COVID-19 Vaccination Planning
Lilian Peake, MD, MPH
State Epidemiologist, Director of the Office of Epidemiology
Lead, Public Health Surveillance and Guidance Workgroup
November 24, 2020
Image Source: Presentation by Anthony S. Fauci, MD, Director of the National Institute for Allergy and Infectious Diseases, NIH2
PHASE I PHASE II PHASE IIIPHASE
VACCINEAVAILABILITY
TARGET POPULATION
FRONTLINE HEALTH CARE WORKERS
CRITICAL INFRASTRUCTURE STAFF
LTC RESIDENTS/STAFFMEDICALLY VULNERABLE
OTHER PRIORITY POPULATIONS
GENERAL PUBLIC
VACCINE DELIVERY METHOD
TARGETED, CLOSED POINTS OF
DISPENSING (CPODs)
CPODs and PHARMACIES
COMMUNITY VACCINATION PARTNERS and PHARMACIES
OPEN PODs and
PHARMACIES
VIRGINIA’s COVID-19 VACCINATION STRATEGY*
INITIAL ESTIMATED
POPULATION640,994 3,005,741 4,888,784
*Strategy will be updated after ACIP recommendations are released3
Virginia COVID-19 Vaccine Advisory Workgroup
● Vaccine Safety and
Efficacy
● Partnerships
● Barriers to Vaccination
● Communications and
Messaging
4
CDC Advisory Committee on Immunization Practices (ACIP)
Initial COVID-19 Vaccine Allocation
Process
● Scientific data
● Implementation feasibility
● Ethical principles
1. Maximize benefits and
minimize
2. Promote justice
3. Mitigate health inequities
4. Promote transparency
Candidate Groups
● Healthcare personnel
(21M)
● Other essential workers
(87M)
● Adults with high-risk
medical conditions (>100M)
● Adults aged 65 years (53M)
Source: www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947e3-H.pdf5
Initial Plan for COVID-19 Vaccine Prioritization
Process
Last updated 11/24/206
Continued on next slide
Initial Plan for COVID-19 Vaccine Prioritization
Process (continued)
Last updated 11/24/207
Continued on next slide
Initial Plan for COVID-19 Vaccine Prioritization
Process (continued)
Last updated 11/24/208
Planning & Exercises
● 10/8/20 - Statewide Plan Seminar
● 10/9/20 - Plan submitted to CDC
● 10/14/20 – Statewide Exercise
● 11/9/20 - Planning Call with Operation Warp Speed
● 11/30/20 – End-to-end testing of vaccine distrubution
● Late Nov/Early Dec - TA Call with CDC and Operation Warp Speed
Ongoing● Local planning and exercises
● HHS Region III Vaccine Task Force coordination
● Coordination with Unified Command and intra-state counterparts
● Coordination with CDC and inter-state counterparts9
Operations
● Key partnerships○ Hospitals
○ Long-term care facilities
○ Community providers (medical providers, pharmacies)
● Updating management information systems○ Vaccine allocation
○ Vaccine ordering/tracking
○ Clinic operations (including appointment scheduling and
recording of doses administered)
○ Tracking of doses administered
10
Flow of Information
11
Logistics
● Centralized ordering by VDH through CDC VTrckS system
● Distribution○ Pfizer - direct distribution to manage ultra cold conditions
○ Others – McKesson
○ Supported by FedEx and UPS
● Virginia’s initial strategy for Phase 1 vaccination (could
change based on ACIP recommendations)○ Healthcare system hub & spoke model
○ CDC Pharmacy Partnership for LTCF
○ State Pharmacy Partnership
12
Supplied by
Manufacturer
Supplied by
CDC
Required by Entity
Receiving/Administering Vaccine
● Vaccine shipped
either from
manufacturing site to
point of vaccination
(possibly utilizing a
GPS tracking
mechanism with
temperature logger
during shipment) or
from CDC wholesaler
to vaccination site
● All vaccines may not
include data logger
to use during
storage
● Diluent
● Syringe/needle for
to use for dilution
● Syringe/needle for
administration
(likely 1 mL syringe
with 23-25G
needed, various
lengths of ⅝”, 1”,
1½”) based on
population being
immunized
● Alcohol swabs
● Dry ice for replenishment or freezer of -
75ºC±15ºC
● Freezer -25 to -10ºC
● Refrigerator 2 to 8ºC
● Data Logger even for the ultra cold storage of
vaccine
● Adhesive strips (i.e. Band-Aids)
● Alcohol prep pads
● Sharps Containers
● Needles/syringes
● Protective equipment (i.e. gloves) for handling
dry ice
● Contactless thermometers
● Gauze
● epinephrine auto-injectors
● Gloves/PPE
Logistics
13
Pre-positioning Ultra Cold Vaccine
● 16 facilities/systems with ultra-cold freezer capabilities
where Pfizer vaccine could be pre-positioned in the initial
phase
● Top 7 sites
○ Cover ~70% of Virginia acute care hospitals
○ Include all 6 healthcare regions
○ Cover ~70% of the healthcare system workforce
● All 16 sites would cover 95% of the health systems
workforce
14
Local Health Department Preparation
● Primary focus = Phase 2 & 3 (could change based on ACIP
recommendations)
● Finalize vaccine clinic plans to add physical distancing
● Recruit volunteers (MRC) as “force multipliers”
● Hire contract staff
● Order ancillary supplies
● Prepare for “push packs” of PPE from VDEM
● Training, including:○ New CDC information management systems
○ Logistics like handling dry ice safely
○ Management and administration of new vaccines15
Communications
● Vaccination campaign will dovetail
with comprehensive COVID-19
pandemic public information campaign
○ “Virginia's Health is in Our Hands”
○ COVID-19 hotspot campaigns
○ Prevention messages for holidays
● Campaign will be based on detailed
research initiative to gauge target
audiences’ perspectives on COVID-19
vaccines
16
Questions
17
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