Oregon’s COVID-19 Vaccine Distribution Plan

Article Courtesy of Oregon Health Authority Published 1/6/2021 | Download PDF

 Topline messages

  • Vaccination is the safest, most effective and most reliable way to keep yourself, your family and your community healthy and safe from COVID-19.
  • COVID-19 vaccines are 95% effective and have undergone rigorous safety testing.
  • Oregon will prioritize people who are most at risk and hardest hit. Front-line health care workers will receive the first vaccinations, with a focus on staff who are at highest risk of exposure to the virus in their work. Residents and staff in nursing homes and other long-term care facilities also will be among the first vaccinated.
  • Vaccination gives us hope that the pandemic will end, but in the meantime, we need to continue safety measures to keep the virus from spreading: wear a mask, physically distance from others, wash your hands, avoid gatherings and stay home when you’re sick.

 Vaccine rollout

  • Oregon receives shipments of vaccine every week, which are distributed throughout the state. As we go forward, we will have more outlets for people to get the vaccine, such as local public health departments and eventually pharmacies, so we expect that the velocity of vaccination will increase. In general, the vaccine uptake among hospital workers and residents of skilled nursing facilities is increasing.

Safety and efficacy

  • The vaccine won’t end the pandemic, but vaccination will. It’s important that everyone is vaccinated to achieve community immunity.
  • COVID-19 vaccines have been evaluated extensively in large-scale clinical trials that involved more people than in a typical vaccine trial. These trials involved adults from a diverse and inclusive range of races, ethnicities and ages, including people from communities of color.
  • COVID-19 vaccines are vetted for safety and efficacy by three independent scientific groups, including the Data Safety Monitoring Board (DSMB), the Vaccines and Related Biological Products Advisory Committee (VRBPAC) and the Advisory Committee on Immunization Practices (ACIP).
  • It’s important that people remember basic COVID-19 safety measures to stop the spread of disease: wear a mask, social distance, avoid large gatherings and social get- togethers, wash your hands and stay home when you’re sick.

Sequencing

  • As COVID-19 vaccines become available, Oregon Health Authority (OHA) will ensure the distribution process is based on community involvement that will provide an equitable system challenging the roles of power, privilege and racism—informed by a newly assembled COVID-19 Vaccine Advisory Committee (VAC).
  • Using an equity framework, OHA is currently distributing COVID-19 vaccines in line with the phased approach recommended by CDC’s Advisory Committee on Immunization Practices (ACIP):
    • 1a. Health care workers, EMS, long-term care facility (LTCF) employees and residents.
    • 1b. Workers such as teachers, bus drivers, food processing workers and other people who keep our society open and economy moving. OHA’s Vaccine Advisory Committee, representing community perspectives, will identify and prioritize this group.
    • 1c. People with underlying health conditions and people older than 65.
  • Details for Oregon’s Phase 1a are available on the OHA COVID-19 vaccine website in the Oregon’s Phase 1a COVID-19 Vaccine Plan and Recommended Sequencing document. Additional guidance was provided on Monday, January 5 in the Sequencing Update memo. In addition to using an equity framework, OHA is consulting with Oregon’s nine federally recognized tribes and conferring with the Urban Indian Health Program on COVID-19 vaccine issues that may impact the tribes (and the health of their members) who have chosen to receive the state vaccine allocation as part of planning and decision-making regarding COVID-19 vaccine distribution.
  • While everyone within the 1a group will be vaccinated as soon as possible, there simply aren’t enough vaccines yet. OHA considered many individual, group and societal factors, as well as logistical challenges to determine the current vaccine sequencing order. The operational logistics for vaccine delivery to all individuals included in Phase 1a are under development, and OHA is working with partners to finalize and communicate these details.
  • Additional groups beyond Phase 1a will be defined by the work of the Vaccine Advisory Committee. Vaccination will depend on how quickly vaccines come to Oregon and will likely be available through health care providers, local health departments and retail pharmacies.

COVID-19 Vaccine Advisory Committee (VAC)

  • The goal of the COVID-19 VAC is to co-create a vaccine sequencing plan focused on health equity to ensure the needs of systemically affected populations, including communities of color, tribal communities and people with intellectual and developmental disabilities, are met.
  • OHA’s COVID-19 VAC will advise OHA on vaccine sequencing plans for Phases 1b, 1c and 2, with the goal of ensuring that communities most impacted by COVID-19 are prioritized. Using OHA’s definition of health equity, the COVID-19 VAC will:
  • Advise OHA on the ethical principles that should guide decisions on sequencing of COVID-19 vaccines.
  • Review data on COVID-19 and immunization inequities.
  • Using the ethical principles, advise OHA on which workers, high-risk groups or critical populations should be sequenced at what time, taking into consideration where they are located across the state.
  • The first VAC meeting is January 7, 2021, 9 am-noon. For more information, visit the VAC webpage.

Allocation

Both Pfizer and Moderna vaccines are arriving in Oregon every week. See Table 1 for vaccine allocations by setting.

Allocation Terms

Prime = # of vaccine for first dose administration

Boost = # of vaccine for second dose administration

Orders & shipments

As of January 5, 2021, OHA is ordering 2nd dose allocations (boost doses) on behalf of all sites. Orders will automatically ship to hospitals to mirror their prime dose allocations. OHA will eventually switch to a “pull” methodology where sites will have to order their own 2nd doses.

OHA will communicate the timing of this switch in advance. Second doses of Pfizer vaccine will be delivered 3 weeks after the first dose shipments and Moderna 4 weeks after.

Allocation methodology

CDC allocates doses to states pro-rata (based upon the percent of the U.S. population they represent). For Oregon, that is about 1.28%. Oregon is then allocated on a weekly basis about 1.28% of the available COVID-19 vaccines produced by all manufacturers. Moderna COVID- 19 vaccine deliveries in Oregon began Dec. 21 and included doses to the six Tribes and the Urban Indian Health program that are participating in the state distribution program.

 

Daily Update from Oregon Health Authority

1 Updated: 1/5/21

2 Data source: CDC

3 Data is preliminary and subject to change (for future anticipated allocations)

4Other facilities may include tribal health clinics, correctional sites with inpatient facilities, EMS/first responder providers, local public health authorities and urgent care sites.

5 OHA is using preliminary allocation data assumptions to drive our planning process for the coming weeks.

6 Allocations are smaller than the initial allocations Oregon received because manufacturers were able to stockpile vaccine before approval. These allocations represent vaccine being released as it is produced and they are likely to change as production ramps up.

Distribution

To accelerate vaccine access, hospitals or other sites that have received COVID-19 vaccine through the state may transfer excess doses to a Local Public Health Authority or other fully enrolled COVID-19 vaccine provider registered with the state to receive vaccine, as long as the hospital or other site is tracking the transfer in the Oregon Health Authority’s ALERT IIS. This permission is not a substitute for redistribution agreements, but a clarification that one- off, occasional unplanned transfers are acceptable as long as the transfer recipient is approved to receive COVID-19 vaccine. Formal redistribution agreements are required for organizations with routine plans to receive COVID-19 vaccine at a main site and redistribute to smaller facilities. Questions about this process and which providers are approved to receive COVID vaccine can be sent to Vaccine.ProviderEnroll@dhsoha.state.or.us.

Long-term care facilities (LTCFs)

Oregon is participating in a Federal Pharmacy Partnership Program with CVS, Walgreens and Consonus pharmacy.

  • Pharmacy partners will provide on-site vaccination clinics in partnership with LTCFs and congregate care settings throughout Oregon.
  • Vaccination began in skilled nursing facilities with these pharmacy partners on Dec. 21.

Vaccine administration

 

Table of COVID-19 Vaccine Doses Delivered

1Updated: 1/5/21

2Data source: ALERT Immunization Information System (IIS)

3Data is preliminary and subject to change. COVID-19 vaccination providers must document vaccine administration in their medical record systems within 24 hours of administration, and report administration data to ALERT IIS no later than 72 hours after administration.

4 Doses listed as unknown were electronically submitted using the COVID-19 vaccine group code and no product information is available at this time. OHA will be working with provider to complete data submission.

  • The vaccine provider sites around the state have up to 72 hours to report vaccines administered, so the actual number of vaccines administered may actually be higher.
  • Beginning the week of January 18, 2021, trays of vaccine will include ancillary supplies for up to 1170 doses. Providers can order supplemental ancillary kits to accommodate the extra doses through MedSurge/McKesson in the coming days; see the provider website for more information.
  • The COVID-19 vaccine will be available at no cost, though providers may charge insurance an administration fee.

ALERT IIS (Immunization Information System)

  • ALERT IIS is a computerized statewide immunization registry that serves as a critical vaccination tool for providers. ALERT IIS consolidates immunization data from both the public and private health care sectors into one complete record for individuals in Oregon. This helps health care providers, parents and individuals keep track of immunization status, even if those immunizations were given by more than one provider.
  • For the COVID-19 response, ALERT IIS provides a single portal all providers can use for ordering, managing inventory, transferring vaccine to other COVID-19 providers and submitting doses administered. Providers must enter COVID-19 vaccines within 72 hours of giving them.
  • Oregon Immunization Program will use data from ALERT IIS to identify regions with low vaccination coverage and/or few enrolled providers, and partner with social services, faith-based organizations and other community organizations to reach individuals who have not been served.
  • The majority of vaccine providers already use Oregon’s ALERT IIS, including mass, mobile and employment clinic organizations. The system has a statewide recall system that will provide second-dose reminders during the general population phase of COVID- 19 response.

Data dashboards

The vaccine data dashboard on OHA’s COVID-19 website will be updated regularly.

Questions

211 is a statewide, multi-lingual information service that can answer anyone’s questions about the COVID-19 vaccine in Oregon, including when and where people can access their vaccination. Call 211 or visit https://www.211info.org.

Questions about enrolling as a COVID-19 vaccination provider can be sent to: Vaccine.ProviderEnroll@dhsoha.state.or.us.

General questions: Covid19.vaccine@state.or.us

Visit our OHA COVID-19 Vaccine Website: http://healthoregon.org/covidvaccine

Spanish: http://healthoregon.org/vacunacovid

Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

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