Region 10 Office of the Assistant Secretary for Health (OASH) Administrator as well as the other Region 10 SHOs. Idaho’s 44 counties are divided into seven local public health districts. The SHO, Medical Director, and key state Division of Public Health (DPH) staff meet two times a week with the Directors of Idaho’s seven local public health districts (PHDs). 
     
    Last modified: 11/17/2020

    Illinois

    SARS-CoV-2/COVID-19 Mass Vaccination Planning Guide - Draft
    Source: Illinois Department of Public Health; October 2020; Version 2.0
     
    Vaccine Administration Documentation and Reporting
    The Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE) is the state’s immunization information system (IIS) and will be the primary system utilized to order and track vaccine administration. All vaccine providers must be registered in the Illinois Health Alert Network – HAN/SIREN. 
     
    Structure / Provider Recruitment and Enrollment
    The Vaccine Administration Division will work with vaccine providers in each of the health care coalition regions and with local public health jurisdictions to determine each provider’s capacity to manage vaccine distribution. To assist with mass vaccination operations at their POD sites and with seeking qualified volunteers, vaccine providers can utilize Illinois Helps, a state registry of volunteers for both medical and non-medical occupations who can be activated in a disaster or public health emergency. 
     
    Illinois also has a two-tiered strategy to ensure vaccine delivery:  
    • Tier 1 will utilize current shipping practices of the Vaccines for Children Program and existing local health department vaccine distribution infrastructures for mass vaccination  
    • Tier 2 serves as back-up and/or support to previous carriers and utilizes identified state partners such as the Illinois Department of Corrections that maintains refrigerated fleet vehicles for transport of biologics. 
    Equity in Distribution and Messaging
    IDPH’s calculation for proportional vaccine allocation will be adjusted to account for equity, potential hotspots and regional positions within the state. The Illinois Health Alert Network – HAN/ SIREN will disseminate health information, make emergency notifications, and alert all health and vaccine provider staff. Second-dose reminders will be done using CDC vaccine cards, call and text reminders, and via the reminder/recall functionality of I-CARE. 
     
    Last modified: 11/17/2020

    Indiana

    COVID-19 Vaccine Allocation Plan - Interim Draft
    Source: Indiana Department of Health; October 14, 2020
     
    Vaccine Administration Documentation and Reporting
    The Children and Hoosier Immunization Registry Program (CHIRP) is a secure web-based application administered by the IDOH and used as the state’s Immunization information system (IIS). The data from CHIRP will help provide a variety of program metrics and maps which will be presented within the state’s existing COVID-19 website. 
     
    Provider Recruitment and Enrollment
    Indiana vaccine providers include primary care physicians, pharmacists, and local health departments. Currently, 743 providers are enrolled in the Indiana Vaccines for Children (VFC) Program who are actively vaccinating and recording vaccination administration data in CHIRP. There are 1,923 other facilities that are administering vaccines and have established a bi-directional interface with CHIRP. IDOH will also work with the Indiana Hospital Association, Indiana Pharmacy Alliance, and others to recruit even more vaccination partners. 
     
    Equity in Distribution and Messaging
    The IDOH Office of Public Affairs (OPA) will coordinate the communication plan, with timelines and tracking mechanisms to ensure that communications are timely and proactive, yet flexible to adjust to program changes. OPA will review, research and monitor social media awareness regarding the public’s perception of the vaccine to adjust messaging to ensure that communication addresses the barriers that most influence vaccine uptake. Indiana will also deliver second-dose communications as needed through healthcare electronic health records (EHRs), Vaccination Record Cards, CHIRP, Scheduling of Second Dose Duration First Does Administration, and other means. The Equitable Distribution and Communication Advisory Group advises on equitable coverage of populations for the vaccine and helps to identify communication gaps. Consultation with the IDOH Office of Minority Health and Translations will help ensure that all vaccine communication will be crafted to most effectively reach each specific audience. 
     
    Organizational Structure
    Indiana’s Department of Health has a Department Operations Center which uses an Incident Support Model (ISM). Indiana has adapted its planning and response capability based upon the following operational constructs: A central State Emergency Operations Center (SEOC), an Executive Policy Group, and 10 Public Health Preparedness Districts. Districts vary in their infrastructure, however several commonalities of Districts include: District Planning Councils, Healthcare Coalitions, and Indiana District Response Task Forces. Counties, local governments, and the State benefit from sharing resources, eliminating redundancy in critical response activities, and coordinating emergency planning, training, and exercise activities.
     
    Last modified: 11/17/2020

    Iowa

    COVID-19 Vaccination Strategy - Draft
    Source: Iowa Department of Public Health; October 12, 2020; Version 1.2
     
    Vaccine Administration Documentation and Reporting
    IDPH will utilize the Immunization Registry Information System (IRIS) for the allocation, distribution, and documentation of COVID-19 vaccine. 
     
    Provider Recruitment and Enrollment
    Local public health agencies will allocate vaccines local healthcare providers and other organizations such as pharmacies. Collaboration will occur between the IDPH, Iowa local public health agencies and Iowa healthcare providers to administer pandemic vaccines.  A REDCap survey will be used to document and approve potential vaccine providers. 
     
    Equity in Distribution and Messaging
    COVID-19 vaccine uptake and coverage will be monitored in critical populations and enhanced strategies to reach populations with low vaccination uptake or coverage will be implemented. Iowa’s Vaccination Communication Plan is divided into different areas based on the audience and the specific communication needs of the audience. Local Public Health Agencies and the IDPH have developed working relationships with local newspaper and television news staff. Press releases will be developed by the IDPH’s Public Information Officer (PIO) and will be sent to LPHA via the Iowa Health Alert Network (HAN) or email. Each local agency will adapt news releases to their agency and release the information to their local communication channels. IRIS can help healthcare providers send reminders letters and postcards when patients are due for additional doses of vaccine or recall patients to schedule immunization appointments. 
     
    Organizational Structure
    IDPH has convened an internal COVID-19 Vaccine Planning team with representation from the state immunization bureau, the hospital and public health preparedness and response bureau, and other entities. Coordination and communication with Iowa’s 99 local public health agencies (one per county) is essential to the vaccine response. Ongoing weekly webinars and meetings are scheduled with LHDs and healthcare providers for sharing updates and providing guidance documents. 
     
    Last modified: 11/17/2020

    Kansas

    COVID-19 Vaccination Plan - Draft
    Source: Kansas Department of Health and Environment; October 16, 2020; Version 1.2; Reviewed November 4, 2020
     
    Vaccine Administration Documentation and Reporting
    Kansas is working with KSWebIZ, the state immunization registry, to create data extracts. The internal Kansas COVID-19 vaccine planning committee will establish processes for monitoring critical components of the program such as vaccine allocations, distribution, and uptake.
     
    Provider Recruitment and Enrollment
    Kansas will participate in the Pharmacy Partnership for Long-term Care Program coordinated by the CDC. The Pharmacy Partnership for Long-term Care Program provides end-to-end management of the COVID-19 vaccination process. Recruitment and enrollment of other providers will be targeted at different organizations depending on the current phase of the state distribution, with hospitals, LHDs, FQHCs and pharmacies primarily making up the first phase providers. If it is determined that there are areas of the state that have limited access to vaccine providers, the Kansas Immunization Program will prepare for mobile clinics using the state’s influenza playbook.
     
    Equity in Distribution and Messaging
    The Kansas Department of Health and Environment (KDHE) will work with partner organizations to ensure that all people are addressed inclusively, with respect, using non - stigmatizing, bias-free language and that the materials are not misleading or confusing. KDHE will utilize the risk communication principles from the CDC’s Vaccinate with Confidence framework. Overall goals will be to educate the public on the distribution of vaccines, implement confidence messaging, engage in dialogue with internal and external partners to address vaccine program implementation, and providing guidance to local health departments and clinicians. The Immunization Outreach Coordinator will provide routine communications and will identify and distribute social media tools for internal and external stakeholders. For second-dose reminders, vaccine providers will use the vaccination record card as well as reminder/recalls available through existing electronic health record systems and/or KSWebIZ.
     
    Organizational Structure
    The Kansas Department of Health and Environment (KDHE) has an internal COVID-19 Vaccine Planning Committee that consists of multiple stakeholders from within and outside the Agency. In Kansas, the public health system is decentralized and KDHE serves all 105 counties of the state. The local health departments report to their local Board of Health, which is typically the local Board of County Commissions. There will be collaboration, cooperation, and coordination of both KDHE and the local health departments in the development and implementation of the COVID-19 Vaccine Plan for Kansas. Local health departments are represented on the internal COVID-19 vaccine planning committee. 
     
    Last modified: 11/17/2020

    Kentucky

    COVID-19 Vaccination Plan - Draft
    Source: Kentucky Public Health; October 2020; October 2020
     
    Vaccine Administration Documentation and Reporting
    COVID-19 Vaccine Providers will submit data to the Kentucky Immunization Registry (KYIR). A KYIR Data Quality Analyst and KYIR on-boarders will utilize reports from KYIR to monitor data quality and timeliness of data submission for vaccine providers. 
     
    Provider Recruitment and Enrollment
    Once enrollment of critical phase 1 providers is completed, geographic information system (GIS) mapping will be used to identify gaps in coverage and targeted recruitment efforts will then be implemented. KDPH is recruiting providers with the assistance of the Kentucky Hospital Association (KHA), the Kentucky Health Department Association (KHDA), and others.
     
    Equity in Distribution and Messaging
    KDPH will utilize “mobile vaccination teams” to support and provide vaccines to defined targeted groups and populations impacted by health inequity. A survey will help by collecting information on these populations that will also inform the development of appropriate messaging and delivery mechanisms for the public and for healthcare providers. The Kentucky SNS Crisis Communication Guide will be key a resource for public communication during the vaccination campaign. A “multi-front” communication strategy utilizing the KDPH Commissioner’s Office, the CHFS Office of Public Affairs, the Governor’s Office, external partner agencies and a contracted communications firm will ensure accurate and effective messaging across all populations. Information may be disseminated via social media, web site postings, interviews, newspaper editorials, flyers, billboards, television and radio broadcasts. KDPH will also evaluate and adapt to social media trends in order to combat the challenges of misinformation. KDPH will utilize the Kentucky Immunization Registry (KYIR) Mass Event Model for the majority of second dose reminders. Vaccine providers will schedule the patient’s second-dose appointment when delivering their first dose.
     
    Organizational Structure
    Kentucky’s vaccination planning is a combined state and local responsibility that requires close collaboration between KDPH, Local Health Departments (LHDs) external agencies, and community partners. Kentucky public health has a “shared governance” health structure within which both KDPH and LHDs will play key roles in the vaccination campaign. For Kentucky’s Vaccination Allocation Committee (VAC), KDPH will use the Kentucky Health and Medical Preparedness Committee (HMPAC), as well as leadership from KDPH’s COVID-19 planning and coordination team and representatives for critical population groups identified by CDC. 
     
    Last modified: 11/17/2020

    Louisiana

    COVID-19 Vaccination Playbook - Interim Draft
    Source: Louisiana Department of Health Office of Public Health; October 16, 2020; Version 01

     

    Vaccine Administration Documentation and Reporting
    Submitting vaccination information to the LDH, as required in statute, will be done through the Louisiana Immunization Network, LINKS. This will also include provider enrollment data. 
     
    Provider Recruitment and Enrollment
    Pharmacy engagement and Closed Point of Dispensing (POD) planning will be the framework for the initial phase of the vaccine response. Most COVID-19 vaccine providers are already registered vaccine providers due to rulemaking in April 2020.  
     
    Equity in Distribution and Messaging
    Members with health equity expertise are in each Work Group to address health disparities in all areas. The Governor established a Health Equity Task Force to support COVID-19 safety and prevention in communities with health disparities. Mobile Vaccination Teams will be deployed to areas where gaps in access are identified. The network and engagement of the Governor’s Health Equity Task Force, along with the Office of Public Health’s (OPH) Office of Community Outreach & Health Equity, will engage the public with Tele-Town Hall meetings. The nine Regional Field staff will help identify populations in the state that are hard to reach for vaccination services. The Governor’s Office and Homeland Security and Emergency Preparedness (GOHSEP) maintains a Joint Information Center (JIC) and is supported by LDH Public Information Officers (PIOs). A vaccine web page is in development for the Louisiana Department of Health (LDH) COVID-19 website. Direct communications with vaccine providers by OPH are aided by a Regional and State Health Alert Network (HAN). Messaging to the public uses the “211” Statewide system while higher-level communications relites on trusted LDH OPH State and Regional designated spokespersons. LINKS delivers second-dose reminders by several means including postcards and auto dialers, while the state reminds vaccine recipients through the consumer access portal, MyIR Mobile. 
     
    Organizational Structure
    The Louisiana Department of Health (LDH) Office of Public Health (OPH) is the lead agency for pandemic response and works collaboratively with state, local, and private agencies. The OPH formed the Vaccine Action Collaborative (VAC) which in turn established work groups for the COVID-19 response effort: Prioritization and Allocation; Planning, Logistics and Operations; and Communications and Outreach. The VAC includes representation from both public and private sectors. Louisiana has a centralized public health system for 62 of the 64 parishes and will use the NIMS Incident Command System (ICS) to manage incidents.  
     
    Last modified: 11/16/2020

    Maine

    COVID-19 Vaccination Plan - Interim Draft
    Source: Maine Center for Disease Control and Prevention; October 16, 2020; Version 1.0

     

    Vaccine Administration Documentation and Reporting
    The Maine Immunization Information System IIS will be utilized for vaccine doses administered by providers. The Division of Public Health Nursing (PHN) will reconcile after each clinic the number of doses given. The Maine Immunization Program will develop a COVID-19 Vaccine Distribution webpage for the website. They will also be surveying the Hospitals after the first Phase 1a vaccine has been distributed and assess uptake and lessons learned. 
     
    Provider Recruitment and Enrollment
    Maine Immunization will prioritize enrollment of hospitals, long-term care facilities, and pharmacies. District Liaisons from the public health districts plan to enroll all 37 Maine hospitals as vaccine provider sites as a priority for Phase 1. Vaccination of target groups will occur in closed, point-of-dispensing (POD) settings with the health care systems throughout Maine. Other providers will include Indian Health Service sites, mobile vaccination providers, federally qualified health care facilities, and urgent care clinics. 
     
    Equity in Distribution and Messaging
    Maine will collaborate with partners already engaged with disproportionately affected populations, such as the DHHS’ Health Equity Improvement Initiative, in order to effectively reach them. Messaging and outreach will be culturally responsive language, available in languages that represent the communities, non-stigmatizing and bias-free. District Public Health Liaisons can work with immigrant and other non-majority populations to achieve the highest possible vaccine uptake. Maine's Health Alert Network system (HAN) will be used to inform stakeholders in real time. Community health workers (CHW) will be engaged as part of the educational outreach efforts. Communication channels will use an existing partnership with the Maine Association of Broadcasters to deliver messaging through radio and television broadcasts, while digital media will be delivered via social media. Written communication channels will also be facilitated using GovDelivery and other direct channels. Second-dose reminders will be sent via their IIS’s built-in reminder recall functionality and the built-in scheduling and record keeping capabilities of their enrolled vaccine providers. 
     
    Organizational Structure
    The Maine Center for Disease Control (Maine CDC) serves as the State's public health agency and it is being supported by the Maine DHHS for their work on the COVID-19 vaccination plan and implementation. District Public Health (DPH) ensures the delivery of public health services across Maine’s nine public health districts. Each public health district is led by a District Liaison, who coordinates with Maine CDC staff in the district (Public Health Unit) and who provides leadership with an elected executive committee for the district coordinating council. District Liaisons serve as the primary point of contact (POC) between community clinic organizers and administrators, county emergency management agencies, and the health care system.
     
    Last modified: 11/16/2020

    Maryland

    COVID-19 Vaccination Plan - Draft
    Source: Maryland Department of Health; October 16, 2020; Version 1.0

     

    Vaccine Administration Documentation and Reporting
    ImmuNet is the place where providers register to become a vaccine provider, order vaccines, track delivery of vaccine, report doses administered, and determine when second doses are due. PrepMod will be used as the main vaccine management system during Phase 1. MDH will have a flu and Covid-19 dashboard, which will include both cases and vaccine status, and they will have a dashboard for the data collected by ImmuNet. 
     
    Provider Recruitment and Enrollment
    MDH is enrolling healthcare providers (HCPs), local health departments (LHDs), employee occupational health and pharmacists via ImmuNet. MDH is working with the Maryland Board of Pharmacy and Maryland Pharmacy Association to coordinate and communicate with the state’s 4,900 provider pharmacies, both chain and independent.
     
    Equity in Distribution and Messaging
    The MDH Center for Immunization (CFI) has developed an enrollment process for vaccine providers that will allow high visibility on where vaccine providers are located, where additional providers are needed, or where LHD PODs can provide a vaccination safety net. ImmuNet will be used to continuously monitor of vaccination metrics to ensure equitable distribution of vaccines through a broad network of vaccination providers. MDH will coordinate with trusted community partners, priority group representatives, and representatives of vulnerable populations, along with a marketing vendor, to develop and disseminate messaging. Second dose reminders will be provided to patients via PrepMod, provider-based systems, and Maryland MyIR, a consumer vaccination portal, which allows registered users to obtain their current vaccination records from ImmuNet and which can also issue reminder messages. 
     
    Organizational Structure
    CFI will lead the operations aspects of the vaccine plan implementation and the MDH Office of Preparedness and Response (OP&R) will lead the planning, coordination and logistics. TCFI and OP&R have established an incident command system (ICS) to organize the vaccination response. CFI will use federal COVID-19 funding to hire additional staff including a functional analyst to work with ImmuNet data, and an administrative specialist to supervise provider registration and the approval of vaccine orders.
     
    Last modified: 11/16/2020

    Massachusetts

    COVID-19 Vaccination Plan - Interim Draft
    Source: Massachusetts Department of Public Health; October 16, 2020; Version 1.0
     
    Vaccine Administration Documentation and Reporting
    The Massachusetts Immunization Information System (MIIS) will be used to capture COVID-19 vaccine doses administered data. Massachusetts Department of Public Health (MDPH) Bureau of Infectious Disease and Laboratory Sciences (BIDLS) has also purchased the PrepMod System to connect to the MIIS for real-time reporting. 
     
    Provider Recruitment and Enrollment
    MDPH is prioritizing hospitals, long term care facilities, skilled nursing facilities (SNF), emergency medical services (EMS), and others for provider enrollment. There are close to 3,000 provider sites registered and enrolled in the MDPH vaccine distribution system and/or reporting data to the MIIS. This includes all pediatric provider sites, major hospital systems, community health centers, local health departments, and approximately 1,000 pharmacy locations.
     
    Equity in Distribution and Messaging
    The communication approach will use earned and paid media to reach disproportionately impacted groups and will use a data-driven process to develop a public awareness messaging campaign. MDPH will establish points of contact and communication methods for organizations, employers, or communities (as appropriate) within the identified critical population groups where those relationships do not currently exist.
     
    Organizational Structure
    The Commissioner of Public Health oversees a public health workforce of nearly 3,000, and a department comprised of eight bureaus and six offices responsible for a range of programs including surveillance and prevention of diseases dangerous to the public health. The  Immunization Division (MCVP) is the lead for COVID-19 vaccination planning, distribution, and implementation efforts. The Office of Local and Regional Health (OLRH) connects local public health departments with information and resources from the MDPH.  Massachusetts has a decentralized public health system, and its 351 cities and towns have the authority to provide public health services to its residents. There are currently six regional Health and Medical Coordinating Coalitions (HMCCs) in Massachusetts that conduct capabilities-based, cross-disciplinary planning and support for public health and provide medical response during emergencies.
     
    Last modified: 11/18/2020

    Michigan

    COVID-19 Vaccination Plan - Interim Draft
    Source: Michigan Department of Health & Human Services; October 16, 2020; Version 1.0
     
    Vaccine Administration Documentation and Reporting
    The Michigan Care Improvement Registry (MCIR) which is the statewide IIS will be used to track all COVID vaccine doses administered. The Division of Immunization has developed a public-facing influenza vaccine dashboard, that provides users with location of vaccine providers and data regarding vaccine doses administered and vaccination coverage.  
     
    Provider Recruitment and Enrollment
    The Division of Immunizations will work with local public health for the initial allocations of the vaccine which will be directed to 143 hospitals and health systems. After initial allocations to hospitals, allocations will be made to each of the 45 health jurisdictions based on the social vulnerability index, population and other factors. LHDs will use community relationships to allocate additional vaccines to community providers who can reach vulnerable populations.  
     
    Equity in Distribution and Messaging
    The Michigan Department of Health and Human Services (MDHHS) has a communication division to ensure that all communication is developed with consideration for health equity, using culturally responsive language that is bias-free. Michigan will ensure equitable access to a vaccine by monitoring provider data with regards to site location, and by tracking vaccine administration saturation by county. MDHHS also will work closely with the Community Health Emergency Coordination Center (CHECC) to coordinate state vaccine messaging consistency. The CHECC along with the State Emergency Operation Center (SEOC) ensures widely shared information throughout the State through conference calls, emails, and blast messages as well as the  Michigan Health Alert Network (MIHAN). Second-dose reminders will be conducted using vaccine record cards from the CDC, postcards as needed, and centralized text messaging via MCIR. 
     
    Organizational Structure
    Michigan’s Division of Immunization is one of 4 Divisions within the Bureau of Infection Disease Prevention but is temporarily reporting to the State Epidemiologist within the Bureau of epidemiology and Population Health. Local Health Departments are key partners to the success of the COVID-19 vaccination program as each one has a well-established SNS plan which has exercised points of dispensing and contains mass vaccination. 
     
    Last modified: 11/18/2020

    Minnesota

    Interim COVID-19 Vaccination Plan - Executive Summary
    Plan Status and Source:  Minnesota has not yet made a full comprehensive COVID-19 vaccination plan available to the public. A summary of their plan can be found here.   
     
    Last modified: 11/18/2020

    Mississippi

    COVID-19 Vaccination Plan - Draft
    Source: Mississippi State Department of Health; October 16, 2020; Version 1
     
    Vaccine Administration Documentation and Reporting
    MSDH will use Mississippi Immunization Information eXchange (MIIX). The MIIX unit will be responsible for Remind/Recall, IZ Gateway Feeds, and deduplications. MSDH OIMM will be available to provide additional support or technical assistance for smaller vaccination providers or rural clinic settings. 
     
    Provider Recruitment and Enrollment
    During Phase I, MSDH will focus on closed point-of-dispensing (CPOD) settings. While prioritizing enrollment activities for CPODs in Phase 1, MSDH will simultaneously plan open POD (OPOD) drive-through sites for future phases to vaccinate those who live in remote, rural areas with access difficulties. MSDH will enroll commercial and private sector partners/providers and public health sites. All 82 counties can access vaccination in 1 week with 16 rotating PODs a day. 
     
    Equity in Distribution and Messaging
    The MSDH Office of Communications will conduct focus groups to inform concerns, misconceptions and other issues regarding COVID-19 vaccination. The Office of Communication will use TV, radio, print, social media, and virtual meetings to communicate information regarding the vaccination plans. Specific information about disease transmission prevention, and about vaccine priority groups for COVID-19 vaccine will be disseminated prior to vaccine availability. As a vaccine becomes available, local and statewide media will be responsible for disseminating access information to the appropriate groups. Their communication plan includes a risk communication plan that contains different methods for issuing critical information to the public about the outbreak and control measures using joint information process (JIC), at both State and local levels. MSDH messages will be tailored for each audience and developed with consideration for health equity. Information will be presented in culturally responsive language and available in languages that represent the communities in MS. The state will develop plans to ensure equitable access to vaccination for the critical populations identified. Second dose reminders will be conducted through the MIIX system and through a contract with Avaya for text reminders. 
     
    Organizational Structure
    MSDH is a centralized public health agency with 86 health department clinics in 81 of the 82 counties. The state is divided into three public health regions each having a Regional Health Officer, a Regional Administrator, a Chief Nurse, and other staff who direct activities in all of the local health departments in the counties within the Regions. Statewide representation on the internal planning team (including regional health department staff) ensures that all facets of the public health network are represented and contribute to the effort.
     
    Last modified: 11/18/2020

    Missouri

    COVID-19 Vaccination Plan - Draft
    Source: Interagency COVID-19 Vaccination Planning Team; October 11, 2020
     
    Vaccine Administration Documentation and Reporting
    The state Immunization Information System (IIS)for the vaccine campaign is ShowMeVax (SMV).   Any/all reporting of program metrics within a public-facing website will require close coordination with state communications officials and the Governor's office.
     
    Provider Recruitment and Enrollment
    Vaccinations will take place in closed Points of Dispensing (PODS). Missouri’s multi-step process for provider enrollment identifies potential providers, engages them, enrolls them and then sustains their participation within COVID vaccination efforts. Potential providers included hospital systems, primary care providers, volunteer organizations, occupational health programs, Department of Corrections, and local public health departments. Additionally, mobile vaccination teams will be deployed within the nine Missouri regions to help limit the need for redistribution beyond the original recipient of vaccines.
     
    Equity in Distribution and Messaging
    The Missouri Department of Health and Senior Services (DHSS) multi-sourced media campaign focuses on vaccine stigma reduction, consistent messaging, and encouragement. The campaign will run from 10 days before vaccine delivery and continue six to eight months after the first vaccine delivery. DHSS communication strategy involves monitoring and trending of traditional media and social media venues at the state and regional levels. DHSS will be working closely with the communications firm Elasticity to develop effective digital outreach strategies. The Regional Implementation Teams (RITs) will help plan for health equity, using surveys and maps to identify underserved populations and the wide variety of demographic and social risk factor distributions across the State of Missouri.  The RITs will also partner with medical schools in key areas to leverage outreach clinics into the homeless, minority, and underserved populations to deliver the vaccine via trusted entities.
     
    Organizational Structure
    Missouri has established the Missouri Interagency COVID-19 Vaccination Planning Team to coordinate the vaccination plan, and five-person regional Vaccination Support Teams (VST) in each of the State's nine State Emergency Management Agency (SEMA) regions. Regional Implementation Teams (RIT), made up of local healthcare and community leaders, coordinate the local deployments of vaccinations with the support and guidance of the State implementation Team (SIT). Made up of representatives from the RITs and leadership from the Bureau of Immunizations, the SIT is a central coordinating group for information dissemination, problem-solving, and ensuring local voices are part of the plan. Regional VSTs are composed of an executive, nurses, and a public health specialist.
     
    Last modified: 11/18/2020

     

    Montana

    COVID-19 Vaccination Plan - Draft
    Source: Montana Department of Public Health and Human Services; October 16, 2020; Version 1.2
     
    Vaccine Administration Documentation and Reporting
    Immunization staff will determine which data collection method to use based on the provider needs and capabilities. Methods include the Immunization Information System (imMTrax), the Vaccine Administration Management System (VAMS) and PrepMOD. ImMTrax will be used to calculate program metrics and relevant data will be shared using the Department’s Coronavirus page located on their public dashboard.
     
    Provider Recruitment and Enrollment
    Eligible providers will be determined based on their ability to access and use the Immunization Information System (IIS) software, report administration data within 24 hours, sustain cold-chain management of the vaccine with appropriate storage equipment, and commit to training. 
     
    Equity in Distribution and Messaging
    DPHHS will use  federal guidance to determine priority populations. DPHHS public messaging is coordinated through the department’s Public Information Officer (PIO). Public information will 1) Notify the public of the arrival of vaccine into the state and introduce the plan for distribution and the reasons supporting it; 2) Notify the public when there is an increase of vaccine in the state and is available to an expanded group of at-risk populations and the providers offering it; and 3) Provide regular encouraging and positive messages for everyone to receive both doses of the vaccine. Message templates are shared with local and tribal health jurisdictions for their use as well While some variables will change regarding communication throughout the multiple phases, items that won’t change include the audiences, modes of communication, and information sources. For second-dose reminders, Montana’s IIS has a Reminder/Recall module which can be used to effectively communicate to vaccine recipients. 
     
    Organizational Structure
    DPHHS fosters collaborative partnerships with counties, tribes, healthcare entities and others as part of the pandemic response. The operational hub will be in DPHHS’s Immunization Section in the Communicable Disease Control and Prevention Bureau (CDCPB). Two key advisory groups will guide the effective vaccination effort:  
    • Internal Planning Advisory Group (reporting to the Governor’s Coronavirus Taskforce)  
    • Vaccination Plan Coordination Planning Team which will be comprised of key community stakeholders from across Montana representing multiple entities 
     
    Last modified: 11/18/2020

    Nebraska

    COVID-19 Vaccination Plan  - Draft
    Source: Department of Health and Human Services; October 16, 2020
     
    Vaccine Administration Documentation and Reporting
    The NDHHS will use the Nebraska State Immunization Information System (NESllS) to house and maintain the vaccination distribution data. The backup plan will be to use the Vaccine Administration Management System (VAMS). Nebraska will monitor progress in COVID-10 Vaccination Program implementation by tracking provider enrollment, the population's access to vaccination services, NESllS performance, reporting, vaccine ordering and distribution, and vaccination coverage. Additionally, Nebraska is creating a dashboard which will query data captured within NESllS and produce regularly updated visualization tools.
     
    Provider Recruitment and Enrollment
    Providers must enroll in the United States Government (USG) COVID-19 vaccination program, coordinated through NDHHS Immunization Program. NDHHS will continue provider recruitment and enrollment as the vaccine supply increases.
     
    Equity in Distribution and Messaging
    If there is a vaccine shortage/limit, NDHHS Immunization staff will ensure vaccine ordering is based on equitable distribution of vaccine across Nebraska designed to vaccinate identified priority groups. Distribution of vaccine will utilize the same model used for the distribution of vaccines under the Vaccines for Children (VFC) program. NDHHS will establish points of contacts with organizations, employers, and leaders within critical population groups by having a coordinated public information campaign. INebraska local health departments function as the local public health authority and voice within their communities.
     
    Organizational Structure
    The NDHHS Incident Commander oversees the Preparedness section and is acting as the Point of Contact for the Nebraska COVID-19 response. This program will invite external representatives from Local Health Departments (LHD), the hospital association, Federally Qualified Health Clinics (FQHC), Community Based Clinics (CBC), and health disparity/tribal communities.
     
    Last modified: 11/18/2020

    New Hampshire

    While New Hampshire’s full comprehensive COVID-19 vaccination plan is not publicly available, there is some information on it as reported by New Hampshire Public Radio (NHPR) on October 22nd. Lori Shibinette, commissioner of the state Department of Health and Human Services, said that the plan had been submitted to the CDC on October 16th and have already noticed a need to amend the document in light of new information on long-term care testing with vaccinations. New Hampshire is the only state in the nation without an immunization database. This may be a problem if it is not ready by the time a vaccine becomes available, however Shibinette said the state is working to have an immunization database ready by early December and that they have “two or three other options that [they] will use until the registry is up.”

    Source

    New Jersey

    COVID-19 Vaccination Plan - Interim Draft
    Source: New Jersey Department of Health (NJDOH); October 16, 2020; Version 1
     
    Vaccine Administration Documentation and Reporting
    The New Jersey Immunization Information System (NJIIS) is the mechanism used to capture vaccine doses administered in the state. Data has been integrated into New Jersey COVID-19 Dashboard, which is accessible directly through the New Jersey COVID-19 Information Hub and the New Jersey Department of Health’s website.
     
    Provider Recruitment and Enrollment
    NJDOH has over 800 VFC providers and 126 317-Funded Adult Vaccine Program providers. The current 317-Funded Adult Vaccine providers include local health departments, FQHCs and non-profit organizations. The New Jersey Local Information Network and Communications System (LINCS) is a network of 22 strategically positioned local health departments located throughout the state of NJ. LINCS agencies will subsequently determine the Local Health Department partners in each of their 22 locations. NJDOH will also work in conjunction with them and other local and county authorities to coordinate the vaccine effort within their jurisdictions.
     
    Equity in Distribution and Messaging
    Communication will match the phased approach of the vaccine distribution. A statewide public awareness campaign will be tailored to health care personnel--organizations and clinicians who will receive information about receiving and administering the vaccine. All messaging, including infographics, FAQs, websites etc., will be disseminated to the public and stakeholder groups and will be culturally appropriate and translated into multiple languages. Other channels will include the New Jersey COVID-19 Information Center and a “211” line. Social media will also be used to inform and engage with the public via multiple platforms including Facebook, Twitter and a COVIDNJ Alert App. Information will also be disseminated regularly by and through well-established public health channels including the New Jersey Local Information Network Communication System (NJLINCS) agency Health Educators/Risk Communicators and professional organizations including the Medical Society of New Jersey and others. NJDOH will achieve health equity by diversifying collaborators and perspectives in the planning and delivery of the vaccine, partnering with community leaders to support education and outreach, accommodating the delivery needs of specific populations, and by tracking and adapting to distribution data.
     
    Organizational Structure
    Governor Murphy created the Coronavirus Task Force (CTF) and designated the Commissioner of the NJDOH as the Task Force Chair.  The Vaccine Task Force (VTF) is an arm housed within the Department of Health to support the CTF’s efforts to plan and implement a statewide COVID-19 vaccine program. The VTF has nine work groups which expand their membership to engage participation from key stakeholder groups including key NJLINCS and local public health (LPH) representatives, because the work of the VTF will be supported by the 22 NJLINCS agencies and over 94 local health departments (LHDs). New Jersey is planning on local delivery and close collaboration with regions, counties, and localities.
     
    Last modified: 11/19/2020

    New Mexico

    COVID-19 Vaccination Plan - Preliminary Draft
    Source: New Mexico Department of Health (NMDOH) ; October 16, 2020
     
    Vaccine Administration Documentation and Reporting
    Provider documentation of vaccine administration for COVID-19 vaccine will mostly occur from the New Mexico Statewide Immunization Information System (NMSIIS) users who have automated data exchange from their EHR directly into the registry data base.  NMDOH is also considering VAMS for providers not enrolled in NMSIIS. Metrics related to COVID-19 testing can be found here.
     
    Provider Recruitment and Enrollment
    Vaccines will be primarily distributed in closed “point of dispensing” (POD) settings to specific groups depending on the phase. Early “hub” events will administer hundreds of vaccinations in one day through hospitals, large community health centers, and mobile clinics. NMDOH will later rely on smaller public health centers and pharmacies that could conduct closed or semi-closed POD events. The NMDOH registry currently includes 389 Vaccine For Children (VFC) and 81 Adult vaccine providers enrolled in NMSIIS.  NMDOH is actively engaging with pharmacists through the New Mexico Pharmacists Association to enroll pharmacists as COVID-19 vaccinators.
     
    Equity in Distribution and Messaging
    Coordinating communications will adapt to the needs of the current phase of vaccine distribution. Channels for the communications strategy include daily press releases, weekly press conferences led by top health leaders, statistical analyses, a public dashboard on status of cases by county, and social media. The NMDOH also established the NMDOH COVID Call Center staffed with registered nurses.  Information sites include the Office of Governor Michelle Lujan Grisham and the COVID-19 specific pages on the NMDOH website. For second dose reminders, NMDOH will mainly use the MNSISS reminder/recall report options. They will also use the existing messaging platform used by Public Health Division sites. NMDOH will utilize the online IIS system and provider enrollment via the Tiberius platform to track and identify gaps in access to COVID-19 vaccination services. If gaps are identified in COVID-19 vaccination services, the Immunization Program will conduct provider recruitment activities and work with PHD to provide mass vaccination clinics.
     
    Organizational Structure
    NMDOH is a centralized statewide public health system that coordinates the public health response to COVID-19. Two divisions of NMDOH are leading the COVID-19 Vaccine planning effort: 
    • NMDOH’s Public Health Division manages the public health offices throughout the state 
    • The Epidemiology and Response Division is leading surveillance and data analytics
    NMDOH’s public health agency includes four Public Health Regions and a public health office in most of the state’s 33 counties, all under one chain of command. NMDOH incorporates guidance from federal partners, collaborates with local authorities, and works closely with local Emergency Managers (EM) 
     
    Last modified: 11/19/2020

    New York

    COVID-19 Vaccination Program
    Source: New York State Department of Health; October 2020

     

    Overall management of New York’s vaccination program will require a Vaccine Central Command Center (VC3) to oversee all aspects of vaccine delivery, administration, and other operational aspects of the program. The VC3 will operate within the existing New York State Incident Command structure following sound emergency response principles, in concert with the ongoing broader pandemic response to ensure that all partners clearly understand each other’s roles and responsibilities. Pandemic vaccination planning, distribution, and monitoring will require close collaboration between state and local public health, external agencies, and community partners. The VC3 will include representatives of state agencies that will be charged with managing all aspects of the COVID-19 vaccine program in close coordination with local public health, healthcare, and community-based organizations.

    To administer the vaccine, New York State will rely on an established network of health care providers, including hospitals, LTCFs (nursing homes, adult care facilities (ACFs), assisted living), Federally Qualified Health Centers (FQHCs), Community Health Centers, Rural Health Clinics, private provider offices, local health departments, and other entities that will serve as Vaccination Administration Sites (VAS). In addition, the state will work with commercial and independent pharmacies, businesses, and other organizations to enable on-site vaccination at these sites. Other VASs include schools, colleges and universities, homeless shelters, correction facilities, and sites where target populations gather (i.e., senior centers, social service offices, food pantries, etc.) New York State will plan for quick activation and mobilization of mass vaccination point of dispensing (POD) sites, designed to be operationalized once vaccine availability increases and outpaces provider administration capacity. In addition, New York State will designate mobile vaccination units, similar to the rapid response team testing efforts that have been deployed statewide to help control viral spread and outbreaks to increase access to hard to reach populations including smaller congregate living facilities.

    Since the onset of the COVID-19 crisis, New York State has worked in close partnership with local health departments (LHDs) across the state. To support local health departments in the administration of the COVID-19 vaccine, New York State will: advise each LHD regarding storage requirements for vaccines that the LHD may be expected to store and/or administer; ensure they are prepared to fully implement their local mass vaccination plans in accordance with State and Federal guidance; advise on protocols for building public trust in the vaccine, and provide technical and logistical assistance as needed. New York State government, as authorized by the state legislature in statute, has throughout the COVID-19 crisis made uniform and consistent decisions for the entire state regarding public health emergency response, a successful model that has helped New York flatten the curve. To ensure coordinated and efficient statewide distribution and administration, all localities, vaccine recipients and administration entities in New York State will be required to follow the state’s central planning process and guidance for COVID-19 vaccination.

    The New York State Immunization Information System (NYSIIS) is a confidential, secure, web-based system that collects and maintains demographic and immunization information in one consolidated record for persons of all ages in New York State (outside of New York City). NYSIIS will be the system for pre-ordering vaccine, ongoing tracking, reporting, and collecting of priority group information. Facilities and providers, including hospitals, nursing homes, adult care facilities, clinics, pharmacies, Federally Qualified Health Centers (FQHCs), and additional public and private providers will be trained and enrolled in NYSIIS.

    An online website for New Yorkers seeking information regarding vaccine eligibility and appointment scheduling will be available that offers a vaccine eligibility screening tool and a vaccine administration site locator. Individuals will be able to enter information on the website to see if they meet vaccine eligibility In addition to the support services offered online, a call center will be available for patients and providers to access live support to raise any issues with vaccine access and delivery. A robust data analytics program will track issues that are identified and processed through the call center and online support modules to enable quick action to troubleshoot common issues as they arise. Websites and call centers will be designed to offer support for all New Yorkers including for those with disabilities, non-English speakers, and those with limited language proficiency. New York State will work closely with partners statewide who can assist in ensuring that all public communication is done in a way to ensure that those with health inequities are represented and ensure that access to vaccine is not a barrier for underserved communities. Achieving high rates of vaccination will depend upon a successful and robust public education campaign and properly executed communication strategy. The state will launch an ongoing public education campaign to ensure New Yorkers have the latest, and most accurate, information related to the facts about the vaccine itself, the progress and success of the program and all critical information needed regarding access to vaccination. In addition, engagement with community organizations, localities, tribal nations, and healthcare providers is essential to ensure critical information is distributed reliably to all New Yorkers.

    North Carolina

    COVID-19 Vaccination Plan - Interim Draft
    Source: North Carolina Department of Health and Human Services; October 16, 2020; Version 1

     

    The North Carolina Office of Emergency Medical Services Healthcare Preparedness Program (OEMS HPP) will leverage existing partnerships and develop new ones as needed to ensure successful implementation of the state COVID-19 vaccination plan. Local Health Departments will serve as a conduit of information to their local stakeholders and community regarding vaccination planning and implementation. They will also assist with technical assistance from stakeholders within their county or counties and serve as vaccination sites. North Carolina Division of Public Health will send a representative, as needed, to the SEOC during vaccination operation implementation and be the lead agency for LHD outreach. Other partners will be utilized as needed. Assignment of responsibilities and representatives within each LHD will be determined by each LHD or per respective All-Hazard Plans

    The entities responsible for the allocation of the vaccine will be the state of North Carolina allocating to providers, and then the provider will ensure that administration occurs based on priority groups. The distribution role of the state will be to ensure accurate delivery of information provided for each provider and the timely entry of orders. The contract distributor will ensure that vaccines and ancillary supplies are delivered in a timely, temperature-controlled, efficient manner.

    NC DPH will conduct bidirectional feedback between LHDs and DHHS Communications to ensure the local perspective is incorporated by leveraging opportunities. NC DPH will provide vetted DHHS Communications messaging to LHDs including: Messages targeted to vulnerable and historically marginalized populations; sharing messaging among LHDs that have been favorably received locally by HMPs. Alerts to LHD patients about flu and COVID-19 vaccine. Messaging via trusted relationships between LHDs and K-12 public schools, institutes of higher education (IHEs), correctional facilities, agricultural and meat-packing businesses. LHDs will work with local emergency management to activate mass vaccination strategies throughout their jurisdictions according to their All-Hazard Plan (AHP). This should include not only clinic-based vaccination, but also community-based, mobile, and non-traditional vaccination sites

    The full data, reporting, and performance tracking ecosystem under development includes integration of North Carolina’s COVID-19 vaccine IT systems, including but not limited to immunization information systems (IIS), referred to as the North Carolina Immunization Registry (NCIR), with the CDC’s Vaccine Administration Management System (VAMS) modules, Immunization (IZ) Gateway, Vaccine Tracking System (VTrckS), a potential alternative system, and other COVID-19 data exchanges. As part of this work, data dashboards will be deployed for both internal and external dashboards for analysis and reporting purposes. The dashboards will provide transparent reporting on who is receiving the vaccine, vaccination availability phases, demographics, and more.

    North Dakota

    COVID-19 Vaccination Plan - Interim Draft
    Source: North Dakota Department of Health; October 16, 2020; Version 1.2

     

    COVID-19 vaccination planning falls under the planning section of the Unified Command. After approved, most aspects of this plan fall under the Operations Section, within the Disease Control Branch in the Mass Immunization Group. Provider recruitment will be advertised through various provider associations (North Dakota Medical, Pharmacy, LTC, and Hospital Associations), immunization list serv, and the NDDoH website. Enrollment with the state will be required to receive COVID-19 vaccine; even providers already enrolled as a Vaccines for Children (VFC) Program provider will have to enroll specifically to receive COVID-19 vaccine.

    In North Dakota various types of providers are eligible to vaccinate including registered nurses and LPNs, but pharmacy techs in ND are typically not able. Health and Human Services (HHS) recently authorized pharmacists to vaccinate against COVID-19 for individuals 3 and older. Additional detail is expected from CDC regarding priority groups to be vaccinated. The National Academy of Medicine, Engineering and Sciences has finalized a Framework for Equitable Allocation of COVID-19 Vaccine to use as a guide for determining priorities. Nonetheless, North Dakota will have to make decisions regarding how specific doses are allocated.

    Vaccine allocation will attempt to distribute vaccine fairly across the state according to the extent that vaccination providers have access to prioritized populations. Priority groups specified by the ACIP and the North Dakota Advisory Committee on COVID-19 Vaccination Ethics will provide recommendations if prioritization among those recommendations are necessary. During Phase 1, large, urban areas will hold mass clinics for outreach to eligible groups (e.g., healthcare workers, essential workers) in addition to supplying vaccine to health systems and long-term care facilities (if targeted by prioritization as expected). If vaccine can be redistributed or transferred, then smaller clinics can be held proximal to high risk populations (e.g., rural health care workers, areas with urban American Indian populations or elderly housing) or carried by vaccinators into homes of the homebound.

    A vaccine section was added to the NDDoH COVID-19 website for public communication and updates. The ND COVID-19 hotline will be utilized to answer questions from the public regarding COVID-19 vaccine. In the COVID-19 vaccine enrollment agreement North Dakota will require facilities to post vaccine availability to vaccinefinder.org or a similar vaccine locator website once vaccine is publicly available. Provider enrollment data that is submitted to the CDC twice weekly will also prepopulate vaccinefinder.org with healthcare facility information. A media campaign to promote and educate about COVID-19 vaccination will be developed. It is anticipated that CDC and other partners will also have media campaigns. The joint information system will be used to develop the campaign. As needed, external stakeholders will be consulted regarding communications. The Unified Command Joint Information System can be called upon at any time (24/7) to rapidly disseminate messages through social media, media list serves, etc. This has been exercised throughout the COVID-19 pandemic. All providers must agree to submit the data to NDIIS within 24 hours of administration if they wish to become COVID-19 vaccine providers.

    Ohio

    COVID-19 Vaccination Plan - Interim Draft
    Source: Ohio Department of Health; October 16, 2020

     

    The Vaccine Preparedness Office (VPO) consists of ten distinct workstreams to plan and validate vaccine readiness across the entire lifecycle of a vaccine (from ordering, to distribution, administration, funding, and tracking). From the beginning of this pandemic, the Governor’s Office, the Ohio Department of Health, the Emergency Management Agency, and partner departments have been working collaboratively, in partnership with Ohio’s 113 local health departments and local government officials, to prepare and protect Ohioans. Meetings between officials with these organizations occur regularly to align efforts, identify gaps and provide resources. A coordination committee, comprised of local points of contact for all health districts, will be created to streamline communication and logistical coordination between each district and the state.

    Ohio plans to begin with the vaccination of high-risk health care workers and first responders during this phase. For the estimation and locating of critical populations, the population was segmented on a county-by-county level using data from medical claims, Bureau of Labor Statistics, U.S. Census, and CMS COVID-19 nursing home data. Ohio, with support from third-parties, has prepared a robust vaccine deployment analytical tool. One of the tool’s capabilities is the ability to select specific critical population groups and size and locate them based on publicly available census, medical claims, labor, and school district and university enrollment data.

    Having created a comprehensive criteria list for a potential candidate, the team will create and manage a reference list of all potential providers in the state. These providers could include, but are not limited to: local departments of health, healthcare systems, pharmacies (independent, large chains, grocery stores), long-term care facilities, community health centers (Federally Qualified Health Centers and Regional Health Centers), emergency medical services (EMS), correctional facilities, behavioral health and rehabilitation centers and Ohio Department of Health Internal Constituents (e.g., VFC Program, Perinatal Hepatitis B Program). The state will proactively reach out to these groups through a communication campaign to facilitate registration.

    For data collection, Ohio will use the existing IIS system (ImpactSIIS) and connect to the IZ Gateway via Connect and Share. Providers will be responsible for reporting to Ohio’s ImpactSIIS. Providers will be required to send data each 24-hour period. Ohio is still determining what metrics are most appropriate to be posted on a public-facing website.

    Oklahoma

    COVID-19 Vaccination Plan - Working Draft
    Source: Oklahoma State Department Of Health

     

    The Commissioner of Health is the leader of a centralized public health agency which covers 75 of the 77 counties in Oklahoma. The majority of the Core Team have been critical members of the COVID-19 response in Oklahoma and have established a strong working relationship. Continual communication will occur between the Immunization Division and providers to ensure all requirements or potential complications are addressed. The Vaccination Program Team will ensure state officials stay briefed on vaccine program metrics of success including vaccine uptake, supplies, throughput, and tracking. Local public health officials participate in coordination calls twice weekly related to all COVID-19 related response priorities. Local health departments will continue to keep stakeholders and the general public informed. The program will be engaged with pharmacies, correctional facilities, homeless shelters, community-based organizations, and others.

    Healthcare staff working in Long Term Care and Assisted Living Facilities will be the first priority. Vaccine supply for these staff will be initially provided by the state allocation, especially during instances of very limited supply. Later in Phase I and subject to implementation of federal Pharmacy Partners Plan, the majority of Oklahoma’s Medicare Certified LTC/ALFs will come from federal allotments directly provided by national pharmacy agreements. The COVID Vaccine Team will work with the facilities not certified by Medicare to determine the best way to distribute/administer vaccine to their employees. These staff will be vaccinated though closed pods and strike teams via direct shipments to LHDs (the term LHD includes also THD, OCCHD)

    Oklahoma began creating a potential pandemic provider list in January 2020 as a required activity under Core grant. Providers were recruited through the Oklahoma Heath Advisory Network (OK-HAN), which reached approximately 5,000 healthcare providers throughout Oklahoma. Vaccines for Children providers were reached through the Immunization Field Consultants (IFCs). Over 515 pandemic providers including LHDs, RHCs, FQHCs, hospitals and others enrolled with Immunization Service before CDC released its provider enrollment forms. The Vaccine Coordinator and Immunization Nurse are leading the provider enrollment effort and have reached out to 70 LHDs. The LHDs (including also THD and OCCHD) will be part of vaccine administration to all populations in phase 1. For phase 1, Local County Health Departments will be used to administer state allocated vaccine to LTC and public health staff through closed PODs and will work with partners to coordinate vaccine to tribally ran LTC and public health programs. Later, the Department of Health will reach out to large hospitals to administer vaccine to their Health Care workers providing direct in-patient care to COVID patients.

    COVID-19 vaccine administrations will be collected through a combination of Oklahoma State Immunization Information System (OSIIS), and the Vaccine Administration Management System (VAMS). COVID vaccine reports will be generated through Enhanced OSIIS and SAS software will be used to look at vaccine coverage, inventory, and administrations. These reports will be used to monitor vaccine inventory, administrations, vaccine coverage for high priority and high-risk groups to help ensure maximum COVID vaccine coverage of the Oklahoma population. Oklahoma will use a GIS map for planning of COVID 19 vaccine distribution and administration. Some components of the map will be shared with the public such as COVID Vaccine providers and locations and availability of clinics. Attention and consideration are being given to the level of information being made publicly available, as security of the vaccine at the recipient facility must be ensured.

    Objectives for communication include creating awareness of the first phase of distribution to phase 1 populations, developing an awareness and activation campaign that will provide Oklahomans within the phase 1 priority list the information they need to make a decision about getting vaccinated, and arming providers and partners across the state with key information that will allow them to inform and guide Oklahomans as they prepare to receive the vaccine. Oklahoma State Communications team will be working closely with the Oklahoma and Tulsa Health Departments, tribal PIOs, hospital associations to ensure messaging consistency, clarity and accuracy of information being shared from the CDC and the federal government through OSDH to the rest of the state.

    Oregon

    COVID-19 Vaccination Plan- Interim Draft
    Source: Oregon Health Authority | Oregon Immunization Program; November 6, 2020; Interim Draft 1.1

     

    The Oregon Health Authority (OHA) regulates or administers many of the state's health care programs, such as those administered through the Public Health Division (PHD), as well as Oregon’s Medicaid program, the Oregon Health Plan (OHP). The Oregon Immunization Program is responsible for facilitating the delivery of immunizations. The OIP Vaccine Planning Unit has been formed to coordinate the planning and implementation of COVID-19 vaccine distribution in Oregon. The public health system in Oregon is a partnership between the Oregon Health Authority and local public health authorities. There are structures and processes in place to guide the coordination of public health efforts within counties and statewide. Coordination between state and local authorities to plan the allocation and distribution of the COVID-19 vaccine will follow these established processes. Oregon is building clear communication pathways to facilitate cooperative planning with counties, engage county partners to establish clear roles and responsibilities for counties and the state, and clarify allocation processes to ensure consistent COVID-19 vaccine usage throughout the state.

    Oregon intends to leverage existing relationships with currently enrolled Vaccines for Children (VFC) and public access providers, to enroll providers to receive and administer the COVID-19 vaccine. They will also engage Local Public Health Authorities to assist in recruitment, and partner with the Oregon Association of Hospitals and Health Systems, the Academy of Family Physicians, community-based organizations who work with critical populations, the Coalition for Community Health Clinics and Oregon Primary Care Association to advise us on prioritizing enrollment. Finally, Oregon will partner with Coordinated Care Organizations (CCOs), which are contracted by OHA to provide health services for Medicaid members

    All providers, current and new, will submit records of all doses administered to Oregon’s Immunization Information System (IIS), ALERT IIS, within 24 hours of administration. Oregon’s communication objectives include providing information to the public about planning, policy, operations using crisis and emergency risk communication principles: Be first. Communications will be proactive and timely. Being first is always balanced by the accuracy needed to maintain credibility, and to be right and respectful in our approach. The state will also ensure messaging and communications are culturally responsive and linguistically accessible. The communication will educate the public about the development, authorization, distribution, and execution of COVID-19 vaccines and that situations are continually evolving. OHA will track several metrics and publish them on the immunization program and COVID-19 website.

    Pennsylvania

    While the full plan is not publicly available yet, Pennsylvania’s Department of Health has released and executive summary of it. The distribution will use existing agreements with pharmacies to aid in the distribution of the vaccine when it becomes available. During the first phase of vaccination distribution, the DOH will focus its efforts on Healthcare Personnel, First Responders, Critical Workers and individuals with high-risk conditions. The department will utilize a three-phased recruiting and enrollment approach for vaccination providers. Phase 1 is currently under way and focuses on hospitals, Federally Qualified Health Centers, County and Municipal Health Departments, and DOH State Health Centers. Phases 2 and 3 will be expanded to existing Vaccines for Children (VFC) and non VFC providers and pharmacies throughout the commonwealth.

    Clear communication is a key function to ensure the public is educated on the COVID-19 vaccine. The Office of Communications will be responsible for utilizing multiple mechanisms to provide vaccination updates to the public. It is anticipated that DOH will use press releases, news briefings, the department website and social media to ensure public confidence in the safety and efficacy of COVID-19 vaccines.

    DOH will utilize the CDC COVID-19 Vaccination Response Dashboard to estimate critical population categories, implement data into the administration of vaccine and record COVID19 vaccine administration data. Metrics will be shared via DOH’s existing COVID-19 Data Dashboard on the department’s public website.

    Summary

    South Carolina

    The State has established a Unified Command Group (UCG) to coordinate and unify response functions. It has also established Emergency Support Functions (ESFs) with state agencies and volunteer organizations to support response and recovery operations. County Emergency Management will maintain communication with the State Emergency Operation Center (SEOC). Counties will provide disaster situational updates and forward requests for assistance as necessary to the SEOC.

    DHEC is closely monitoring guidance put forth by the CDC's Advisory Committee on Immunization Practices (ACIP), the National Institutes of Health, and the National Academies of Sciences, Engineering, and Medicine (NASEM), and other sources regarding identified populations of focus for COVID-19 vaccination. DHEC will recruit and enroll COVID-19 vaccination providers through ICS Immunizations Branch. They will assemble a pandemic provider enrollment and management team to execute the administrative and outreach functions needed. The lead of this team will be responsible for communicating provider enrollment data to the CDC twice weekly.

    DHEC will require vaccination providers enrolled in the COVID-19 Vaccination program in Phase 1 to utilize the VAMS tool for vaccine administration documentation and reporting. For phases 2 and 3, DHEC will require documentation and reporting through a combination of VAMS and the state's immunization information system, SIMON. The DHEC's Immunizations Branch will monitor all planned mobile clinics' reporting status, ensuring that providers fully report their data via VAMS (phase 1 and 2) or the IIS mass vaccination module (phase 2). The DHEC VAMS Coordinator and IIS team will monitor provider reporting via VAMS or the IIS in phases 2 and 3.

    Efforts are underway to help keep the public informed on the COVID-19 vaccine. This includes incorporating educational messaging into agency talking points, news releases, and social media copy. The JIC has currently targeted communications efforts at reaching the general population, state and local leaders, and key stakeholders and partners. The JIC will tailor communications to address the initial populations' specific needs identified to be impacted by each phase of the program's role. To support this, the agency is currently working collaboratively with members of the Vaccine Task Force.

    Vaccine Plan - Draft

    South Dakota

    As of October 27th, the full COVID-19 vaccination plan for South Dakota has been submitted according to a report by The Dickinson Press, however the full comprehensive document has not yet been made available to the public. There are not many certain details about what the plan contains. The South Dakota Department of Health officials are currently working on responding to feedback and recommendations made by the CDC on their initially submitted draft.

    Source

    Tennessee

    COVID-19 Vaccination Plan - Initial Draft
    Source: Tennessee Department of Health; October 16, 2020; Version 1.0

     

    The initial TDH COVID-19 Vaccination Program Planning Team included members of the Vaccine Preventable Diseases and Immunization Program team and the Office of Emergency Preparedness. TDH has convened a Pandemic Vaccine Planning Stakeholder group which meets every two weeks and is leveraged to help inform allocation decisions, define priority populations, and identify gaps in knowledge. The group is comprised of more than 28 different offices, agencies, and departments representing public health, rural health, refugee and other minority populations, legislators, experts in bioethics, medical societies, communications experts, health care coalitions, emergency management, and others. Tennessee is a hybrid state where 89 of its 95 counties report to the State and six metros are independent from the State. Tennessee contracts with these six counties (Shelby, Madison, Davidson, Sullivan, Knox, and Hamilton) to conduct public health activities. Coordination between the State and local authorities occurs through numerous channels, including partnering agencies, medical societies, health care coalitions, and emergency management agencies, in addition to multiple opportunities for partners to participate in calls and webinars (bi-weekly COVID-19 update webinar for clinicians, bi-weekly calls between TDH and metro, regional and local health departments, monthly calls with Tennessee Hospital Association, long term care facilities, and others, bi-weekly press conferences that include the Commissioner of Health, and others).

    Ten percent of the State’s allocation of COVID-19 vaccines will be reserved by the State for use in targeted areas with high Social Vulnerability Index (SVI) values. Five percent of the State’s allocation of COVID-19 vaccines will be distributed equitably among all 95 counties. Eighty-five percent of the State’s allocation of COVID-19 vaccines will be distributed among all 95 counties based upon their populations. TDH plans to use Geographic Information System (GIS) mapping and Tiberius functionality to locate/map all critical populations. The state will recruit/enroll all hospitals as vaccine providers and will then start onboarding local and regional pharmacy partners not already working through CDC. The State will also be deploying vaccination strike teams across the state that will be able to conduct on-site vaccination events for targeted populations that may not have ready access to another vaccine provider. Once hospitals and pharmacies are onboarded, they will begin focusing on large employers, urgent care clinics, and community providers that will be able to reach additional individuals within these priority populations.

    Tennessee will use the Tennessee Immunization Information System (TennIIS) to collect COVID19 vaccine doses administered by providers. The satellite, temporary and off-site clinics will use TennIIS’ Mass Immunization Module to document COVID-19 vaccine administration at the time of the mass vaccination event. All public health clinics have been trained on TennIIS’ Mass Immunization Module and will be using this module during this fall’s flu mass vaccination events and during the Fight Flu TN event. This will prepare public health users for documenting COVID-19 vaccine administration later this year. Publicly-reported vaccination program metrics may mimic the current format used to report COVID-19 metrics on the THD public website.

    Texas

    COVID-19 Vaccination Plan - Draft
    Source: Texas Department of State Health Services; October 16, 2020; Version 1.0

     

    The Texas Department of State Health Services (DSHS) will utilize an internal COVID-19 vaccine planning and coordination team gathered from across the agency, including the Immunization Program. DSHS is collaborating with the Texas Division of Emergency Management (TDEM) and the Texas Emergency Management Council (TEMC) to identify targeted populations and logistical requirements for providing them COVID-19 vaccine. TDEM works closely with local jurisdictions, state agencies, and federal partners to ensure Texas becomes more resilient for future disasters. The TEMC includes 39 state agencies and nonprofit emergency assistance organizations.

    Texas will use a combination of publicly available datasets, data provided by CDC, and data from other state agencies, state regulatory boards and private partners to: identify, estimate numbers of, and locate vulnerable and frontline populations via mapping. Critical populations will likely include healthcare personnel likely to be exposed to or treat people with COVID-19, people at increased risk for severe illness from COVID-19, including those with underlying medical conditions and people 65 years of age and older, and other vulnerable, frontline workers.

    Texas will implement a statewide integrated communications/outreach/engagement plan. The plan is tiered for providers (recruitment, vaccine administration), the public (information, call to action) and stakeholders (outreach, support and feedback). Key audiences are as follows: healthcare providers; community-based public health partners and coalitions; local and regional health entities; city, regional and statewide elected officials and administrators; municipal departments/agencies; vulnerable and frontline audiences identified by the CDC; and the public. An emphasis will be placed on targeting media outlets favored by the following audiences: vulnerable and frontline workers; people at increased risk for severe illness or death; people at increased risk of acquiring or transmitting COVID-19; and people with limited access to vaccination services.

    Texas will use ImmTrac2 as the official repository of data because this will be the basis for the data reported to the CDC and used for their analysis. DSHS will ensure that all the necessary protections are in place for the data in transit and at rest. Due to Texas’s laws governing the Texas Immunization Registry, no individual data will be shared via the CDC Immunization Gateway. Providers must report doses used in ImmTrac2 and complete the reporting process within the VAOS system to keep information on their inventory up to date. This includes reporting doses wasted and transferred. Reporting must be completed within 24 hours of usage, waste, or transfer. Texas will track and monitor progress on providers, vaccine ordering and distribution, and vaccination coverage by county from lmmTrac2.

    Utah

    The Utah Health Department revealed their COVID-19 vaccination plan on October 21st according to a report by The Salt Lake Tribune. The full plan document does not appear to be publicly available online yet. Utah’s Legislature’s Health and Human Services Interim Committee were informed that the first doses will go to those who staff emergency departments, urgent care facilities, COVID-19 units and long-term care facilities, as well as to those health care workers who have preexisting health conditions.

    Rick Lakin, immunization program manager for the Utah Department of Health, noted that in the final phase of vaccine distribution the health department will begin monitoring vaccine uptake “through population data.”

    “This will allow us to look at populations within the state of Utah that have low vaccination rates and we maybe want to improve [that] coverage,” he said. “We’ll work with our local health departments to ensure that we can reach out to those vulnerable populations that have not received their vaccine at this point yet.”

    Source

    Vermont

    COVID-19 Vaccination Plan - Draft
    Source: Vermont Department of Health; October 16, 2020; Version 1.0
     
    Vaccine Administration Documentation and Reporting
    Vermont will use a hybrid approach to collecting data about vaccine doses administered. This includes use of the CDC Vaccine Administration Management System (VAMS) as well as established reporting systems to Vermont Immunization Registry (VT IIS). Work is underway to develop an internal and public facing dashboard to share key information with all stakeholders. The dashboard will build upon the current Vermont COVID-19 Dashboard.  
     
    Provider Recruitment and Enrollment
    The Immunization Program will reach out by email to all potential COVID-19 vaccination providers and target the appropriate settings that maximize the number of people who can be vaccinated. The providers include currently enrolled practices, hospitals, LTCFs, pharmacies, congregate settings, Visiting Nurses Associations (VNA) and others. In addition to email, the Vermont Immunization Bulletin will be used to spread awareness of the COVID-19 vaccination program and promote enrollment.  
     
    Equity in Distribution and Messaging
    Vaccine allocation will be based on population data, with attention to critical populations. Vaccine administration data will be closely monitored and reviewed at a granular level by county, town and health service area. The Immunization Program is collaborating with the Health Equity and Community Engagement Team to ensure access to disadvantaged communities and people of color. GIS mapping and Social Vulnerability Indices will be employed to identify areas with limited access and direct distribution efforts. 
     
    A comprehensive communication and media plan is in development, which will consider low and high uptake scenarios throughout each phase of the plan. Vermont will develop a marketing strategy, building on ongoing marketing efforts around COIVD-19 prevention.   
     
    Organizational Structure
    Two main workgroups are overseeing the COVID-19 planning work in Vermont: 
    • COVID-19 Vaccination Advisory Committee: Provides overall guidance to the planning work. Membership will include a subgroup of the Crisis Standards of Care Committee and those serving the highest risk populations. 
    • Statewide COVID-19 Vaccination Planning Team: Includes experts from VDH, Vermont Emergency Management, UVM Medical Center, and the Vermont Agency of Digital Service, and is responsible for fully developing the vaccination plan. Three subgroups are developing distinct aspects of the plan: information technology; logistics; communications. 
    Statewide coordination and implementation of the plan is managed jointly by the State Emergency Operations Center (SEOC) and the VDH’s Health Operation Center (HOC), which includes the newly formed Vaccination Branch and its four sections: immunization program operations; technical response; points of distribution (POD) mass vaccination; and data management. The HOC connects directly with the 12 Local Health Office Emergency Operations Centers. 
     
    Last modified: 11/18/2020

    Virginia

    COVID-19 Vaccination Plan - Interim Draft
    Source: Virginia Department of Health; October 1, 2020; Version 1.1
     
    Vaccine Administration Documentation and Reporting
    To receive/administer the COVID-19 vaccine, vaccination providers must enroll in the federal COVID-19 Vaccination Program by means of the Virginia Electronic Registration for Immunization Programs (VERIP) System. CDC’s Vaccine Administration Management System (VAMS) will be available to VDH/provider sites that need assistance in patient registration and scheduling, clinic flow, supply management, patient record management and reporting.   
     
    Provider Recruitment and Enrollment
    VDH has developed a COVID-19 Vaccine Provider Intent Form for interested providers or facilities to indicate intent to administer COVID-19 vaccine to patients and/or staff. Information collected will allow VDH to set up necessary accounts for vaccine ordering and reporting. 
     
    Equity in Distribution and Messaging
    VDH, in collaboration with partner agencies and organizations, is actively working to identify the critical infrastructure workforce, people at increased risk for severe COVID-19 illness and people at increased risk of acquiring or transmitting COVID-19. Public health messages and products will be tailored for each audience and developed with consideration for health equity, using plain language that is easily understood. Information will be presented in culturally responsive language and available in languages that represent the communities. Local health districts will coordinate local messaging efforts with their local jurisdictions’ public information officers.
     
    Organizational Structure
    VDH consists of 33 local health districts, with each health district supporting one or more local jurisdictions. These local health districts report to the State Health Commissioner through the Deputy Commissioner for Community Health Services. In addition to serving as stand-alone plans, local health district emergency preparedness, response and recovery plans support their local Emergency Operations Plans (EOPs) and the VDH Emergency Preparedness Response and Recovery Plan. For preparedness and response purposes, the VDH has organized the 33 health districts into five regions. Each region has a regional team that provides technical assistance to the districts and augments district staffing as necessary during times of emergency.  
     
    Last modified: 11/18/2020

    Washington

    COVID-19 Vaccination Plan - Interim Draft
    Source: Washington State Department of Health; October 2020; Version 1
     
    Vaccine Administration Documentation and Reporting
    The Washington State Department of Health will use REDCap to collect provider enrollment information and will use PrepMod and the ISS to collect doses administered data from providers within 24 hours of vaccine administration. The department plans to publish COVID-19 Vaccination Program metrics to be available for the public.
     
    Provider Recruitment and Enrollment
    In the earliest phase, the department will identify and prioritize enrollment of health care system and partners who can support high-throughput vaccination services. The department and the Washington State Pharmacy Association (WSPA) will engage pharmacies and educate them about the process of enrollment and the expectation of how reporting and distribution will work.  
     
    Equity in Distribution and Messaging
    The state’s allocation framework will be informed by cross-cutting equity considerations based on community and partner input. The department is developing a prioritization and allocation framework in consultation with public health and health care partners; first responders; critical and essential workforce sectors; business groups; black, indigenous, and people of color communities; education systems; and other governments, including tribal nations, local governments, and local health jurisdictions.
     
    The department’s equity and social justice staff will be conducting surveys, interviews and focus groups with various groups in the state to determine attitudes about vaccination and gauge the effectiveness of the department’s messaging and their receptiveness to it. 
     
    Organizational Structure
    The COVID-19 Response Program is under the oversight of the Deputy Secretary for COVID-19 Response. The department will work with the preparedness, immunization, and communications teams at all 35 local health jurisdictions in Washington to plan for the allocation and distribution of a COVID-19 vaccine. Additionally, an engagement strategy has been developed to seek input and participation local health officers and administrators via the Washington State Association of Local Public Health Officials (WSALPHO), governmental partners (state agencies and commissions that serve priority populations), health care system partners, community groups and organizations, and statewide associations and advisory boards. 
     
    Last modified: 11/18/2020

    West Virginia

    COVID-19 Vaccination Plan - Preliminary Draft
    Source: West Virginia Department Of Health And Human Resources, Division Of Immunization Services; October 16, 2020
     
    Vaccine Administration Documentation and Reporting
    The WVDHHR Division of Immunization Services (DIS) will oversee continuous monitoring throughout the COVID-19 Vaccination Program to ensure the program is achieving desired outcomes. Key programmatic metrics will be added to the existing West Virginia COVID-19 Dashboard.
     
    Provider Recruitment and Enrollment
    WVDHHR has prioritized recruitment efforts for vaccination providers who will administer the vaccine during Phase 1 including local health departments (LHDs), hospitals, Federally Qualified Health Centers (FQHCs), and pharmacies. All providers will be required to formally enroll in the COVID-19 Vaccination Program by completing a web-based Provider Agreement and Provider Profile. Once Phase 1 vaccination providers have been successfully enrolled and onboarded, recruitment will shift to targeting additional provider groups.  
     
    Equity in Distribution and Messaging
    In addition to the population groups which will receive the initial limited doses, other identified key population groups include people from racial and ethnic minority groups. Messaging will be developed with consideration for health equity.  
     
    A sub-workgroup was established to focus solely on communications and messaging. The core members of this group include representatives from DIS, WVDHHR Office of Communications, WV National Guard Public Affairs and the Center for Rural Health Development.
     
    Organizational Structure
    The WVDHHR Health Command has been established for mobilization of the WVDHHR’s COVID-19 response. Several LHD representatives are members of the core planning group. WVDHHR holds weekly COVID-19 response calls with all LHDs to disseminate information and identify support needs. These calls have been used as a forum to provide updates on the state’s vaccine planning efforts and the recommended actions that should be taken locally. Prior to implementation, weekly calls will be established that focus on detailed aspects of the vaccination program planning and implementation by LHDs. 
     
    Last modified: 11/18/2020

    Wisconsin

    COVID-19 Vaccination Plan - Draft
    Source: Wisconsin Department of Health Services (DHS); October 2020

     
    Vaccine Administration Documentation and Reporting
    The Wisconsin Immunization Registry (WIR) is widely used by vaccinators throughout the state to record administered vaccine doses, to guide clinical decision making, run reports and advise as to which clients are due or overdue for immunizations. Currently, Wisconsin is still determining whether it will use an additional product to supplement WIR does.  
     
    Provider Recruitment and Enrollment
    Wisconsin plans to use existing communication channels to notify stakeholders, including current WIR users, VFC and VFA providers and local and tribal public health. Additionally, the state will engage the Public Health/Healthcare Coordinating Council, Wisconsin Public Health Association, Wisconsin Hospital Association, Wisconsin Primary Health Care Association, Wisconsin Rural Hospital Cooperative and the Milwaukee Health Care Coordinating Committee to let their membership know when registration is open and to encourage enrollment. Wisconsin will also work with partners such as the Division of Quality Assurance (to reach long term care and assisted living facilities), the Division of Medicaid Services, the Pharmacy Society of Wisconsin and the membership of the Wisconsin Council on Immunization Practices, which includes a variety of partners to reach out to potential vaccinators. 
     
    Equity in Distribution and Messaging
    The Harm Reduction & Prevention work stream of the COVID-19 Response Team (CRT) CRT aims to connect with high-risk and communities disproportionately impacted by the COIVD-19 pandemic. This partnership aims to assure that the immunization program is able to engage, build upon and lean on community partners to deliver immunizations in a way that demonstrates Wisconsin’s commitment to leading with equity.  
     
    The communications plan has separate goals for each phase of the campaign, each one tailored to the needs of different groups, including the general public, initial priority groups, vaccinators and stakeholders.
     
    Organizational Structure
    The COVID-19 Response Team (CRT) was formed in July 2020 and its Director reports to the DHS Deputy Secretary. It provides strategic and operational coordination for the Department’s involvement in the Statewide Emergency Response for the COVID-19 pandemic. The COVID-19 Vaccination Program planning was integrated into the CRT structure in September. The integration provided visibility for the effort, ensured coordination across the statewide response and allowed access to an array of expertise within the department and across government agencies. 
     
    Last modified: 11/18/2020

    Wyoming

    COVID-19 Vaccination Plan - Interim Draft
    Source: Wyoming Department of Health; October 16, 2020; Interim Draft 1
     
    Vaccine Administration Documentation and Reporting
    The Immunization Unit (Unit) will use RedCap for provider enrollment in the COVID-19 Vaccination Program. The Unit will reach out to organizations through collaboration with Public Health Nursing Offices (PHNOs), County Health Departments (CHDs), professional associations, licensing boards, etc. to communicate the process for enrolling providers.  
     
    Provider Recruitment and Enrollment
    The Unit is responsible for routine distribution of all publicly purchased vaccines in Wyoming to providers enrolled in the Public Vaccine Programs. Coordination of critical population vaccinations will be planned and conducted at the local level through the Public PHNOs and County Health Departments CHDs. The WDH Public Health Nursing (PHN) Unit supervises state County Nurse Managers in 19 counties within Wyoming where county and state PHNs administer and deliver a number of public health programs.  
     
    Equity in Distribution and Messaging
    Racial and ethnic minority groups, as well as tribal populations, are considered critical populations under Wyoming’s COVID-19 vaccination plan. Additionally, Wyoming will establish points of contact and communication methods for organizations, agencies and communities within critical population groups.  
     
    The WDH public information officer (PIO) and personnel within the WDH COVID-19 Vaccination Planning Team will coordinate and deliver public health information using the department’s routine practices, applying crisis and risk communication principles as needed.
     
    Organizational Structure
    The Public Health Division of the Wyoming Department of Health has primary responsibility for coordinating development of the plan. Vaccinations of healthcare provider populations will be completed by hospitals, PHNOs or CHDs and the Eastern Shoshone Tribal Health Department. PHNOs and CHDs will be enrolled as vaccine providers first to ensure appropriate planning to immunize healthcare providers in their county. Hospitals will be enrolled as vaccine providers to immunize their workforce as well as other healthcare providers in their community. 
     
    Last modified: 11/18/2020

    Background and Resources 

    Background

    About Operation Warp Speed

    Operation Warp Speed (OWS) is a multi-agency federal partnership led by the Department of Health and Human Services (HHS), that has been tasked with organizing efforts to accelerate the development, manufacturing, and distribution of COVID-19 vaccines and other countermeasures including diagnostics and therapeutics. The goal of this initiative, as outlined by HHS, is to “deliver 300 million doses of a safe, effective vaccine for COVID-19 by January 2021”.

    Vaccine Development

    The Departments of Health and Human Services (HHS) and Defense (DoD) have announced billions of dollars toward the development of six vaccine candidates: BioNTech SE/Pfizer, Moderna, AstraZeneca/Oxford, Janssen Pharmaceuticals, Novavax, and Sanofi/GlaxoSmithKline. Congress has allocated roughly $10 billion to this effort through supplemental appropriations in previously passed COVID-19 relief bills including the CARES Act.

    As of today, Moderna, BioNTech/Pfizer, and AstraZeneca/Oxford have already begun Phase III clinical trials for their respective vaccine candidates, the final stage of clinical development. The other three companies will follow by the end of the year. Following the completion of Phase III trials, vaccine candidates will have to undergo approval by the Food and Drug Administration (FDA).

    Federal Vaccine Distribution Plan

    HHS and OWS are seeking to finalize planning for production and distribution of the vaccine as early as possible so that they may begin distribution immediately following FDA approval and authorization.

    On September 16, 2020 HHS announced its COVID-19 vaccine distribution plan. The plan was developed in coordination with the Centers for Disease Control and Prevention (CDC) and the Department of Defense (DoD). The agencies released the plan in the form of a brief report to Congress outlining a strategic overview of the plan, and an interim playbook for state, tribal, territorial and local public health programs to begin operationalizing a vaccination response to COVID-19 within their respective jurisdictions.

    The plan outlines four main tenets:

    • Stakeholder engagement and communication with the public to improve vaccine confidence and uptake.
    • Immediate distribution upon FDA approval (within 24 hours).
    • Safe administration and availability of administration supplies.
    • Data monitoring through IT tracking systems.

    While many elements of the strategy are still in process pending the outcome of Phase III trials and the timeline for FDA approval, CDC’s jurisdictional playbook serves as a framework that outlines many preliminary steps states and localities-- especially counties, can be taking now to prepare for vaccine distribution.

    The playbook is particularly geared towards CDC Immunization and Vaccines for Children Cooperative Agreement funding awardees. The CDC will distribute federal funding for vaccine preparedness to the 64 jurisdictions with existing cooperative agreements under this program. The agency is also requiring the awardees to submit detailed vaccine distribution plans to their CDC project officers no later than October 16, 2020.

    COVID-19 Vaccination Program Planning Basics

    The playbook outlines the following guidance to assist jurisdictions in operationalizing and launching a COVID-19 Vaccination Program.

    Use of Planning Assumptions & Adaptation

    The playbook emphasizes the importance of “full situational awareness” when planning a vaccine distribution program, which involves balancing the information we have on hand, versus what is not yet known about the vaccine; such as the type of vaccine that will be available, how much of it will be available, and what the efficacy will be. The resource includes an appendix of planning assumptions, which should be taken into consideration during early planning efforts.

    In addition to planning assumptions, the playbook encourages the adaptation of previous vaccination response plans such as those for H1N1, the seasonal flu and childhood immunization programs.

    Following the development of a plan, the playbook encourages the use of tabletop exercises to identify weaknesses, especially for plans involving multiple levels of government and cross sectoral partners.

    Development of Internal Planning and Coordination Teams.

    The playbook recommends the formation of an internal planning and coordination teams to provide thoughtful insight and expertise from a wide array of state and local jurisdictions. Such jurisdictions may include, but are not limited to:

    • Immunization and preparedness professionals
    • Legal professionals
    • Media and public affairs professionals
    • Clinical experts in isolated population fields (e.g. aging, HIV/AIDS, or rural health) 
    • Local public health jurisdictions

    Development of External Implementation Committees.

    In addition to the formation of an internal planning committee, the CDC recommends that jurisdictions leverage external partnerships through the formation of COVID-19 Vaccination Program implementation committees. The members of this committee should represent key COVID-19 vaccination providers for critical population groups, (outlined on page X of this analysis).

    Many of the examples provided by the CDC of stakeholders to be included in external implementation committees are county owned or operated, including:

    • Emergency management agencies
    • Local health departments
    • Health systems & hospitals (including critical access hospitals for rural areas, in-patient psychiatric facilities)
    • Community Health Centers
    • Rural Health Clinics (RHCs)
    • Long-term care facilities, nursing homes, skilled nursing facilities
    • Correctional facilities

    *Please see playbook for full list of suggested stakeholders.

    State & Local Coordination

    As states work with counties and other sectors of local government around the planning of a COVID-19 vaccination program plan, the CDC playbook emphasizes the importance of aligning areas of responsibility and specific to maximize resources, quality and efficiency of the program and avoid the duplication of efforts.

    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

    Critical 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.

    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.

    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.

    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.

    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. 

    Take Action

    The CDC is suggesting that states and local jurisdictions use the playbook to develop their COVID-19 vaccination plans. The plans must be submitted to CDC through the corresponding project officer assigned to each of the 64 jurisdictional awardees of the Immunization and Vaccines for Children Cooperative Agreement by October 16, 2020. See Appendix B for the complete list of the 64 jurisdictions and the corresponding project officers.

    Timeline

    Release of Framework

    September 16, 2020

    Jurisdiction Vaccination Plan Due to CDC

    October 16, 2020

    Phase 3 Clinical Trial Completion

    End of 2020/ Early 2021

    FDA Approval and Authorization

    2021

    Phased Allocation of Vaccination Doses

    2021

    Key next steps for counties:

    • Reach out to your state’s CDC Jurisdiction Project Officer for Vaccine Development to ensure that your county expertise and resource needs are reflected in jurisdictional plans.
    • Contact your Representative and Senators to request that Congress provide direct and flexible COVID-19 funding for state and local governments to assist with the acquisition of supplies and resources for vaccine distribution.

    Resources

    Federal Funding & Mandates for Vaccine Development and Distribution

    Bill Title (Number)

    Funding Amount Allocated

    Summary of Provision

    Coronavirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123)

    $61 million

    Provided additional funding for FDA "Salaries and Expenses" for COVID-19 response, which includes "the development of necessary medical countermeasures and vaccines".

    $3.1 billion

    Provided additional funding for the HHS "Public Health and Social Services Emergency Fund". The funding was provided to help respond to COVID-19, including the "development of necessary countermeasures and vaccines". These funds can also be used "for the construction, alteration, or renovation of non-Federally owned facilities for the production of vaccines". The bill also instructs the HHS Secretary to use these funds to purchase vaccines.

    $300 million

    Provided additional funding made available to the "Public Health and Social Services Emergency Fund" for the same purposes listed above. However, the funding is only available if the HHS Secretary notifies Congress that the $3.1 billion allocation "will be obligated imminently and that additional funds are necessary to purchase vaccines...".

    Families First Coronavirus Response Act (P.L. 116-127)

    Medicaid FMAP assistance increased temporarily by 6.2% for each state/territory

    States were only eligible for this temporary increase in federal medical assistance if the State provides "coverage under such plan (or waiver), without the imposition of cost sharing…for any testing services and treatments for COVID-19, including vaccines...".

    Coronavirus Aid, Relief and Economic Security Act (CARES, P.L. 116-136)

    $80 million

    Provided additional funding for FDA "Salaries and Expenses" for COVID-19 response, which includes "the development of necessary medical countermeasures and vaccines".

    $706 million

    Provided additional funding for NIH. Mandates that no less than $156 million of these dollars be used "for the study of, construction of, demolition of, renovation of, and acquisition of equipment for, vaccines and infectious diseases research facilities".

    $3.5 billion

    Provided additional funding for the HHS "Public Health and Social Services Emergency Fund". The funding was provided to help respond to COVID-19, including the "development of necessary countermeasures and vaccines". $3.5 billion of this funding is allocated to the Biomedical Advanced Research and Development Authority for "manufacturing, production and purchase....of vaccines, therapeutics, diagnostics...". These funds can also be used "for the construction, alteration, or renovation of non-Federally owned facilities for the production of vaccines".

    N/A

    Required the strategic national stockpile to include PPE and other medical supplies "required for the administration of drugs, vaccines and other biological products".

    N/A

    Mandates that the Secretaries of HHS, Labor and Treasury "require group health plans and health insurance issuers…to cover (without cost-sharing) any qualifying coronavirus preventive service", including vaccines.

    Requires that any licensed COVID-19 vaccine be covered under the Medicare Part B program without cost-sharing

    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

    • 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
    • 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

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

    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. 

    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.
    2020-10-21
    Basic page
    2020-11-23

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 begin planning for an equitable distribution of the COVID-19 vaccine at the local level.

Jump to Section

Explore State Distribution Plans

Alaska

Source: State of Alaska Department of Health and Social Services; October 16, 2020; Version 1
 

Alaska’s COVID-19 Vaccine ECHO (Extension for Community Healthcare Outcomes) is a partnership with the State and with Alaska Native Tribal Health Consortium (ANTHC) to provide COVID-19 vaccine planning and operation updates. It uses videoconferencing technology to connect a team of interdisciplinary experts with primary care providers, other health services professionals, and community members. These videoconferences create virtual learning communities by connecting Alaska’s COVID-19 experts with specific audiences on specific topics. Additionally, to reach public and consumer audiences, the Vaccine Communication/Education Team will implement a blend of paid, earned, and owned media.

The Alaska Native Tribal Health Consortium (ANTHC) is a non-profit Tribal health organization designed to meet the unique health needs of Tribal people living in Alaska. In partnership with the more than 180,000 Tribal people that we serve and THOs of the Tribal, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction. ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,000 employees offering an array of health services to people around the nation’s largest state.

Alabama

COVID-19 Vaccination Plan - Interim Draft
Source: Alabama Department of Public Health (ADPH); November 5, 2020
 
Vaccine Administration Documentation and Reporting
Alabama’s lifespan registry, ImmPRINT, collects data on all vaccines administered. There are currently over 4,000 sites that utilize ImmPRINT daily. ImmPRINT is capable of real-time reporting and can produce all metrics to be shared with the ADPH’s Digital Media Branch Director for display on department’s website.
 
Provider Recruitment and Enrollment
Primary provider types include Local Health Departments, Hospitals/Health Care Organizations, Long Term Care Facilities, and Pharmacies of which there are 856 out of 1500 pharmacies enrolled. The ADPH Immunization Division (IMM) uses ImmPRINT for provider enrollment and management and there are currently more than 2,677 healthcare sites who are working with ImmPRINT. Providers will include external partners, like the Alabama Hospital Association, the Medical Association for the State of Alabama, and the State Committee of Public Health. In addition, ADPH continues to reach out to all the other major healthcare systems and providers, including the members of the Alabama Adolescent and Adult Vaccine Task Force.
 
Equity in Distribution and Messaging
Pharmacies can identify and conduct outreach to their patients who may not necessarily have a defined “medical home” and can serve the immunization needs of this population. ADPH IMM will use ImmPRINT to monitor provider locations to determine if additional recruitment is necessary for areas that are insufficiently staffed to meet the anticipated demand based on population density and any known disparity regions. IMM will monitor vaccine administration statistics by county to cover race and high-risk populations. Messaging to the public will be phase based and use existing channels. Alabama’s Health Alert Network via the Alabama Emergency Response Technology (ALERT) will be among major tools for updating the public as well. IMM has the capability to send second‐dose reminders via postcard and email but will be looking to develop more methods including radio, social media, and text alerts.
 
Organizational Structure
ADPH is the health agency for the state of Alabama and the State Board of Health is an advisory board to support all public health matters. ADPH consists of 6 districts, which includes 65 out of 67 county health departments. ADPH is a centralized public health system and all levels, including central office and counties, are under the authority of the SHO. The state is responsible for coordination of the pandemic influenza response within and between jurisdictions, while public health districts and county health departments (CHDs) are responsible for coordination of pandemic vaccine response with other organizations in their region. 
 
Last modified: 11/23/2020

Arizona

Arizona Department of Health Services (ADHS) submitted its Draft Arizona COVID-19 Vaccination Plan but is not as of yet publicly available. According to an update on the ADHS website on October 20th:

To inform this draft plan, ADHS has worked since April with a large and diverse group of stakeholders that includes county and tribal public health, outpatient healthcare providers and associations, inpatient healthcare providers and associations, payors, pharmacy and EMS stakeholders, and state and local emergency management agencies. This partner involvement and feedback is so critical to making sure that Arizona has the best possible plan for vaccine distribution, and also includes the development and implementation of training and exercises to inform the state’s pandemic vaccine response.

The Draft Arizona COVID-19 Vaccination Plan highlights Arizona’s local allocator model, which designates county health departments and tribal health partners as the local authorities responsible for approving vaccine allocations to providers within each jurisdiction. It also focuses on the importance of communication, as the CDC anticipates a vaccine requiring two doses spaced three to four weeks apart.  

The vaccination program will be led by a state advisory committee referred to as the Vaccine and Antiviral Prioritization Advisory Committee which will be comprised of a group of experts from ADHS and its partners.

Source

Arkansas

Source: Arkansas Department Of Health; October 16, 2020; Work in Process 
 
Vaccine Administration Documentation and Reporting
The ADH Immunization Information System (IIS), WebIZ, is the statewide centralized repository of immunization information and will be used to track vaccine distribution. All COVID-19 vaccination providers must be registered in the system and must submit vaccination information to WebIZ within 24 hours of vaccine administration. 
 
Provider Recruitment and Enrollment
ADH is recruiting new providers through the COVID-19 Prevention Workgroup, through a COVID-19 Provider Enrollment link on the ADH website and a notice and link to the WebIZ Homepage. ADH is also working with partner organizations and creating an online COVID-19 vaccination provider enrollment process.  
 
Equity in Distribution and Messaging
The Arkansas Vaccine Medical Advisory Committee’s subcommittee on COVID-19 vaccination will adapt and apply the ACIP and NAM recommendations to develop specific recommendations for each priority population in Arkansas.  
 
The ADH Office of Health Communications, along with the ADH Office of Health Equity and ADH subject matter experts will coordinate messaging across multiple platforms and channels to communicate with all audiences before availability of a vaccine as well as through the different phases of the program. Emphasis will be placed on reaching groups with increased risk or with limited access to vaccination services, including Arkansas’ Hispanic and Marshallese populations. All messaging will be reviewed to ensure it is culturally appropriate, respectful, and free of stigma and/or bias and to verify that it uses plain language that is accessible by the intended audience.  
 
Organizational Structure
ADH has established both internal and external working groups to help guide vaccination efforts. ADH, a unified or centralized health department, is headquartered in Little Rock and has a total of 94 Local Health Units – with at least one in each of the state’s 75 counties. The open and closed Points of Distribution (POD) program can be used in all three of the suggested phases of the COVID-19 vaccination plan. The Arkansas State Strategic National Stockpile (SNS) program has historically relied on coordination and collaboration of ADH Local Health Units, businesses, community organizations and volunteers in the actions of mass distribution and redistribution of medical countermeasures.
 
Last modified: 11/18/2020

California

Source: California Department of Public Health; October 16, 2020; Version 1.0
 
Vaccine Administration Documentation and Reporting
Data from all COVID-19 vaccine doses administered by providers will be stored in California’s Immunization Registry (CAIR). CAIR supports real-time immunization record query messages (QBP) and can be accessed online to help providers and other authorized users track patient immunization records and reduce missed opportunities. 
 
Provider Recruitment and Enrollment
Vaccine provider recruitment and enrollment will be conducted primarily by local health departments, based on their existing partnerships with the provider community. Eligible providers will be invited to enroll in the COVID-19 Provider Enrollment and Ordering Management System. Once successfully enrolled, providers will be eligible to receive vaccine allocations. 
 
Equity in Distribution and Messaging
California has developed a health equity metric, which helps guide the state’s counties in their continuing efforts to fight COVID-19 more effectively. Additionally, California has established a Health Equity Technical Assistance Team that will partner with key regional collaborative and advocacy groups to develop and menu and playbook of best practices, resources and vendors with an equity focus to share and provide resources to counties. 
 
California’s communication plan aligns with the vaccine distribution timeline and will be implemented throughout all phases. The plan includes public and stakeholder engagement with a focus on tailored messaging to key populations and vulnerable communities to ensure maximum vaccine uptake. The plan includes an expedited process to issue urgent public health communications through a rapid response crisis communication hub. 
 
Organizational Structure
CDPH resides within the cabinet-level California Health and Human Services Agency (CHHS) and is leading much of the state’s COVID-19 response activities. Local government entities must use the state’s Standardized Emergency Management System (SEMS) to be eligible for any reimbursement of response-related costs under the state’s disaster assistance programs.
 
CDPH works closely with local health departments to coordinate and provide technical assistance for all the different aspects of provider enrollment, data elements and outreach. At the local level, jurisdictions have local immunization and pandemic flu coordinators that already have connections to local health care vaccine providers. 
 
Last modified: 11/18/2020

Colorado

Source: Colorado Department of Public Health and Environment; October 16, 2020; Version 1.0

 

Demonstration of proactive communication strategies for second-dose reminders

The Colorado Department of Public Health and Environment’s (CDPHE) will work with local public health agencies (LPHA) to determine where vaccines should go within their jurisdiction. Colorado will analyze the results of an initial COVID-19 Vaccine Provider Interest Survey and coordinate with Local Public Health Agencies (LPHA) to determine the vaccination providers who will be initially enrolled in the COVID-19 Vaccination Program for Phase 1. The state will use the Colorado Immunization Information System (CIIS) to track the data.

Second-dose reminders

Colorado will strongly encourage COVID-19 vaccination providers to schedule a patient’s second-dose appointment when they receive their first dose as patients are more likely to present for a second dose if the appointment is already on their calendar. Whenever possible, second-dose reminders will come directly from the COVID-19 vaccination provider who first immunized the patient as patients are more receptive to receiving messages from trusted and known sources. Proactive scheduling of second-dose appointments can also assist COVID-19 vaccination providers with planning and anticipated inventory needs.

For COVID-19 vaccination providers without existing mechanisms for performing second-dose reminders, Colorado will promote the use of the CIIS which has a reminder/recall report feature and can be run by LPHAs by county level population. This feature also has the capability to reprocess the same reminder/recall run and generate a report of those patients who have become up-to-date since the initial reminder/recall report was generated and those patients who are still not-up-to-date. The state has created a Patient Reminder/Recall training toolkit for clinics which includes training videos, best practices, guidance on reviewing the quality and accuracy of the clinic’s data before running a reminder/recall, and templates for reminder messages. The state also recently invested in a health messaging system (Teletask) that enables them to send automated phone messages, text messages. Lastly, Colorado will have a Public Portal available which provide secure access for patients to have another method by which they can stay on top of their COVID-19 vaccine schedules.

Delaware

The Delaware Division of Public Health submitted an executive summary for its COVID-19 vaccine plan to the Centers for Disease Control and Prevention during the week of October 26th. The plan itself is currently not publicly available.

Source

Florida

While Florida’s COVID-19 Vaccination Plan is not yet publicly available, it has been reviewed and summarized by Tampa Bay’s news station, WTSP. A link to that article and video clip is available for this summary. Florida’s Department of Health is integrating a planning structure based on lessons learned from the H1N1 pandemic, such as by “increasing the inclusion of community partners to provide vaccinators.” All 67 county health departments will be directly involved in vaccination administration. The DOH will be using an “Incident Command Structure” comprised of experts and representatives from the immunization program, epidemiology, EMS, long-term care associations and others. The Department of Health will be coordinating their vaccine efforts with hospitals, pharmacies, correctional facilities, homeless shelters, community-based organizations, long-term care facilities and public safety agencies. The vaccine distribution currently considers the following groups to be priority recipients though it is subject to change at the time a vaccine actually becomes available: health care personnel, essential workers, those with medical conditions placing them at high-risk for COVID-19 complications, and adults who are 65 years of age, or older.

Source

Georgia

Source: Georgia Department of Public Health; October 15, 2020; Version 1
 
Vaccine Administration Documentation and Reporting
Using the Georgia Registry of Immunization Transactions and Services (GRITS) to collect COVID-19 vaccine doses administered data from providers.  
 
Provider Recruitment and Enrollment
Public Health Districts (PHDs) will use Points of Distribution (PODs) for vaccine distribution which will include public health clinics, hospitals, long term care facilities (LTCs), emergency medical services (EMS), etc. Other potential vaccine providers will include health districts, currently enrolled Vaccines for Children (VFC) providers, and previous H1N1 mass vaccination providers. The recruitment process surveys the potential providers and then assigns them to a population tier based on providers’ ability to store, manage and distribute vaccines.
 
Equity in Distribution and Messaging
DPH has established a COVID-19 Health Equity Team which engages community-based organizations (CBOs) to address health inequities exacerbated by COVID-19. The Department of Public Health (DPH) will utilize the current partnerships created by this team to collect estimates on critical populations and locate them. Coordination of communication efforts about vaccine development and availability will be led by the state DPH Division of Communications. The public will receive this information from the state DPH website, social media, media reports and additional marketing campaigns as funding allows. Healthcare providers will be informed through the Regional Coordinating Hospital System and through the DPH constant contact list-serve. Partner agencies will be updated and informed through the Joint Information Center (JIC) operations, and redundantly through communications with the 18 Public Health districts and their communicators. Second-dose reminders will be completed through provider built-in systems and a statewide reminder recall program as a backup. 
 
Organizational Structure
Georgia’s 18 Health Districts and local public health departments work with local community partners, healthcare organizations, long-term care facilities, businesses, industries, and professional organizations. Each district will be required to establish points of contact for key critical populations to a) identify and locate critical populations in their geographic area and b) communicate timely and effective COVID-19 vaccination messaging. 
 
Last modified: 11/17/2020

Hawaii

Plan Status and Source: No full plan for public access.
 
Hawaii does not as of yet have their full plan documented online for public access. However, their Department of Health posted a summary on October 22nd. Lt. Gov. Josh Green made the following statement: 
 
“This has to be a coordinated effort between the state and counties. It will also require extensive outreach and education to healthcare providers and their patients. Everyone’s kokua is critical to the success of the vaccination plan, so we must make sure everyone’s roles and responsibilities are clearly defined.” 
 
Vaccine Administration
During the initial phase of vaccine distribution, Hawaii Department of Health will prioritize high-risk healthcare employees at hospitals and others involved with direct patient care, first responders who have high risk for COVID-19 exposure, and Hawaii residents of all ages who have underlying health conditions, including those 65 and older who live in congregate settings 
 
Documentation and Reporting
Hawaii will use the Hawaii Immunization Registry (HIR) system for data tracking and for provider enrollment. 
 
Organizational Structure
The Hawaii Department of Health (HDOH), as the lead state health agency and lead state agency for State Emergency Support Function 8 (SESF #8) Public Health and Medical Services, formed a Core Planning Team with representatives from local, state, and federal levels as well as private sector partners under the leadership of the Disease Outbreak Control Division (DOCD) Immunization Branch (IMB) to develop the state's COVID‐19 Vaccination Plan. HDOH will use two primary coordinating bodies, a Vaccination Core Planning Team and a Vaccination Program Implementation Committee, as well as standing and ad hoc working groups to support the COVID‐19 vaccination program 
 
Last modified: 11/17/2020

Idaho

Source: Idaho Department of Health and Welfare; October 16, 2020; Version 1
 
Vaccine Administration Documentation and Reporting
The Idaho Immunization Program (IIP) will use PrepMod to collect COVID-19 vaccination administration data from vaccine providers. IIP will set targets for successful implementation which includes monitoring staffing, budgets, and supplies. Idaho Resource Tracking System will be used by IIP and the Public Health Preparedness and Response Program to monitor vaccine supplies. 
 
Provider Recruitment and Enrollment
The Idaho Immunization Program (IIP) will initially focus on recruiting local public health districts, hospitals, and FQHCs as vaccine providers. Pharmacies could also be enrolled to conduct mass vaccination clinics in areas of need. A public Idaho COVID-19 Vaccine Provider Toolkit will be developed as a reference guide for vaccine providers. Provider recruitment/enrollment will match the 3-phased approach to COVID-19 vaccination, and the DPH and state medical actors will work closely with the directors of the local public health districts to coordinate the vaccine delivery. 
 
Equity in Distribution and Messaging
DHW is engaging with partners and the Idaho COVID-19 Vaccine Advisory Committee to prioritize subgroups and ensure equity and transparency in vaccine distribution and administration. DHW has also convened a COVID-19 Communications Task Force that will lead vaccination communications. Communication will include targeted messaging to essential agents like providers and priority populations with information on vaccine availability and safety. Channels will include social media, websites, blog platforms, as well as other government partners, and DHW’s media and marketing contractor. The COVID-19 Vaccine Advisory Committee (CVAC) will rely on input from disparate populations in order to assure equitable access to a vaccine. Second-dose reminders will be sent through Prepmod’s reminder feature and the reminder feature within Idaho’s IIS, IRIS (Immunization Reminder Information System)
 
Organizational Structure
Idaho has a decentralized public health structure. At the highest level, Idaho’s State Health Officer (SHO) is in regular communication with the Region 10 Office of the Assistant Secretary for Health (OASH) Administrator as well as the other Region 10 SHOs. Idaho’s 44 counties are divided into seven local public health districts. The SHO, Medical Director, and key state Division of Public Health (DPH) staff meet two times a week with the Directors of Idaho’s seven local public health districts (PHDs). 
 
Last modified: 11/17/2020

Illinois

Source: Illinois Department of Public Health; October 2020; Version 2.0
 
Vaccine Administration Documentation and Reporting
The Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE) is the state’s immunization information system (IIS) and will be the primary system utilized to order and track vaccine administration. All vaccine providers must be registered in the Illinois Health Alert Network – HAN/SIREN
 
Structure / Provider Recruitment and Enrollment
The Vaccine Administration Division will work with vaccine providers in each of the health care coalition regions and with local public health jurisdictions to determine each provider’s capacity to manage vaccine distribution. To assist with mass vaccination operations at their POD sites and with seeking qualified volunteers, vaccine providers can utilize Illinois Helps, a state registry of volunteers for both medical and non-medical occupations who can be activated in a disaster or public health emergency. 
 
Illinois also has a two-tiered strategy to ensure vaccine delivery:  
  • Tier 1 will utilize current shipping practices of the Vaccines for Children Program and existing local health department vaccine distribution infrastructures for mass vaccination  
  • Tier 2 serves as back-up and/or support to previous carriers and utilizes identified state partners such as the Illinois Department of Corrections that maintains refrigerated fleet vehicles for transport of biologics. 
Equity in Distribution and Messaging
IDPH’s calculation for proportional vaccine allocation will be adjusted to account for equity, potential hotspots and regional positions within the state. The Illinois Health Alert Network – HAN/ SIREN will disseminate health information, make emergency notifications, and alert all health and vaccine provider staff. Second-dose reminders will be done using CDC vaccine cards, call and text reminders, and via the reminder/recall functionality of I-CARE
 
Last modified: 11/17/2020

Indiana

Source: Indiana Department of Health; October 14, 2020
 
Vaccine Administration Documentation and Reporting
The Children and Hoosier Immunization Registry Program (CHIRP) is a secure web-based application administered by the IDOH and used as the state’s Immunization information system (IIS). The data from CHIRP will help provide a variety of program metrics and maps which will be presented within the state’s existing COVID-19 website
 
Provider Recruitment and Enrollment
Indiana vaccine providers include primary care physicians, pharmacists, and local health departments. Currently, 743 providers are enrolled in the Indiana Vaccines for Children (VFC) Program who are actively vaccinating and recording vaccination administration data in CHIRP. There are 1,923 other facilities that are administering vaccines and have established a bi-directional interface with CHIRP. IDOH will also work with the Indiana Hospital Association, Indiana Pharmacy Alliance, and others to recruit even more vaccination partners. 
 
Equity in Distribution and Messaging
The IDOH Office of Public Affairs (OPA) will coordinate the communication plan, with timelines and tracking mechanisms to ensure that communications are timely and proactive, yet flexible to adjust to program changes. OPA will review, research and monitor social media awareness regarding the public’s perception of the vaccine to adjust messaging to ensure that communication addresses the barriers that most influence vaccine uptake. Indiana will also deliver second-dose communications as needed through healthcare electronic health records (EHRs), Vaccination Record Cards, CHIRP, Scheduling of Second Dose Duration First Does Administration, and other means. The Equitable Distribution and Communication Advisory Group advises on equitable coverage of populations for the vaccine and helps to identify communication gaps. Consultation with the IDOH Office of Minority Health and Translations will help ensure that all vaccine communication will be crafted to most effectively reach each specific audience. 
 
Organizational Structure
Indiana’s Department of Health has a Department Operations Center which uses an Incident Support Model (ISM). Indiana has adapted its planning and response capability based upon the following operational constructs: A central State Emergency Operations Center (SEOC), an Executive Policy Group, and 10 Public Health Preparedness Districts. Districts vary in their infrastructure, however several commonalities of Districts include: District Planning Councils, Healthcare Coalitions, and Indiana District Response Task Forces. Counties, local governments, and the State benefit from sharing resources, eliminating redundancy in critical response activities, and coordinating emergency planning, training, and exercise activities.
 
Last modified: 11/17/2020

Iowa

Source: Iowa Department of Public Health; October 12, 2020; Version 1.2
 
Vaccine Administration Documentation and Reporting
IDPH will utilize the Immunization Registry Information System (IRIS) for the allocation, distribution, and documentation of COVID-19 vaccine. 
 
Provider Recruitment and Enrollment
Local public health agencies will allocate vaccines local healthcare providers and other organizations such as pharmacies. Collaboration will occur between the IDPH, Iowa local public health agencies and Iowa healthcare providers to administer pandemic vaccines.  A REDCap survey will be used to document and approve potential vaccine providers. 
 
Equity in Distribution and Messaging
COVID-19 vaccine uptake and coverage will be monitored in critical populations and enhanced strategies to reach populations with low vaccination uptake or coverage will be implemented. Iowa’s Vaccination Communication Plan is divided into different areas based on the audience and the specific communication needs of the audience. Local Public Health Agencies and the IDPH have developed working relationships with local newspaper and television news staff. Press releases will be developed by the IDPH’s Public Information Officer (PIO) and will be sent to LPHA via the Iowa Health Alert Network (HAN) or email. Each local agency will adapt news releases to their agency and release the information to their local communication channels. IRIS can help healthcare providers send reminders letters and postcards when patients are due for additional doses of vaccine or recall patients to schedule immunization appointments. 
 
Organizational Structure
IDPH has convened an internal COVID-19 Vaccine Planning team with representation from the state immunization bureau, the hospital and public health preparedness and response bureau, and other entities. Coordination and communication with Iowa’s 99 local public health agencies (one per county) is essential to the vaccine response. Ongoing weekly webinars and meetings are scheduled with LHDs and healthcare providers for sharing updates and providing guidance documents. 
 
Last modified: 11/17/2020

Kansas

Source: Kansas Department of Health and Environment; October 16, 2020; Version 1.2; Reviewed November 4, 2020
 
Vaccine Administration Documentation and Reporting
Kansas is working with KSWebIZ, the state immunization registry, to create data extracts. The internal Kansas COVID-19 vaccine planning committee will establish processes for monitoring critical components of the program such as vaccine allocations, distribution, and uptake.
 
Provider Recruitment and Enrollment
Kansas will participate in the Pharmacy Partnership for Long-term Care Program coordinated by the CDC. The Pharmacy Partnership for Long-term Care Program provides end-to-end management of the COVID-19 vaccination process. Recruitment and enrollment of other providers will be targeted at different organizations depending on the current phase of the state distribution, with hospitals, LHDs, FQHCs and pharmacies primarily making up the first phase providers. If it is determined that there are areas of the state that have limited access to vaccine providers, the Kansas Immunization Program will prepare for mobile clinics using the state’s influenza playbook.
 
Equity in Distribution and Messaging
The Kansas Department of Health and Environment (KDHE) will work with partner organizations to ensure that all people are addressed inclusively, with respect, using non - stigmatizing, bias-free language and that the materials are not misleading or confusing. KDHE will utilize the risk communication principles from the CDC’s Vaccinate with Confidence framework. Overall goals will be to educate the public on the distribution of vaccines, implement confidence messaging, engage in dialogue with internal and external partners to address vaccine program implementation, and providing guidance to local health departments and clinicians. The Immunization Outreach Coordinator will provide routine communications and will identify and distribute social media tools for internal and external stakeholders. For second-dose reminders, vaccine providers will use the vaccination record card as well as reminder/recalls available through existing electronic health record systems and/or KSWebIZ.
 
Organizational Structure
The Kansas Department of Health and Environment (KDHE) has an internal COVID-19 Vaccine Planning Committee that consists of multiple stakeholders from within and outside the Agency. In Kansas, the public health system is decentralized and KDHE serves all 105 counties of the state. The local health departments report to their local Board of Health, which is typically the local Board of County Commissions. There will be collaboration, cooperation, and coordination of both KDHE and the local health departments in the development and implementation of the COVID-19 Vaccine Plan for Kansas. Local health departments are represented on the internal COVID-19 vaccine planning committee. 
 
Last modified: 11/17/2020

Kentucky

Source: Kentucky Public Health; October 2020; October 2020
 
Vaccine Administration Documentation and Reporting
COVID-19 Vaccine Providers will submit data to the Kentucky Immunization Registry (KYIR). A KYIR Data Quality Analyst and KYIR on-boarders will utilize reports from KYIR to monitor data quality and timeliness of data submission for vaccine providers. 
 
Provider Recruitment and Enrollment
Once enrollment of critical phase 1 providers is completed, geographic information system (GIS) mapping will be used to identify gaps in coverage and targeted recruitment efforts will then be implemented. KDPH is recruiting providers with the assistance of the Kentucky Hospital Association (KHA), the Kentucky Health Department Association (KHDA), and others.
 
Equity in Distribution and Messaging
KDPH will utilize “mobile vaccination teams” to support and provide vaccines to defined targeted groups and populations impacted by health inequity. A survey will help by collecting information on these populations that will also inform the development of appropriate messaging and delivery mechanisms for the public and for healthcare providers. The Kentucky SNS Crisis Communication Guide will be key a resource for public communication during the vaccination campaign. A “multi-front” communication strategy utilizing the KDPH Commissioner’s Office, the CHFS Office of Public Affairs, the Governor’s Office, external partner agencies and a contracted communications firm will ensure accurate and effective messaging across all populations. Information may be disseminated via social media, web site postings, interviews, newspaper editorials, flyers, billboards, television and radio broadcasts. KDPH will also evaluate and adapt to social media trends in order to combat the challenges of misinformation. KDPH will utilize the Kentucky Immunization Registry (KYIR) Mass Event Model for the majority of second dose reminders. Vaccine providers will schedule the patient’s second-dose appointment when delivering their first dose.
 
Organizational Structure
Kentucky’s vaccination planning is a combined state and local responsibility that requires close collaboration between KDPH, Local Health Departments (LHDs) external agencies, and community partners. Kentucky public health has a “shared governance” health structure within which both KDPH and LHDs will play key roles in the vaccination campaign. For Kentucky’s Vaccination Allocation Committee (VAC), KDPH will use the Kentucky Health and Medical Preparedness Committee (HMPAC), as well as leadership from KDPH’s COVID-19 planning and coordination team and representatives for critical population groups identified by CDC. 
 
Last modified: 11/17/2020

Louisiana

Source: Louisiana Department of Health Office of Public Health; October 16, 2020; Version 01

 

Vaccine Administration Documentation and Reporting
Submitting vaccination information to the LDH, as required in statute, will be done through the Louisiana Immunization Network, LINKS. This will also include provider enrollment data. 
 
Provider Recruitment and Enrollment
Pharmacy engagement and Closed Point of Dispensing (POD) planning will be the framework for the initial phase of the vaccine response. Most COVID-19 vaccine providers are already registered vaccine providers due to rulemaking in April 2020.  
 
Equity in Distribution and Messaging
Members with health equity expertise are in each Work Group to address health disparities in all areas. The Governor established a Health Equity Task Force to support COVID-19 safety and prevention in communities with health disparities. Mobile Vaccination Teams will be deployed to areas where gaps in access are identified. The network and engagement of the Governor’s Health Equity Task Force, along with the Office of Public Health’s (OPH) Office of Community Outreach & Health Equity, will engage the public with Tele-Town Hall meetings. The nine Regional Field staff will help identify populations in the state that are hard to reach for vaccination services. The Governor’s Office and Homeland Security and Emergency Preparedness (GOHSEP) maintains a Joint Information Center (JIC) and is supported by LDH Public Information Officers (PIOs). A vaccine web page is in development for the Louisiana Department of Health (LDH) COVID-19 website. Direct communications with vaccine providers by OPH are aided by a Regional and State Health Alert Network (HAN). Messaging to the public uses the “211” Statewide system while higher-level communications relites on trusted LDH OPH State and Regional designated spokespersons. LINKS delivers second-dose reminders by several means including postcards and auto dialers, while the state reminds vaccine recipients through the consumer access portal, MyIR Mobile
 
Organizational Structure
The Louisiana Department of Health (LDH) Office of Public Health (OPH) is the lead agency for pandemic response and works collaboratively with state, local, and private agencies. The OPH formed the Vaccine Action Collaborative (VAC) which in turn established work groups for the COVID-19 response effort: Prioritization and Allocation; Planning, Logistics and Operations; and Communications and Outreach. The VAC includes representation from both public and private sectors. Louisiana has a centralized public health system for 62 of the 64 parishes and will use the NIMS Incident Command System (ICS) to manage incidents.  
 
Last modified: 11/16/2020

Maine

Source: Maine Center for Disease Control and Prevention; October 16, 2020; Version 1.0

 

Vaccine Administration Documentation and Reporting
The Maine Immunization Information System IIS will be utilized for vaccine doses administered by providers. The Division of Public Health Nursing (PHN) will reconcile after each clinic the number of doses given. The Maine Immunization Program will develop a COVID-19 Vaccine Distribution webpage for the website. They will also be surveying the Hospitals after the first Phase 1a vaccine has been distributed and assess uptake and lessons learned. 
 
Provider Recruitment and Enrollment
Maine Immunization will prioritize enrollment of hospitals, long-term care facilities, and pharmacies. District Liaisons from the public health districts plan to enroll all 37 Maine hospitals as vaccine provider sites as a priority for Phase 1. Vaccination of target groups will occur in closed, point-of-dispensing (POD) settings with the health care systems throughout Maine. Other providers will include Indian Health Service sites, mobile vaccination providers, federally qualified health care facilities, and urgent care clinics. 
 
Equity in Distribution and Messaging
Maine will collaborate with partners already engaged with disproportionately affected populations, such as the DHHS’ Health Equity Improvement Initiative, in order to effectively reach them. Messaging and outreach will be culturally responsive language, available in languages that represent the communities, non-stigmatizing and bias-free. District Public Health Liaisons can work with immigrant and other non-majority populations to achieve the highest possible vaccine uptake. Maine's Health Alert Network system (HAN) will be used to inform stakeholders in real time. Community health workers (CHW) will be engaged as part of the educational outreach efforts. Communication channels will use an existing partnership with the Maine Association of Broadcasters to deliver messaging through radio and television broadcasts, while digital media will be delivered via social media. Written communication channels will also be facilitated using GovDelivery and other direct channels. Second-dose reminders will be sent via their IIS’s built-in reminder recall functionality and the built-in scheduling and record keeping capabilities of their enrolled vaccine providers. 
 
Organizational Structure
The Maine Center for Disease Control (Maine CDC) serves as the State's public health agency and it is being supported by the Maine DHHS for their work on the COVID-19 vaccination plan and implementation. District Public Health (DPH) ensures the delivery of public health services across Maine’s nine public health districts. Each public health district is led by a District Liaison, who coordinates with Maine CDC staff in the district (Public Health Unit) and who provides leadership with an elected executive committee for the district coordinating council. District Liaisons serve as the primary point of contact (POC) between community clinic organizers and administrators, county emergency management agencies, and the health care system.
 
Last modified: 11/16/2020

Maryland

Source: Maryland Department of Health; October 16, 2020; Version 1.0

 

Vaccine Administration Documentation and Reporting
ImmuNet is the place where providers register to become a vaccine provider, order vaccines, track delivery of vaccine, report doses administered, and determine when second doses are due. PrepMod will be used as the main vaccine management system during Phase 1. MDH will have a flu and Covid-19 dashboard, which will include both cases and vaccine status, and they will have a dashboard for the data collected by ImmuNet. 
 
Provider Recruitment and Enrollment
MDH is enrolling healthcare providers (HCPs), local health departments (LHDs), employee occupational health and pharmacists via ImmuNet. MDH is working with the Maryland Board of Pharmacy and Maryland Pharmacy Association to coordinate and communicate with the state’s 4,900 provider pharmacies, both chain and independent.
 
Equity in Distribution and Messaging
The MDH Center for Immunization (CFI) has developed an enrollment process for vaccine providers that will allow high visibility on where vaccine providers are located, where additional providers are needed, or where LHD PODs can provide a vaccination safety net. ImmuNet will be used to continuously monitor of vaccination metrics to ensure equitable distribution of vaccines through a broad network of vaccination providers. MDH will coordinate with trusted community partners, priority group representatives, and representatives of vulnerable populations, along with a marketing vendor, to develop and disseminate messaging. Second dose reminders will be provided to patients via PrepMod, provider-based systems, and Maryland MyIR, a consumer vaccination portal, which allows registered users to obtain their current vaccination records from ImmuNet and which can also issue reminder messages. 
 
Organizational Structure
CFI will lead the operations aspects of the vaccine plan implementation and the MDH Office of Preparedness and Response (OP&R) will lead the planning, coordination and logistics. TCFI and OP&R have established an incident command system (ICS) to organize the vaccination response. CFI will use federal COVID-19 funding to hire additional staff including a functional analyst to work with ImmuNet data, and an administrative specialist to supervise provider registration and the approval of vaccine orders.
 
Last modified: 11/16/2020

Massachusetts

Source: Massachusetts Department of Public Health; October 16, 2020; Version 1.0
 
Vaccine Administration Documentation and Reporting
The Massachusetts Immunization Information System (MIIS) will be used to capture COVID-19 vaccine doses administered data. Massachusetts Department of Public Health (MDPH) Bureau of Infectious Disease and Laboratory Sciences (BIDLS) has also purchased the PrepMod System to connect to the MIIS for real-time reporting. 
 
Provider Recruitment and Enrollment
MDPH is prioritizing hospitals, long term care facilities, skilled nursing facilities (SNF), emergency medical services (EMS), and others for provider enrollment. There are close to 3,000 provider sites registered and enrolled in the MDPH vaccine distribution system and/or reporting data to the MIIS. This includes all pediatric provider sites, major hospital systems, community health centers, local health departments, and approximately 1,000 pharmacy locations.
 
Equity in Distribution and Messaging
The communication approach will use earned and paid media to reach disproportionately impacted groups and will use a data-driven process to develop a public awareness messaging campaign. MDPH will establish points of contact and communication methods for organizations, employers, or communities (as appropriate) within the identified critical population groups where those relationships do not currently exist.
 
Organizational Structure
The Commissioner of Public Health oversees a public health workforce of nearly 3,000, and a department comprised of eight bureaus and six offices responsible for a range of programs including surveillance and prevention of diseases dangerous to the public health. The  Immunization Division (MCVP) is the lead for COVID-19 vaccination planning, distribution, and implementation efforts. The Office of Local and Regional Health (OLRH) connects local public health departments with information and resources from the MDPH.  Massachusetts has a decentralized public health system, and its 351 cities and towns have the authority to provide public health services to its residents. There are currently six regional Health and Medical Coordinating Coalitions (HMCCs) in Massachusetts that conduct capabilities-based, cross-disciplinary planning and support for public health and provide medical response during emergencies.
 
Last modified: 11/18/2020

Michigan

Source: Michigan Department of Health & Human Services; October 16, 2020; Version 1.0
 
Vaccine Administration Documentation and Reporting
The Michigan Care Improvement Registry (MCIR) which is the statewide IIS will be used to track all COVID vaccine doses administered. The Division of Immunization has developed a public-facing influenza vaccine dashboard, that provides users with location of vaccine providers and data regarding vaccine doses administered and vaccination coverage.  
 
Provider Recruitment and Enrollment
The Division of Immunizations will work with local public health for the initial allocations of the vaccine which will be directed to 143 hospitals and health systems. After initial allocations to hospitals, allocations will be made to each of the 45 health jurisdictions based on the social vulnerability index, population and other factors. LHDs will use community relationships to allocate additional vaccines to community providers who can reach vulnerable populations.  
 
Equity in Distribution and Messaging
The Michigan Department of Health and Human Services (MDHHS) has a communication division to ensure that all communication is developed with consideration for health equity, using culturally responsive language that is bias-free. Michigan will ensure equitable access to a vaccine by monitoring provider data with regards to site location, and by tracking vaccine administration saturation by county. MDHHS also will work closely with the Community Health Emergency Coordination Center (CHECC) to coordinate state vaccine messaging consistency. The CHECC along with the State Emergency Operation Center (SEOC) ensures widely shared information throughout the State through conference calls, emails, and blast messages as well as the  Michigan Health Alert Network (MIHAN). Second-dose reminders will be conducted using vaccine record cards from the CDC, postcards as needed, and centralized text messaging via MCIR. 
 
Organizational Structure
Michigan’s Division of Immunization is one of 4 Divisions within the Bureau of Infection Disease Prevention but is temporarily reporting to the State Epidemiologist within the Bureau of epidemiology and Population Health. Local Health Departments are key partners to the success of the COVID-19 vaccination program as each one has a well-established SNS plan which has exercised points of dispensing and contains mass vaccination. 
 
Last modified: 11/18/2020

Minnesota

Plan Status and Source:  Minnesota has not yet made a full comprehensive COVID-19 vaccination plan available to the public. A summary of their plan can be found here.   
 
Last modified: 11/18/2020

Mississippi

Source: Mississippi State Department of Health; October 16, 2020; Version 1
 
Vaccine Administration Documentation and Reporting
MSDH will use Mississippi Immunization Information eXchange (MIIX). The MIIX unit will be responsible for Remind/Recall, IZ Gateway Feeds, and deduplications. MSDH OIMM will be available to provide additional support or technical assistance for smaller vaccination providers or rural clinic settings. 
 
Provider Recruitment and Enrollment
During Phase I, MSDH will focus on closed point-of-dispensing (CPOD) settings. While prioritizing enrollment activities for CPODs in Phase 1, MSDH will simultaneously plan open POD (OPOD) drive-through sites for future phases to vaccinate those who live in remote, rural areas with access difficulties. MSDH will enroll commercial and private sector partners/providers and public health sites. All 82 counties can access vaccination in 1 week with 16 rotating PODs a day. 
 
Equity in Distribution and Messaging
The MSDH Office of Communications will conduct focus groups to inform concerns, misconceptions and other issues regarding COVID-19 vaccination. The Office of Communication will use TV, radio, print, social media, and virtual meetings to communicate information regarding the vaccination plans. Specific information about disease transmission prevention, and about vaccine priority groups for COVID-19 vaccine will be disseminated prior to vaccine availability. As a vaccine becomes available, local and statewide media will be responsible for disseminating access information to the appropriate groups. Their communication plan includes a risk communication plan that contains different methods for issuing critical information to the public about the outbreak and control measures using joint information process (JIC), at both State and local levels. MSDH messages will be tailored for each audience and developed with consideration for health equity. Information will be presented in culturally responsive language and available in languages that represent the communities in MS. The state will develop plans to ensure equitable access to vaccination for the critical populations identified. Second dose reminders will be conducted through the MIIX system and through a contract with Avaya for text reminders. 
 
Organizational Structure
MSDH is a centralized public health agency with 86 health department clinics in 81 of the 82 counties. The state is divided into three public health regions each having a Regional Health Officer, a Regional Administrator, a Chief Nurse, and other staff who direct activities in all of the local health departments in the counties within the Regions. Statewide representation on the internal planning team (including regional health department staff) ensures that all facets of the public health network are represented and contribute to the effort.
 
Last modified: 11/18/2020

Missouri

Source: Interagency COVID-19 Vaccination Planning Team; October 11, 2020
 
Vaccine Administration Documentation and Reporting
The state Immunization Information System (IIS)for the vaccine campaign is ShowMeVax (SMV).   Any/all reporting of program metrics within a public-facing website will require close coordination with state communications officials and the Governor's office.
 
Provider Recruitment and Enrollment
Vaccinations will take place in closed Points of Dispensing (PODS). Missouri’s multi-step process for provider enrollment identifies potential providers, engages them, enrolls them and then sustains their participation within COVID vaccination efforts. Potential providers included hospital systems, primary care providers, volunteer organizations, occupational health programs, Department of Corrections, and local public health departments. Additionally, mobile vaccination teams will be deployed within the nine Missouri regions to help limit the need for redistribution beyond the original recipient of vaccines.
 
Equity in Distribution and Messaging
The Missouri Department of Health and Senior Services (DHSS) multi-sourced media campaign focuses on vaccine stigma reduction, consistent messaging, and encouragement. The campaign will run from 10 days before vaccine delivery and continue six to eight months after the first vaccine delivery. DHSS communication strategy involves monitoring and trending of traditional media and social media venues at the state and regional levels. DHSS will be working closely with the communications firm Elasticity to develop effective digital outreach strategies. The Regional Implementation Teams (RITs) will help plan for health equity, using surveys and maps to identify underserved populations and the wide variety of demographic and social risk factor distributions across the State of Missouri.  The RITs will also partner with medical schools in key areas to leverage outreach clinics into the homeless, minority, and underserved populations to deliver the vaccine via trusted entities.
 
Organizational Structure
Missouri has established the Missouri Interagency COVID-19 Vaccination Planning Team to coordinate the vaccination plan, and five-person regional Vaccination Support Teams (VST) in each of the State's nine State Emergency Management Agency (SEMA) regions. Regional Implementation Teams (RIT), made up of local healthcare and community leaders, coordinate the local deployments of vaccinations with the support and guidance of the State implementation Team (SIT). Made up of representatives from the RITs and leadership from the Bureau of Immunizations, the SIT is a central coordinating group for information dissemination, problem-solving, and ensuring local voices are part of the plan. Regional VSTs are composed of an executive, nurses, and a public health specialist.
 
Last modified: 11/18/2020

 

Montana

Source: Montana Department of Public Health and Human Services; October 16, 2020; Version 1.2
 
Vaccine Administration Documentation and Reporting
Immunization staff will determine which data collection method to use based on the provider needs and capabilities. Methods include the Immunization Information System (imMTrax), the Vaccine Administration Management System (VAMS) and PrepMOD. ImMTrax will be used to calculate program metrics and relevant data will be shared using the Department’s Coronavirus page located on their public dashboard.
 
Provider Recruitment and Enrollment
Eligible providers will be determined based on their ability to access and use the Immunization Information System (IIS) software, report administration data within 24 hours, sustain cold-chain management of the vaccine with appropriate storage equipment, and commit to training. 
 
Equity in Distribution and Messaging
DPHHS will use  federal guidance to determine priority populations. DPHHS public messaging is coordinated through the department’s Public Information Officer (PIO). Public information will 1) Notify the public of the arrival of vaccine into the state and introduce the plan for distribution and the reasons supporting it; 2) Notify the public when there is an increase of vaccine in the state and is available to an expanded group of at-risk populations and the providers offering it; and 3) Provide regular encouraging and positive messages for everyone to receive both doses of the vaccine. Message templates are shared with local and tribal health jurisdictions for their use as well While some variables will change regarding communication throughout the multiple phases, items that won’t change include the audiences, modes of communication, and information sources. For second-dose reminders, Montana’s IIS has a Reminder/Recall module which can be used to effectively communicate to vaccine recipients. 
 
Organizational Structure
DPHHS fosters collaborative partnerships with counties, tribes, healthcare entities and others as part of the pandemic response. The operational hub will be in DPHHS’s Immunization Section in the Communicable Disease Control and Prevention Bureau (CDCPB). Two key advisory groups will guide the effective vaccination effort:  
  • Internal Planning Advisory Group (reporting to the Governor’s Coronavirus Taskforce)  
  • Vaccination Plan Coordination Planning Team which will be comprised of key community stakeholders from across Montana representing multiple entities 
 
Last modified: 11/18/2020

Nebraska

Source: Department of Health and Human Services; October 16, 2020
 
Vaccine Administration Documentation and Reporting
The NDHHS will use the Nebraska State Immunization Information System (NESllS) to house and maintain the vaccination distribution data. The backup plan will be to use the Vaccine Administration Management System (VAMS). Nebraska will monitor progress in COVID-10 Vaccination Program implementation by tracking provider enrollment, the population's access to vaccination services, NESllS performance, reporting, vaccine ordering and distribution, and vaccination coverage. Additionally, Nebraska is creating a dashboard which will query data captured within NESllS and produce regularly updated visualization tools.
 
Provider Recruitment and Enrollment
Providers must enroll in the United States Government (USG) COVID-19 vaccination program, coordinated through NDHHS Immunization Program. NDHHS will continue provider recruitment and enrollment as the vaccine supply increases.
 
Equity in Distribution and Messaging
If there is a vaccine shortage/limit, NDHHS Immunization staff will ensure vaccine ordering is based on equitable distribution of vaccine across Nebraska designed to vaccinate identified priority groups. Distribution of vaccine will utilize the same model used for the distribution of vaccines under the Vaccines for Children (VFC) program. NDHHS will establish points of contacts with organizations, employers, and leaders within critical population groups by having a coordinated public information campaign. INebraska local health departments function as the local public health authority and voice within their communities.
 
Organizational Structure
The NDHHS Incident Commander oversees the Preparedness section and is acting as the Point of Contact for the Nebraska COVID-19 response. This program will invite external representatives from Local Health Departments (LHD), the hospital association, Federally Qualified Health Clinics (FQHC), Community Based Clinics (CBC), and health disparity/tribal communities.
 
Last modified: 11/18/2020

New Hampshire

While New Hampshire’s full comprehensive COVID-19 vaccination plan is not publicly available, there is some information on it as reported by New Hampshire Public Radio (NHPR) on October 22nd. Lori Shibinette, commissioner of the state Department of Health and Human Services, said that the plan had been submitted to the CDC on October 16th and have already noticed a need to amend the document in light of new information on long-term care testing with vaccinations. New Hampshire is the only state in the nation without an immunization database. This may be a problem if it is not ready by the time a vaccine becomes available, however Shibinette said the state is working to have an immunization database ready by early December and that they have “two or three other options that [they] will use until the registry is up.”

Source

New Jersey

Source: New Jersey Department of Health (NJDOH); October 16, 2020; Version 1
 
Vaccine Administration Documentation and Reporting
The New Jersey Immunization Information System (NJIIS) is the mechanism used to capture vaccine doses administered in the state. Data has been integrated into New Jersey COVID-19 Dashboard, which is accessible directly through the New Jersey COVID-19 Information Hub and the New Jersey Department of Health’s website.
 
Provider Recruitment and Enrollment
NJDOH has over 800 VFC providers and 126 317-Funded Adult Vaccine Program providers. The current 317-Funded Adult Vaccine providers include local health departments, FQHCs and non-profit organizations. The New Jersey Local Information Network and Communications System (LINCS) is a network of 22 strategically positioned local health departments located throughout the state of NJ. LINCS agencies will subsequently determine the Local Health Department partners in each of their 22 locations. NJDOH will also work in conjunction with them and other local and county authorities to coordinate the vaccine effort within their jurisdictions.
 
Equity in Distribution and Messaging
Communication will match the phased approach of the vaccine distribution. A statewide public awareness campaign will be tailored to health care personnel--organizations and clinicians who will receive information about receiving and administering the vaccine. All messaging, including infographics, FAQs, websites etc., will be disseminated to the public and stakeholder groups and will be culturally appropriate and translated into multiple languages. Other channels will include the New Jersey COVID-19 Information Center and a “211” line. Social media will also be used to inform and engage with the public via multiple platforms including Facebook, Twitter and a COVIDNJ Alert App. Information will also be disseminated regularly by and through well-established public health channels including the New Jersey Local Information Network Communication System (NJLINCS) agency Health Educators/Risk Communicators and professional organizations including the Medical Society of New Jersey and others. NJDOH will achieve health equity by diversifying collaborators and perspectives in the planning and delivery of the vaccine, partnering with community leaders to support education and outreach, accommodating the delivery needs of specific populations, and by tracking and adapting to distribution data.
 
Organizational Structure
Governor Murphy created the Coronavirus Task Force (CTF) and designated the Commissioner of the NJDOH as the Task Force Chair.  The Vaccine Task Force (VTF) is an arm housed within the Department of Health to support the CTF’s efforts to plan and implement a statewide COVID-19 vaccine program. The VTF has nine work groups which expand their membership to engage participation from key stakeholder groups including key NJLINCS and local public health (LPH) representatives, because the work of the VTF will be supported by the 22 NJLINCS agencies and over 94 local health departments (LHDs). New Jersey is planning on local delivery and close collaboration with regions, counties, and localities.
 
Last modified: 11/19/2020

New Mexico

Source: New Mexico Department of Health (NMDOH) ; October 16, 2020
 
Vaccine Administration Documentation and Reporting
Provider documentation of vaccine administration for COVID-19 vaccine will mostly occur from the New Mexico Statewide Immunization Information System (NMSIIS) users who have automated data exchange from their EHR directly into the registry data base.  NMDOH is also considering VAMS for providers not enrolled in NMSIIS. Metrics related to COVID-19 testing can be found here.
 
Provider Recruitment and Enrollment
Vaccines will be primarily distributed in closed “point of dispensing” (POD) settings to specific groups depending on the phase. Early “hub” events will administer hundreds of vaccinations in one day through hospitals, large community health centers, and mobile clinics. NMDOH will later rely on smaller public health centers and pharmacies that could conduct closed or semi-closed POD events. The NMDOH registry currently includes 389 Vaccine For Children (VFC) and 81 Adult vaccine providers enrolled in NMSIIS.  NMDOH is actively engaging with pharmacists through the New Mexico Pharmacists Association to enroll pharmacists as COVID-19 vaccinators.
 
Equity in Distribution and Messaging
Coordinating communications will adapt to the needs of the current phase of vaccine distribution. Channels for the communications strategy include daily press releases, weekly press conferences led by top health leaders, statistical analyses, a public dashboard on status of cases by county, and social media. The NMDOH also established the NMDOH COVID Call Center staffed with registered nurses.  Information sites include the Office of Governor Michelle Lujan Grisham and the COVID-19 specific pages on the NMDOH website. For second dose reminders, NMDOH will mainly use the MNSISS reminder/recall report options. They will also use the existing messaging platform used by Public Health Division sites. NMDOH will utilize the online IIS system and provider enrollment via the Tiberius platform to track and identify gaps in access to COVID-19 vaccination services. If gaps are identified in COVID-19 vaccination services, the Immunization Program will conduct provider recruitment activities and work with PHD to provide mass vaccination clinics.
 
Organizational Structure
NMDOH is a centralized statewide public health system that coordinates the public health response to COVID-19. Two divisions of NMDOH are leading the COVID-19 Vaccine planning effort: 
  • NMDOH’s Public Health Division manages the public health offices throughout the state 
  • The Epidemiology and Response Division is leading surveillance and data analytics
NMDOH’s public health agency includes four Public Health Regions and a public health office in most of the state’s 33 counties, all under one chain of command. NMDOH incorporates guidance from federal partners, collaborates with local authorities, and works closely with local Emergency Managers (EM) 
 
Last modified: 11/19/2020

New York

Source: New York State Department of Health; October 2020

 

Overall management of New York’s vaccination program will require a Vaccine Central Command Center (VC3) to oversee all aspects of vaccine delivery, administration, and other operational aspects of the program. The VC3 will operate within the existing New York State Incident Command structure following sound emergency response principles, in concert with the ongoing broader pandemic response to ensure that all partners clearly understand each other’s roles and responsibilities. Pandemic vaccination planning, distribution, and monitoring will require close collaboration between state and local public health, external agencies, and community partners. The VC3 will include representatives of state agencies that will be charged with managing all aspects of the COVID-19 vaccine program in close coordination with local public health, healthcare, and community-based organizations.

To administer the vaccine, New York State will rely on an established network of health care providers, including hospitals, LTCFs (nursing homes, adult care facilities (ACFs), assisted living), Federally Qualified Health Centers (FQHCs), Community Health Centers, Rural Health Clinics, private provider offices, local health departments, and other entities that will serve as Vaccination Administration Sites (VAS). In addition, the state will work with commercial and independent pharmacies, businesses, and other organizations to enable on-site vaccination at these sites. Other VASs include schools, colleges and universities, homeless shelters, correction facilities, and sites where target populations gather (i.e., senior centers, social service offices, food pantries, etc.) New York State will plan for quick activation and mobilization of mass vaccination point of dispensing (POD) sites, designed to be operationalized once vaccine availability increases and outpaces provider administration capacity. In addition, New York State will designate mobile vaccination units, similar to the rapid response team testing efforts that have been deployed statewide to help control viral spread and outbreaks to increase access to hard to reach populations including smaller congregate living facilities.

Since the onset of the COVID-19 crisis, New York State has worked in close partnership with local health departments (LHDs) across the state. To support local health departments in the administration of the COVID-19 vaccine, New York State will: advise each LHD regarding storage requirements for vaccines that the LHD may be expected to store and/or administer; ensure they are prepared to fully implement their local mass vaccination plans in accordance with State and Federal guidance; advise on protocols for building public trust in the vaccine, and provide technical and logistical assistance as needed. New York State government, as authorized by the state legislature in statute, has throughout the COVID-19 crisis made uniform and consistent decisions for the entire state regarding public health emergency response, a successful model that has helped New York flatten the curve. To ensure coordinated and efficient statewide distribution and administration, all localities, vaccine recipients and administration entities in New York State will be required to follow the state’s central planning process and guidance for COVID-19 vaccination.

The New York State Immunization Information System (NYSIIS) is a confidential, secure, web-based system that collects and maintains demographic and immunization information in one consolidated record for persons of all ages in New York State (outside of New York City). NYSIIS will be the system for pre-ordering vaccine, ongoing tracking, reporting, and collecting of priority group information. Facilities and providers, including hospitals, nursing homes, adult care facilities, clinics, pharmacies, Federally Qualified Health Centers (FQHCs), and additional public and private providers will be trained and enrolled in NYSIIS.

An online website for New Yorkers seeking information regarding vaccine eligibility and appointment scheduling will be available that offers a vaccine eligibility screening tool and a vaccine administration site locator. Individuals will be able to enter information on the website to see if they meet vaccine eligibility In addition to the support services offered online, a call center will be available for patients and providers to access live support to raise any issues with vaccine access and delivery. A robust data analytics program will track issues that are identified and processed through the call center and online support modules to enable quick action to troubleshoot common issues as they arise. Websites and call centers will be designed to offer support for all New Yorkers including for those with disabilities, non-English speakers, and those with limited language proficiency. New York State will work closely with partners statewide who can assist in ensuring that all public communication is done in a way to ensure that those with health inequities are represented and ensure that access to vaccine is not a barrier for underserved communities. Achieving high rates of vaccination will depend upon a successful and robust public education campaign and properly executed communication strategy. The state will launch an ongoing public education campaign to ensure New Yorkers have the latest, and most accurate, information related to the facts about the vaccine itself, the progress and success of the program and all critical information needed regarding access to vaccination. In addition, engagement with community organizations, localities, tribal nations, and healthcare providers is essential to ensure critical information is distributed reliably to all New Yorkers.

North Carolina

Source: North Carolina Department of Health and Human Services; October 16, 2020; Version 1

 

The North Carolina Office of Emergency Medical Services Healthcare Preparedness Program (OEMS HPP) will leverage existing partnerships and develop new ones as needed to ensure successful implementation of the state COVID-19 vaccination plan. Local Health Departments will serve as a conduit of information to their local stakeholders and community regarding vaccination planning and implementation. They will also assist with technical assistance from stakeholders within their county or counties and serve as vaccination sites. North Carolina Division of Public Health will send a representative, as needed, to the SEOC during vaccination operation implementation and be the lead agency for LHD outreach. Other partners will be utilized as needed. Assignment of responsibilities and representatives within each LHD will be determined by each LHD or per respective All-Hazard Plans

The entities responsible for the allocation of the vaccine will be the state of North Carolina allocating to providers, and then the provider will ensure that administration occurs based on priority groups. The distribution role of the state will be to ensure accurate delivery of information provided for each provider and the timely entry of orders. The contract distributor will ensure that vaccines and ancillary supplies are delivered in a timely, temperature-controlled, efficient manner.

NC DPH will conduct bidirectional feedback between LHDs and DHHS Communications to ensure the local perspective is incorporated by leveraging opportunities. NC DPH will provide vetted DHHS Communications messaging to LHDs including: Messages targeted to vulnerable and historically marginalized populations; sharing messaging among LHDs that have been favorably received locally by HMPs. Alerts to LHD patients about flu and COVID-19 vaccine. Messaging via trusted relationships between LHDs and K-12 public schools, institutes of higher education (IHEs), correctional facilities, agricultural and meat-packing businesses. LHDs will work with local emergency management to activate mass vaccination strategies throughout their jurisdictions according to their All-Hazard Plan (AHP). This should include not only clinic-based vaccination, but also community-based, mobile, and non-traditional vaccination sites

The full data, reporting, and performance tracking ecosystem under development includes integration of North Carolina’s COVID-19 vaccine IT systems, including but not limited to immunization information systems (IIS), referred to as the North Carolina Immunization Registry (NCIR), with the CDC’s Vaccine Administration Management System (VAMS) modules, Immunization (IZ) Gateway, Vaccine Tracking System (VTrckS), a potential alternative system, and other COVID-19 data exchanges. As part of this work, data dashboards will be deployed for both internal and external dashboards for analysis and reporting purposes. The dashboards will provide transparent reporting on who is receiving the vaccine, vaccination availability phases, demographics, and more.

North Dakota

Source: North Dakota Department of Health; October 16, 2020; Version 1.2

 

COVID-19 vaccination planning falls under the planning section of the Unified Command. After approved, most aspects of this plan fall under the Operations Section, within the Disease Control Branch in the Mass Immunization Group. Provider recruitment will be advertised through various provider associations (North Dakota Medical, Pharmacy, LTC, and Hospital Associations), immunization list serv, and the NDDoH website. Enrollment with the state will be required to receive COVID-19 vaccine; even providers already enrolled as a Vaccines for Children (VFC) Program provider will have to enroll specifically to receive COVID-19 vaccine.

In North Dakota various types of providers are eligible to vaccinate including registered nurses and LPNs, but pharmacy techs in ND are typically not able. Health and Human Services (HHS) recently authorized pharmacists to vaccinate against COVID-19 for individuals 3 and older. Additional detail is expected from CDC regarding priority groups to be vaccinated. The National Academy of Medicine, Engineering and Sciences has finalized a Framework for Equitable Allocation of COVID-19 Vaccine to use as a guide for determining priorities. Nonetheless, North Dakota will have to make decisions regarding how specific doses are allocated.

Vaccine allocation will attempt to distribute vaccine fairly across the state according to the extent that vaccination providers have access to prioritized populations. Priority groups specified by the ACIP and the North Dakota Advisory Committee on COVID-19 Vaccination Ethics will provide recommendations if prioritization among those recommendations are necessary. During Phase 1, large, urban areas will hold mass clinics for outreach to eligible groups (e.g., healthcare workers, essential workers) in addition to supplying vaccine to health systems and long-term care facilities (if targeted by prioritization as expected). If vaccine can be redistributed or transferred, then smaller clinics can be held proximal to high risk populations (e.g., rural health care workers, areas with urban American Indian populations or elderly housing) or carried by vaccinators into homes of the homebound.

A vaccine section was added to the NDDoH COVID-19 website for public communication and updates. The ND COVID-19 hotline will be utilized to answer questions from the public regarding COVID-19 vaccine. In the COVID-19 vaccine enrollment agreement North Dakota will require facilities to post vaccine availability to vaccinefinder.org or a similar vaccine locator website once vaccine is publicly available. Provider enrollment data that is submitted to the CDC twice weekly will also prepopulate vaccinefinder.org with healthcare facility information. A media campaign to promote and educate about COVID-19 vaccination will be developed. It is anticipated that CDC and other partners will also have media campaigns. The joint information system will be used to develop the campaign. As needed, external stakeholders will be consulted regarding communications. The Unified Command Joint Information System can be called upon at any time (24/7) to rapidly disseminate messages through social media, media list serves, etc. This has been exercised throughout the COVID-19 pandemic. All providers must agree to submit the data to NDIIS within 24 hours of administration if they wish to become COVID-19 vaccine providers.

Ohio

Source: Ohio Department of Health; October 16, 2020

 

The Vaccine Preparedness Office (VPO) consists of ten distinct workstreams to plan and validate vaccine readiness across the entire lifecycle of a vaccine (from ordering, to distribution, administration, funding, and tracking). From the beginning of this pandemic, the Governor’s Office, the Ohio Department of Health, the Emergency Management Agency, and partner departments have been working collaboratively, in partnership with Ohio’s 113 local health departments and local government officials, to prepare and protect Ohioans. Meetings between officials with these organizations occur regularly to align efforts, identify gaps and provide resources. A coordination committee, comprised of local points of contact for all health districts, will be created to streamline communication and logistical coordination between each district and the state.

Ohio plans to begin with the vaccination of high-risk health care workers and first responders during this phase. For the estimation and locating of critical populations, the population was segmented on a county-by-county level using data from medical claims, Bureau of Labor Statistics, U.S. Census, and CMS COVID-19 nursing home data. Ohio, with support from third-parties, has prepared a robust vaccine deployment analytical tool. One of the tool’s capabilities is the ability to select specific critical population groups and size and locate them based on publicly available census, medical claims, labor, and school district and university enrollment data.

Having created a comprehensive criteria list for a potential candidate, the team will create and manage a reference list of all potential providers in the state. These providers could include, but are not limited to: local departments of health, healthcare systems, pharmacies (independent, large chains, grocery stores), long-term care facilities, community health centers (Federally Qualified Health Centers and Regional Health Centers), emergency medical services (EMS), correctional facilities, behavioral health and rehabilitation centers and Ohio Department of Health Internal Constituents (e.g., VFC Program, Perinatal Hepatitis B Program). The state will proactively reach out to these groups through a communication campaign to facilitate registration.

For data collection, Ohio will use the existing IIS system (ImpactSIIS) and connect to the IZ Gateway via Connect and Share. Providers will be responsible for reporting to Ohio’s ImpactSIIS. Providers will be required to send data each 24-hour period. Ohio is still determining what metrics are most appropriate to be posted on a public-facing website.

Oklahoma

Source: Oklahoma State Department Of Health

 

The Commissioner of Health is the leader of a centralized public health agency which covers 75 of the 77 counties in Oklahoma. The majority of the Core Team have been critical members of the COVID-19 response in Oklahoma and have established a strong working relationship. Continual communication will occur between the Immunization Division and providers to ensure all requirements or potential complications are addressed. The Vaccination Program Team will ensure state officials stay briefed on vaccine program metrics of success including vaccine uptake, supplies, throughput, and tracking. Local public health officials participate in coordination calls twice weekly related to all COVID-19 related response priorities. Local health departments will continue to keep stakeholders and the general public informed. The program will be engaged with pharmacies, correctional facilities, homeless shelters, community-based organizations, and others.

Healthcare staff working in Long Term Care and Assisted Living Facilities will be the first priority. Vaccine supply for these staff will be initially provided by the state allocation, especially during instances of very limited supply. Later in Phase I and subject to implementation of federal Pharmacy Partners Plan, the majority of Oklahoma’s Medicare Certified LTC/ALFs will come from federal allotments directly provided by national pharmacy agreements. The COVID Vaccine Team will work with the facilities not certified by Medicare to determine the best way to distribute/administer vaccine to their employees. These staff will be vaccinated though closed pods and strike teams via direct shipments to LHDs (the term LHD includes also THD, OCCHD)

Oklahoma began creating a potential pandemic provider list in January 2020 as a required activity under Core grant. Providers were recruited through the Oklahoma Heath Advisory Network (OK-HAN), which reached approximately 5,000 healthcare providers throughout Oklahoma. Vaccines for Children providers were reached through the Immunization Field Consultants (IFCs). Over 515 pandemic providers including LHDs, RHCs, FQHCs, hospitals and others enrolled with Immunization Service before CDC released its provider enrollment forms. The Vaccine Coordinator and Immunization Nurse are leading the provider enrollment effort and have reached out to 70 LHDs. The LHDs (including also THD and OCCHD) will be part of vaccine administration to all populations in phase 1. For phase 1, Local County Health Departments will be used to administer state allocated vaccine to LTC and public health staff through closed PODs and will work with partners to coordinate vaccine to tribally ran LTC and public health programs. Later, the Department of Health will reach out to large hospitals to administer vaccine to their Health Care workers providing direct in-patient care to COVID patients.

COVID-19 vaccine administrations will be collected through a combination of Oklahoma State Immunization Information System (OSIIS), and the Vaccine Administration Management System (VAMS). COVID vaccine reports will be generated through Enhanced OSIIS and SAS software will be used to look at vaccine coverage, inventory, and administrations. These reports will be used to monitor vaccine inventory, administrations, vaccine coverage for high priority and high-risk groups to help ensure maximum COVID vaccine coverage of the Oklahoma population. Oklahoma will use a GIS map for planning of COVID 19 vaccine distribution and administration. Some components of the map will be shared with the public such as COVID Vaccine providers and locations and availability of clinics. Attention and consideration are being given to the level of information being made publicly available, as security of the vaccine at the recipient facility must be ensured.

Objectives for communication include creating awareness of the first phase of distribution to phase 1 populations, developing an awareness and activation campaign that will provide Oklahomans within the phase 1 priority list the information they need to make a decision about getting vaccinated, and arming providers and partners across the state with key information that will allow them to inform and guide Oklahomans as they prepare to receive the vaccine. Oklahoma State Communications team will be working closely with the Oklahoma and Tulsa Health Departments, tribal PIOs, hospital associations to ensure messaging consistency, clarity and accuracy of information being shared from the CDC and the federal government through OSDH to the rest of the state.

Oregon

Source: Oregon Health Authority | Oregon Immunization Program; November 6, 2020; Interim Draft 1.1

 

The Oregon Health Authority (OHA) regulates or administers many of the state's health care programs, such as those administered through the Public Health Division (PHD), as well as Oregon’s Medicaid program, the Oregon Health Plan (OHP). The Oregon Immunization Program is responsible for facilitating the delivery of immunizations. The OIP Vaccine Planning Unit has been formed to coordinate the planning and implementation of COVID-19 vaccine distribution in Oregon. The public health system in Oregon is a partnership between the Oregon Health Authority and local public health authorities. There are structures and processes in place to guide the coordination of public health efforts within counties and statewide. Coordination between state and local authorities to plan the allocation and distribution of the COVID-19 vaccine will follow these established processes. Oregon is building clear communication pathways to facilitate cooperative planning with counties, engage county partners to establish clear roles and responsibilities for counties and the state, and clarify allocation processes to ensure consistent COVID-19 vaccine usage throughout the state.

Oregon intends to leverage existing relationships with currently enrolled Vaccines for Children (VFC) and public access providers, to enroll providers to receive and administer the COVID-19 vaccine. They will also engage Local Public Health Authorities to assist in recruitment, and partner with the Oregon Association of Hospitals and Health Systems, the Academy of Family Physicians, community-based organizations who work with critical populations, the Coalition for Community Health Clinics and Oregon Primary Care Association to advise us on prioritizing enrollment. Finally, Oregon will partner with Coordinated Care Organizations (CCOs), which are contracted by OHA to provide health services for Medicaid members

All providers, current and new, will submit records of all doses administered to Oregon’s Immunization Information System (IIS), ALERT IIS, within 24 hours of administration. Oregon’s communication objectives include providing information to the public about planning, policy, operations using crisis and emergency risk communication principles: Be first. Communications will be proactive and timely. Being first is always balanced by the accuracy needed to maintain credibility, and to be right and respectful in our approach. The state will also ensure messaging and communications are culturally responsive and linguistically accessible. The communication will educate the public about the development, authorization, distribution, and execution of COVID-19 vaccines and that situations are continually evolving. OHA will track several metrics and publish them on the immunization program and COVID-19 website.

Pennsylvania

While the full plan is not publicly available yet, Pennsylvania’s Department of Health has released and executive summary of it. The distribution will use existing agreements with pharmacies to aid in the distribution of the vaccine when it becomes available. During the first phase of vaccination distribution, the DOH will focus its efforts on Healthcare Personnel, First Responders, Critical Workers and individuals with high-risk conditions. The department will utilize a three-phased recruiting and enrollment approach for vaccination providers. Phase 1 is currently under way and focuses on hospitals, Federally Qualified Health Centers, County and Municipal Health Departments, and DOH State Health Centers. Phases 2 and 3 will be expanded to existing Vaccines for Children (VFC) and non VFC providers and pharmacies throughout the commonwealth.

Clear communication is a key function to ensure the public is educated on the COVID-19 vaccine. The Office of Communications will be responsible for utilizing multiple mechanisms to provide vaccination updates to the public. It is anticipated that DOH will use press releases, news briefings, the department website and social media to ensure public confidence in the safety and efficacy of COVID-19 vaccines.

DOH will utilize the CDC COVID-19 Vaccination Response Dashboard to estimate critical population categories, implement data into the administration of vaccine and record COVID19 vaccine administration data. Metrics will be shared via DOH’s existing COVID-19 Data Dashboard on the department’s public website.

Summary

South Carolina

The State has established a Unified Command Group (UCG) to coordinate and unify response functions. It has also established Emergency Support Functions (ESFs) with state agencies and volunteer organizations to support response and recovery operations. County Emergency Management will maintain communication with the State Emergency Operation Center (SEOC). Counties will provide disaster situational updates and forward requests for assistance as necessary to the SEOC.

DHEC is closely monitoring guidance put forth by the CDC's Advisory Committee on Immunization Practices (ACIP), the National Institutes of Health, and the National Academies of Sciences, Engineering, and Medicine (NASEM), and other sources regarding identified populations of focus for COVID-19 vaccination. DHEC will recruit and enroll COVID-19 vaccination providers through ICS Immunizations Branch. They will assemble a pandemic provider enrollment and management team to execute the administrative and outreach functions needed. The lead of this team will be responsible for communicating provider enrollment data to the CDC twice weekly.

DHEC will require vaccination providers enrolled in the COVID-19 Vaccination program in Phase 1 to utilize the VAMS tool for vaccine administration documentation and reporting. For phases 2 and 3, DHEC will require documentation and reporting through a combination of VAMS and the state's immunization information system, SIMON. The DHEC's Immunizations Branch will monitor all planned mobile clinics' reporting status, ensuring that providers fully report their data via VAMS (phase 1 and 2) or the IIS mass vaccination module (phase 2). The DHEC VAMS Coordinator and IIS team will monitor provider reporting via VAMS or the IIS in phases 2 and 3.

Efforts are underway to help keep the public informed on the COVID-19 vaccine. This includes incorporating educational messaging into agency talking points, news releases, and social media copy. The JIC has currently targeted communications efforts at reaching the general population, state and local leaders, and key stakeholders and partners. The JIC will tailor communications to address the initial populations' specific needs identified to be impacted by each phase of the program's role. To support this, the agency is currently working collaboratively with members of the Vaccine Task Force.

Vaccine Plan - Draft

South Dakota

As of October 27th, the full COVID-19 vaccination plan for South Dakota has been submitted according to a report by The Dickinson Press, however the full comprehensive document has not yet been made available to the public. There are not many certain details about what the plan contains. The South Dakota Department of Health officials are currently working on responding to feedback and recommendations made by the CDC on their initially submitted draft.

Source

Tennessee

Source: Tennessee Department of Health; October 16, 2020; Version 1.0

 

The initial TDH COVID-19 Vaccination Program Planning Team included members of the Vaccine Preventable Diseases and Immunization Program team and the Office of Emergency Preparedness. TDH has convened a Pandemic Vaccine Planning Stakeholder group which meets every two weeks and is leveraged to help inform allocation decisions, define priority populations, and identify gaps in knowledge. The group is comprised of more than 28 different offices, agencies, and departments representing public health, rural health, refugee and other minority populations, legislators, experts in bioethics, medical societies, communications experts, health care coalitions, emergency management, and others. Tennessee is a hybrid state where 89 of its 95 counties report to the State and six metros are independent from the State. Tennessee contracts with these six counties (Shelby, Madison, Davidson, Sullivan, Knox, and Hamilton) to conduct public health activities. Coordination between the State and local authorities occurs through numerous channels, including partnering agencies, medical societies, health care coalitions, and emergency management agencies, in addition to multiple opportunities for partners to participate in calls and webinars (bi-weekly COVID-19 update webinar for clinicians, bi-weekly calls between TDH and metro, regional and local health departments, monthly calls with Tennessee Hospital Association, long term care facilities, and others, bi-weekly press conferences that include the Commissioner of Health, and others).

Ten percent of the State’s allocation of COVID-19 vaccines will be reserved by the State for use in targeted areas with high Social Vulnerability Index (SVI) values. Five percent of the State’s allocation of COVID-19 vaccines will be distributed equitably among all 95 counties. Eighty-five percent of the State’s allocation of COVID-19 vaccines will be distributed among all 95 counties based upon their populations. TDH plans to use Geographic Information System (GIS) mapping and Tiberius functionality to locate/map all critical populations. The state will recruit/enroll all hospitals as vaccine providers and will then start onboarding local and regional pharmacy partners not already working through CDC. The State will also be deploying vaccination strike teams across the state that will be able to conduct on-site vaccination events for targeted populations that may not have ready access to another vaccine provider. Once hospitals and pharmacies are onboarded, they will begin focusing on large employers, urgent care clinics, and community providers that will be able to reach additional individuals within these priority populations.

Tennessee will use the Tennessee Immunization Information System (TennIIS) to collect COVID19 vaccine doses administered by providers. The satellite, temporary and off-site clinics will use TennIIS’ Mass Immunization Module to document COVID-19 vaccine administration at the time of the mass vaccination event. All public health clinics have been trained on TennIIS’ Mass Immunization Module and will be using this module during this fall’s flu mass vaccination events and during the Fight Flu TN event. This will prepare public health users for documenting COVID-19 vaccine administration later this year. Publicly-reported vaccination program metrics may mimic the current format used to report COVID-19 metrics on the THD public website.

Texas

Source: Texas Department of State Health Services; October 16, 2020; Version 1.0

 

The Texas Department of State Health Services (DSHS) will utilize an internal COVID-19 vaccine planning and coordination team gathered from across the agency, including the Immunization Program. DSHS is collaborating with the Texas Division of Emergency Management (TDEM) and the Texas Emergency Management Council (TEMC) to identify targeted populations and logistical requirements for providing them COVID-19 vaccine. TDEM works closely with local jurisdictions, state agencies, and federal partners to ensure Texas becomes more resilient for future disasters. The TEMC includes 39 state agencies and nonprofit emergency assistance organizations.

Texas will use a combination of publicly available datasets, data provided by CDC, and data from other state agencies, state regulatory boards and private partners to: identify, estimate numbers of, and locate vulnerable and frontline populations via mapping. Critical populations will likely include healthcare personnel likely to be exposed to or treat people with COVID-19, people at increased risk for severe illness from COVID-19, including those with underlying medical conditions and people 65 years of age and older, and other vulnerable, frontline workers.

Texas will implement a statewide integrated communications/outreach/engagement plan. The plan is tiered for providers (recruitment, vaccine administration), the public (information, call to action) and stakeholders (outreach, support and feedback). Key audiences are as follows: healthcare providers; community-based public health partners and coalitions; local and regional health entities; city, regional and statewide elected officials and administrators; municipal departments/agencies; vulnerable and frontline audiences identified by the CDC; and the public. An emphasis will be placed on targeting media outlets favored by the following audiences: vulnerable and frontline workers; people at increased risk for severe illness or death; people at increased risk of acquiring or transmitting COVID-19; and people with limited access to vaccination services.

Texas will use ImmTrac2 as the official repository of data because this will be the basis for the data reported to the CDC and used for their analysis. DSHS will ensure that all the necessary protections are in place for the data in transit and at rest. Due to Texas’s laws governing the Texas Immunization Registry, no individual data will be shared via the CDC Immunization Gateway. Providers must report doses used in ImmTrac2 and complete the reporting process within the VAOS system to keep information on their inventory up to date. This includes reporting doses wasted and transferred. Reporting must be completed within 24 hours of usage, waste, or transfer. Texas will track and monitor progress on providers, vaccine ordering and distribution, and vaccination coverage by county from lmmTrac2.

Utah

The Utah Health Department revealed their COVID-19 vaccination plan on October 21st according to a report by The Salt Lake Tribune. The full plan document does not appear to be publicly available online yet. Utah’s Legislature’s Health and Human Services Interim Committee were informed that the first doses will go to those who staff emergency departments, urgent care facilities, COVID-19 units and long-term care facilities, as well as to those health care workers who have preexisting health conditions.

Rick Lakin, immunization program manager for the Utah Department of Health, noted that in the final phase of vaccine distribution the health department will begin monitoring vaccine uptake “through population data.”

“This will allow us to look at populations within the state of Utah that have low vaccination rates and we maybe want to improve [that] coverage,” he said. “We’ll work with our local health departments to ensure that we can reach out to those vulnerable populations that have not received their vaccine at this point yet.”

Source

Vermont

Source: Vermont Department of Health; October 16, 2020; Version 1.0
 
Vaccine Administration Documentation and Reporting
Vermont will use a hybrid approach to collecting data about vaccine doses administered. This includes use of the CDC Vaccine Administration Management System (VAMS) as well as established reporting systems to Vermont Immunization Registry (VT IIS). Work is underway to develop an internal and public facing dashboard to share key information with all stakeholders. The dashboard will build upon the current Vermont COVID-19 Dashboard.  
 
Provider Recruitment and Enrollment
The Immunization Program will reach out by email to all potential COVID-19 vaccination providers and target the appropriate settings that maximize the number of people who can be vaccinated. The providers include currently enrolled practices, hospitals, LTCFs, pharmacies, congregate settings, Visiting Nurses Associations (VNA) and others. In addition to email, the Vermont Immunization Bulletin will be used to spread awareness of the COVID-19 vaccination program and promote enrollment.  
 
Equity in Distribution and Messaging
Vaccine allocation will be based on population data, with attention to critical populations. Vaccine administration data will be closely monitored and reviewed at a granular level by county, town and health service area. The Immunization Program is collaborating with the Health Equity and Community Engagement Team to ensure access to disadvantaged communities and people of color. GIS mapping and Social Vulnerability Indices will be employed to identify areas with limited access and direct distribution efforts. 
 
A comprehensive communication and media plan is in development, which will consider low and high uptake scenarios throughout each phase of the plan. Vermont will develop a marketing strategy, building on ongoing marketing efforts around COIVD-19 prevention.   
 
Organizational Structure
Two main workgroups are overseeing the COVID-19 planning work in Vermont: 
  • COVID-19 Vaccination Advisory Committee: Provides overall guidance to the planning work. Membership will include a subgroup of the Crisis Standards of Care Committee and those serving the highest risk populations. 
  • Statewide COVID-19 Vaccination Planning Team: Includes experts from VDH, Vermont Emergency Management, UVM Medical Center, and the Vermont Agency of Digital Service, and is responsible for fully developing the vaccination plan. Three subgroups are developing distinct aspects of the plan: information technology; logistics; communications. 
Statewide coordination and implementation of the plan is managed jointly by the State Emergency Operations Center (SEOC) and the VDH’s Health Operation Center (HOC), which includes the newly formed Vaccination Branch and its four sections: immunization program operations; technical response; points of distribution (POD) mass vaccination; and data management. The HOC connects directly with the 12 Local Health Office Emergency Operations Centers. 
 
Last modified: 11/18/2020

Virginia

Source: Virginia Department of Health; October 1, 2020; Version 1.1
 
Vaccine Administration Documentation and Reporting
To receive/administer the COVID-19 vaccine, vaccination providers must enroll in the federal COVID-19 Vaccination Program by means of the Virginia Electronic Registration for Immunization Programs (VERIP) System. CDC’s Vaccine Administration Management System (VAMS) will be available to VDH/provider sites that need assistance in patient registration and scheduling, clinic flow, supply management, patient record management and reporting.   
 
Provider Recruitment and Enrollment
VDH has developed a COVID-19 Vaccine Provider Intent Form for interested providers or facilities to indicate intent to administer COVID-19 vaccine to patients and/or staff. Information collected will allow VDH to set up necessary accounts for vaccine ordering and reporting. 
 
Equity in Distribution and Messaging
VDH, in collaboration with partner agencies and organizations, is actively working to identify the critical infrastructure workforce, people at increased risk for severe COVID-19 illness and people at increased risk of acquiring or transmitting COVID-19. Public health messages and products will be tailored for each audience and developed with consideration for health equity, using plain language that is easily understood. Information will be presented in culturally responsive language and available in languages that represent the communities. Local health districts will coordinate local messaging efforts with their local jurisdictions’ public information officers.
 
Organizational Structure
VDH consists of 33 local health districts, with each health district supporting one or more local jurisdictions. These local health districts report to the State Health Commissioner through the Deputy Commissioner for Community Health Services. In addition to serving as stand-alone plans, local health district emergency preparedness, response and recovery plans support their local Emergency Operations Plans (EOPs) and the VDH Emergency Preparedness Response and Recovery Plan. For preparedness and response purposes, the VDH has organized the 33 health districts into five regions. Each region has a regional team that provides technical assistance to the districts and augments district staffing as necessary during times of emergency.  
 
Last modified: 11/18/2020

Washington

Source: Washington State Department of Health; October 2020; Version 1
 
Vaccine Administration Documentation and Reporting
The Washington State Department of Health will use REDCap to collect provider enrollment information and will use PrepMod and the ISS to collect doses administered data from providers within 24 hours of vaccine administration. The department plans to publish COVID-19 Vaccination Program metrics to be available for the public.
 
Provider Recruitment and Enrollment
In the earliest phase, the department will identify and prioritize enrollment of health care system and partners who can support high-throughput vaccination services. The department and the Washington State Pharmacy Association (WSPA) will engage pharmacies and educate them about the process of enrollment and the expectation of how reporting and distribution will work.  
 
Equity in Distribution and Messaging
The state’s allocation framework will be informed by cross-cutting equity considerations based on community and partner input. The department is developing a prioritization and allocation framework in consultation with public health and health care partners; first responders; critical and essential workforce sectors; business groups; black, indigenous, and people of color communities; education systems; and other governments, including tribal nations, local governments, and local health jurisdictions.
 
The department’s equity and social justice staff will be conducting surveys, interviews and focus groups with various groups in the state to determine attitudes about vaccination and gauge the effectiveness of the department’s messaging and their receptiveness to it. 
 
Organizational Structure
The COVID-19 Response Program is under the oversight of the Deputy Secretary for COVID-19 Response. The department will work with the preparedness, immunization, and communications teams at all 35 local health jurisdictions in Washington to plan for the allocation and distribution of a COVID-19 vaccine. Additionally, an engagement strategy has been developed to seek input and participation local health officers and administrators via the Washington State Association of Local Public Health Officials (WSALPHO), governmental partners (state agencies and commissions that serve priority populations), health care system partners, community groups and organizations, and statewide associations and advisory boards. 
 
Last modified: 11/18/2020

West Virginia

Source: West Virginia Department Of Health And Human Resources, Division Of Immunization Services; October 16, 2020
 
Vaccine Administration Documentation and Reporting
The WVDHHR Division of Immunization Services (DIS) will oversee continuous monitoring throughout the COVID-19 Vaccination Program to ensure the program is achieving desired outcomes. Key programmatic metrics will be added to the existing West Virginia COVID-19 Dashboard.
 
Provider Recruitment and Enrollment
WVDHHR has prioritized recruitment efforts for vaccination providers who will administer the vaccine during Phase 1 including local health departments (LHDs), hospitals, Federally Qualified Health Centers (FQHCs), and pharmacies. All providers will be required to formally enroll in the COVID-19 Vaccination Program by completing a web-based Provider Agreement and Provider Profile. Once Phase 1 vaccination providers have been successfully enrolled and onboarded, recruitment will shift to targeting additional provider groups.  
 
Equity in Distribution and Messaging
In addition to the population groups which will receive the initial limited doses, other identified key population groups include people from racial and ethnic minority groups. Messaging will be developed with consideration for health equity.  
 
A sub-workgroup was established to focus solely on communications and messaging. The core members of this group include representatives from DIS, WVDHHR Office of Communications, WV National Guard Public Affairs and the Center for Rural Health Development.
 
Organizational Structure
The WVDHHR Health Command has been established for mobilization of the WVDHHR’s COVID-19 response. Several LHD representatives are members of the core planning group. WVDHHR holds weekly COVID-19 response calls with all LHDs to disseminate information and identify support needs. These calls have been used as a forum to provide updates on the state’s vaccine planning efforts and the recommended actions that should be taken locally. Prior to implementation, weekly calls will be established that focus on detailed aspects of the vaccination program planning and implementation by LHDs. 
 
Last modified: 11/18/2020

Wisconsin

COVID-19 Vaccination Plan - Draft
Source: Wisconsin Department of Health Services (DHS); October 2020

 
Vaccine Administration Documentation and Reporting
The Wisconsin Immunization Registry (WIR) is widely used by vaccinators throughout the state to record administered vaccine doses, to guide clinical decision making, run reports and advise as to which clients are due or overdue for immunizations. Currently, Wisconsin is still determining whether it will use an additional product to supplement WIR does.  
 
Provider Recruitment and Enrollment
Wisconsin plans to use existing communication channels to notify stakeholders, including current WIR users, VFC and VFA providers and local and tribal public health. Additionally, the state will engage the Public Health/Healthcare Coordinating Council, Wisconsin Public Health Association, Wisconsin Hospital Association, Wisconsin Primary Health Care Association, Wisconsin Rural Hospital Cooperative and the Milwaukee Health Care Coordinating Committee to let their membership know when registration is open and to encourage enrollment. Wisconsin will also work with partners such as the Division of Quality Assurance (to reach long term care and assisted living facilities), the Division of Medicaid Services, the Pharmacy Society of Wisconsin and the membership of the Wisconsin Council on Immunization Practices, which includes a variety of partners to reach out to potential vaccinators. 
 
Equity in Distribution and Messaging
The Harm Reduction & Prevention work stream of the COVID-19 Response Team (CRT) CRT aims to connect with high-risk and communities disproportionately impacted by the COIVD-19 pandemic. This partnership aims to assure that the immunization program is able to engage, build upon and lean on community partners to deliver immunizations in a way that demonstrates Wisconsin’s commitment to leading with equity.  
 
The communications plan has separate goals for each phase of the campaign, each one tailored to the needs of different groups, including the general public, initial priority groups, vaccinators and stakeholders.
 
Organizational Structure
The COVID-19 Response Team (CRT) was formed in July 2020 and its Director reports to the DHS Deputy Secretary. It provides strategic and operational coordination for the Department’s involvement in the Statewide Emergency Response for the COVID-19 pandemic. The COVID-19 Vaccination Program planning was integrated into the CRT structure in September. The integration provided visibility for the effort, ensured coordination across the statewide response and allowed access to an array of expertise within the department and across government agencies. 
 
Last modified: 11/18/2020

Wyoming

Source: Wyoming Department of Health; October 16, 2020; Interim Draft 1
 
Vaccine Administration Documentation and Reporting
The Immunization Unit (Unit) will use RedCap for provider enrollment in the COVID-19 Vaccination Program. The Unit will reach out to organizations through collaboration with Public Health Nursing Offices (PHNOs), County Health Departments (CHDs), professional associations, licensing boards, etc. to communicate the process for enrolling providers.  
 
Provider Recruitment and Enrollment
The Unit is responsible for routine distribution of all publicly purchased vaccines in Wyoming to providers enrolled in the Public Vaccine Programs. Coordination of critical population vaccinations will be planned and conducted at the local level through the Public PHNOs and County Health Departments CHDs. The WDH Public Health Nursing (PHN) Unit supervises state County Nurse Managers in 19 counties within Wyoming where county and state PHNs administer and deliver a number of public health programs.  
 
Equity in Distribution and Messaging
Racial and ethnic minority groups, as well as tribal populations, are considered critical populations under Wyoming’s COVID-19 vaccination plan. Additionally, Wyoming will establish points of contact and communication methods for organizations, agencies and communities within critical population groups.  
 
The WDH public information officer (PIO) and personnel within the WDH COVID-19 Vaccination Planning Team will coordinate and deliver public health information using the department’s routine practices, applying crisis and risk communication principles as needed.
 
Organizational Structure
The Public Health Division of the Wyoming Department of Health has primary responsibility for coordinating development of the plan. Vaccinations of healthcare provider populations will be completed by hospitals, PHNOs or CHDs and the Eastern Shoshone Tribal Health Department. PHNOs and CHDs will be enrolled as vaccine providers first to ensure appropriate planning to immunize healthcare providers in their county. Hospitals will be enrolled as vaccine providers to immunize their workforce as well as other healthcare providers in their community. 
 
Last modified: 11/18/2020

Background and Resources 

Background

About Operation Warp Speed

Operation Warp Speed (OWS) is a multi-agency federal partnership led by the Department of Health and Human Services (HHS), that has been tasked with organizing efforts to accelerate the development, manufacturing, and distribution of COVID-19 vaccines and other countermeasures including diagnostics and therapeutics. The goal of this initiative, as outlined by HHS, is to “deliver 300 million doses of a safe, effective vaccine for COVID-19 by January 2021”.

Vaccine Development

The Departments of Health and Human Services (HHS) and Defense (DoD) have announced billions of dollars toward the development of six vaccine candidates: BioNTech SE/Pfizer, Moderna, AstraZeneca/Oxford, Janssen Pharmaceuticals, Novavax, and Sanofi/GlaxoSmithKline. Congress has allocated roughly $10 billion to this effort through supplemental appropriations in previously passed COVID-19 relief bills including the CARES Act.

As of today, Moderna, BioNTech/Pfizer, and AstraZeneca/Oxford have already begun Phase III clinical trials for their respective vaccine candidates, the final stage of clinical development. The other three companies will follow by the end of the year. Following the completion of Phase III trials, vaccine candidates will have to undergo approval by the Food and Drug Administration (FDA).

Federal Vaccine Distribution Plan

HHS and OWS are seeking to finalize planning for production and distribution of the vaccine as early as possible so that they may begin distribution immediately following FDA approval and authorization.

On September 16, 2020 HHS announced its COVID-19 vaccine distribution plan. The plan was developed in coordination with the Centers for Disease Control and Prevention (CDC) and the Department of Defense (DoD). The agencies released the plan in the form of a brief report to Congress outlining a strategic overview of the plan, and an interim playbook for state, tribal, territorial and local public health programs to begin operationalizing a vaccination response to COVID-19 within their respective jurisdictions.

The plan outlines four main tenets:

  • Stakeholder engagement and communication with the public to improve vaccine confidence and uptake.
  • Immediate distribution upon FDA approval (within 24 hours).
  • Safe administration and availability of administration supplies.
  • Data monitoring through IT tracking systems.

While many elements of the strategy are still in process pending the outcome of Phase III trials and the timeline for FDA approval, CDC’s jurisdictional playbook serves as a framework that outlines many preliminary steps states and localities-- especially counties, can be taking now to prepare for vaccine distribution.

The playbook is particularly geared towards CDC Immunization and Vaccines for Children Cooperative Agreement funding awardees. The CDC will distribute federal funding for vaccine preparedness to the 64 jurisdictions with existing cooperative agreements under this program. The agency is also requiring the awardees to submit detailed vaccine distribution plans to their CDC project officers no later than October 16, 2020.

COVID-19 Vaccination Program Planning Basics

The playbook outlines the following guidance to assist jurisdictions in operationalizing and launching a COVID-19 Vaccination Program.

Use of Planning Assumptions & Adaptation

The playbook emphasizes the importance of “full situational awareness” when planning a vaccine distribution program, which involves balancing the information we have on hand, versus what is not yet known about the vaccine; such as the type of vaccine that will be available, how much of it will be available, and what the efficacy will be. The resource includes an appendix of planning assumptions, which should be taken into consideration during early planning efforts.

In addition to planning assumptions, the playbook encourages the adaptation of previous vaccination response plans such as those for H1N1, the seasonal flu and childhood immunization programs.

Following the development of a plan, the playbook encourages the use of tabletop exercises to identify weaknesses, especially for plans involving multiple levels of government and cross sectoral partners.

Development of Internal Planning and Coordination Teams.

The playbook recommends the formation of an internal planning and coordination teams to provide thoughtful insight and expertise from a wide array of state and local jurisdictions. Such jurisdictions may include, but are not limited to:

  • Immunization and preparedness professionals
  • Legal professionals
  • Media and public affairs professionals
  • Clinical experts in isolated population fields (e.g. aging, HIV/AIDS, or rural health) 
  • Local public health jurisdictions

Development of External Implementation Committees.

In addition to the formation of an internal planning committee, the CDC recommends that jurisdictions leverage external partnerships through the formation of COVID-19 Vaccination Program implementation committees. The members of this committee should represent key COVID-19 vaccination providers for critical population groups, (outlined on page X of this analysis).

Many of the examples provided by the CDC of stakeholders to be included in external implementation committees are county owned or operated, including:

  • Emergency management agencies
  • Local health departments
  • Health systems & hospitals (including critical access hospitals for rural areas, in-patient psychiatric facilities)
  • Community Health Centers
  • Rural Health Clinics (RHCs)
  • Long-term care facilities, nursing homes, skilled nursing facilities
  • Correctional facilities

*Please see playbook for full list of suggested stakeholders.

State & Local Coordination

As states work with counties and other sectors of local government around the planning of a COVID-19 vaccination program plan, the CDC playbook emphasizes the importance of aligning areas of responsibility and specific to maximize resources, quality and efficiency of the program and avoid the duplication of efforts.

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

Critical 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.

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.

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.

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.

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. 

Take Action

The CDC is suggesting that states and local jurisdictions use the playbook to develop their COVID-19 vaccination plans. The plans must be submitted to CDC through the corresponding project officer assigned to each of the 64 jurisdictional awardees of the Immunization and Vaccines for Children Cooperative Agreement by October 16, 2020. See Appendix B for the complete list of the 64 jurisdictions and the corresponding project officers.

Timeline

Release of Framework

September 16, 2020

Jurisdiction Vaccination Plan Due to CDC

October 16, 2020

Phase 3 Clinical Trial Completion

End of 2020/ Early 2021

FDA Approval and Authorization

2021

Phased Allocation of Vaccination Doses

2021

Key next steps for counties:

  • Reach out to your state’s CDC Jurisdiction Project Officer for Vaccine Development to ensure that your county expertise and resource needs are reflected in jurisdictional plans.
  • Contact your Representative and Senators to request that Congress provide direct and flexible COVID-19 funding for state and local governments to assist with the acquisition of supplies and resources for vaccine distribution.

Resources

Federal Funding & Mandates for Vaccine Development and Distribution

Bill Title (Number)

Funding Amount Allocated

Summary of Provision

Coronavirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123)

$61 million

Provided additional funding for FDA "Salaries and Expenses" for COVID-19 response, which includes "the development of necessary medical countermeasures and vaccines".

$3.1 billion

Provided additional funding for the HHS "Public Health and Social Services Emergency Fund". The funding was provided to help respond to COVID-19, including the "development of necessary countermeasures and vaccines". These funds can also be used "for the construction, alteration, or renovation of non-Federally owned facilities for the production of vaccines". The bill also instructs the HHS Secretary to use these funds to purchase vaccines.

$300 million

Provided additional funding made available to the "Public Health and Social Services Emergency Fund" for the same purposes listed above. However, the funding is only available if the HHS Secretary notifies Congress that the $3.1 billion allocation "will be obligated imminently and that additional funds are necessary to purchase vaccines...".

Families First Coronavirus Response Act (P.L. 116-127)

Medicaid FMAP assistance increased temporarily by 6.2% for each state/territory

States were only eligible for this temporary increase in federal medical assistance if the State provides "coverage under such plan (or waiver), without the imposition of cost sharing…for any testing services and treatments for COVID-19, including vaccines...".

Coronavirus Aid, Relief and Economic Security Act (CARES, P.L. 116-136)

$80 million

Provided additional funding for FDA "Salaries and Expenses" for COVID-19 response, which includes "the development of necessary medical countermeasures and vaccines".

$706 million

Provided additional funding for NIH. Mandates that no less than $156 million of these dollars be used "for the study of, construction of, demolition of, renovation of, and acquisition of equipment for, vaccines and infectious diseases research facilities".

$3.5 billion

Provided additional funding for the HHS "Public Health and Social Services Emergency Fund". The funding was provided to help respond to COVID-19, including the "development of necessary countermeasures and vaccines". $3.5 billion of this funding is allocated to the Biomedical Advanced Research and Development Authority for "manufacturing, production and purchase....of vaccines, therapeutics, diagnostics...". These funds can also be used "for the construction, alteration, or renovation of non-Federally owned facilities for the production of vaccines".

N/A

Required the strategic national stockpile to include PPE and other medical supplies "required for the administration of drugs, vaccines and other biological products".

N/A

Mandates that the Secretaries of HHS, Labor and Treasury "require group health plans and health insurance issuers…to cover (without cost-sharing) any qualifying coronavirus preventive service", including vaccines.

Requires that any licensed COVID-19 vaccine be covered under the Medicare Part B program without cost-sharing

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

Press Contact