County of San Bernardino

COVID-19 Vaccination

DistributionPresentation Developed for Hospital Leadership

Updated: Dec.21, 2020

Moderna

NOT FOR RE-DISTRIBUTION OR

MEDIA

Background & Introductions

Daniel Munoz

Emergency Services Manager,

SBC Fire Office of Emergency Services

Josh Dugas

Assistant Director,

SBC Department of Public Health

Andrew Goldfrach, FACHE

Chief Operating Officer, Arrowhead Regional Medical

Center

Lead, San Bernardino County COVID-19 Vaccine Task Force

Melissa German

Program Manager, SBC Department of Public Health,

Preparedness and Response Program (PRP)

Cliff Hiroshige, Pharm.D

Director of Pharmacy,

Arrowhead Regional Medical Center

2

Michael A. Sequeira, M.D.

San Bernardino County Health Officer

Department of Public Health

Phase 1a - Prioritization

4

Tier 1

•Acute care, psychiatric and correctional facilities hospitals

• Skilled nursing facilities, assisted living facilities, similar settings for older or medically vulnerable individuals

• First responders

• Dialysis Centers

Tier 2

• Intermediate care, for persons who need non-continuous nursing supervision and supportive care

• Home health care, in-home supportive services

• Community health workers, promotoras

• Public Health field staff

• Primary care clinics, FQHCs, Rural Health Centers, correctional facility clinics, urgent care clinics

Tier 3

•Specialty clinics

• Laboratory workers

• Dental/oral health clinics

• Pharmacy staff not working in settings at higher tiers

Tier 1 – Detailed

Initial Distribution – Pfizer – Week of 12/14

• All General Acute Hospitals within the County including MCE Hospitals

Second Distribution – Pfizer and Moderna –Week of 12/21

• General Acute Hospitals EXCLUDING MCE Hospitals

• Specialty Hospitals

• First Responders

• SNF/LTC Facilities not in CDC Partnership

• Third Distribution – Pfizer and Moderna – Tentative Week of 12/28

• General Acute Hospitals EXCLUDING MCE Hospitals

• Specialty Hospitals

• First Responders

• SNF/LTC Facilities not in CDC Partnership

• Dialysis Centers

Phase 1a – Prioritization

5

Dignity Health

• Community Hospital of San Bernardino

• St. Bernardine Medical Center

Kaiser Permanente

• Kaiser Foundation Hospital – Fontana

• Kaiser Foundation Hospital – Ontario

Providence St. Joseph Health

• St. Mary Medical Center

Multi-County Entities (MCE)

Will be receiving allocations directly from

the parent hospital corporation and not

part of the County allocation

6

Vaccine Delivery to Hospitals

Thu., Dec. 10

COVID-19 Vaccination Allocation email was sent to all COVIDReadi

approved hospital providers

Wed. Dec. 16

Initial delivery of Pfizer vaccine to DPH & to hospitals

Mon. Dec 21 or Tue. Dec 22

Expected delivery of Moderna vaccine to

DPH and Hospitals

• DPH and the Office of Emergency Services (OES) will coordinate all vaccine deliveries

• A confirmation email for vaccine delivery will be sent to your primary and secondary point of contact as

designated in COVIDReadi

• Chain of Custody must be completed at point of delivery

7

Vaccine will be redistributed to hospital facilities in a refrigerated state. Do

not freeze vaccine upon receipt.

Recognizing storage availability at each hospital, if your hospital prefers to keep vaccines at the Department of Public Health and delivery of smaller quantities, please connect with Melissa German at prp@dph.sbcounty.gov

Note: All ancillary supplies will be sent with the first distribution.

Storage and Handling – What to Expect

8

Moderna Vaccine

• Multidose vials (10 per vial)

• 10 vials per carton

• Carton is 2” x 2” x 5.4”

Storage and Handling

9

Packaging

• Moderna allotment will be received in a refrigerated state

• Store the vaccine in refrigerator between 2° to 8°C for up to 30 days prior to first use. Do not freeze.

• Vaccine will come with a used by date and must be used by the specified date

• Unpunctured vials may be stored between 2° to 25°C for up to 12 hours

Storage and Handling Storage Prior to Use

10

• After the first dose has been withdrawn, the vial should be

held between 2° to 25°C

• Discard the vial after 6 hours

• Do not freeze

Storage and Handling Storage After First Puncture of the Vaccine Vial

11

• 0.5 mL dose

• Remove number of vial(s) from storage

• Swirl vial gently between each withdrawal. Do not shake. Do not dilute vaccine.

• The vaccine is a white to off-white suspension. It may contain white or translucent product-related particulates. Visually inspect the vaccine vials for other particulate matter and/or discoloration prior to administration. If either of these conditions exists, the vaccine should not be administered.

Storage and HandlingDose Preparation

12

The following ancillary supplies will be delivered with the vaccines:

• Needles (various sizes)

• Syringes (ranging 1-3mL)

• Alcohol prep pads

• Surgical masks

• Face shields

• Vaccine needle guide

• Vaccination record cards

Ancillary Supplies

13

• Reporting Doses Administered

• Reporting Inventory to Vaccine Finder

• Reporting Temperature Excursions

• Reporting Doses Wasted, Spoiled, and Expired

• Reporting Adverse Events to VAERS

Resource: https://eziz.org/covid/reporting

Reporting Requirements

14

• COVID-19 vaccination providers must document vaccine administration in

their medical record systems within 24 hours of administration

• Providers may record dose-level vaccination data in CAIR using any of the

established methods:

• Data interface with providers’ Electronic Health Records (EHR) systems

• PrepMod (which includes vaccine inventory control)

• California Immunization Registry (CAIR2) Mass Vax online tools

• Manual data entry into one of California’s CAIR software applications

Reporting Requirements Reporting Doses Administered

15

• COVID-19 vaccination providers must report the number of doses of COVID-19 vaccine and adjuvants that were unused, spoiled, expired, or wasted

• Once providers are enrolled, they will be preregistered for a VaccineFinder account and provided instructions from vaccinefinder@auth.castlighthealth.com on how to submit daily supply information

Reporting Requirements Reporting Inventory to Vaccine Finder

16

• If COVID-19 vaccines are exposed to temperatures outside the manufacturer-recommended ranges, providers must report these temperature excursions.

• Reporting requirement applies to vaccine shipments as well as vaccines stored in primary storage units or transport containers during vaccine redistribution, repositioning, or transfer.

• Guidance to follow.

Reporting Requirements Temperature Excursions

17

• Organization must report the number of doses of COVID-19 vaccine

and adjuvants that were unused, spoiled, expired, or wasted as

required by the relevant jurisdiction.

• Doses wasted, spoiled, or expired will be reported through

COVIDReadi.

Reporting Requirements Reporting Doses Wasted, Spoiled, and Expired

18

• Per the CDC COVID-19 Vaccination Program Provider Agreement, COVID-19 vaccination providers are required to report the following to VAERS:

• vaccine administration errors (whether associated with an adverse event or not)

• serious adverse events (even if they are not sure if the vaccination caused the event)

• multisystem inflammatory syndrome (MIS) in children or adults

• cases of COVID-19 that result in hospitalization or death

• Report adverse effects to VAERS: https://vaers.hhs.gov

• Report vaccines errors to VERP: https://www.ismp.org/report-medication-error

Reporting Requirements Vaccine Adverse Event Reporting System (VAERS)

19

Reordering ProcessOverview

• Log-in to COVIDReadi

• Click the dashboard

• Place your order

• Use Google Chrome

Reordering ProcessCOVIDReadi

• Clinical Considerations

• Vaccine Hesitancy

• FAQs

• Resources

Message from the Health Officer

22

• Dec. 18 – FDA grants EUA of the Moderna COVID-19 Vaccine

against COVID-19 in individuals 18 years of age or older

• mRNA vaccine

• 94% effective in preventing COVID-19

• Dosing Regimen – 2 doses of 0.5 mL each, 1 month apart (28 days)

• Contraindications - Do not administer to individuals with known

history of severe allergic reaction to any component of the Moderna

Vaccine

Moderna COVID-19 Vaccine EUA Approval

23

• Email us your primary point of contact for delivery of vaccine if different from what you entered in COVIDReadi

• Primary point of contact will receive notification of day and time of delivery

• Identify health care personnel at risk of exposure at your site that will receive initial dose of vaccine

• Administer vaccines within 5 days of shipment

• Expect to receive weekly allocations of vaccine. Details forthcoming.

Next Steps

24

• San Bernardino County COVID-19 Vaccination Toolkit

• CDPH Immunization Branch – Required Training and Resources• https://www.cdph.ca.gov/Programs/CID/DCDC/Pag

es/Immunization/COVID-19VaccineTraining.aspx

• CDPH EZIZ e-learning website• https://eziz.org/covid/reporting• Information about reporting (VaccineFinder, CAIR,

PrepMod, etc.)

• Moderna COVID-19 Vaccine Information • https://www.modernatx.com/covid19vaccine-eua/

Resources

25

https://sbcovid19.com/vaccine/

For questions, concerns or comments:

https://sbcovid19.com/vaccine/

• CDPH COVIDCallCenter

• 1-833-502-1245

• COVIDCallCenter@cdph.ca.gov

• Connect directly with us via email @

• COVID19vax@dph.sbcounty.gov

Stay Connected

26