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

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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

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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

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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

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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

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Questions

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