COVID-19 Vaccination Plans: Alabama, Alaska, Arizona
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All the given states mandate the use of Digital Data Loggers for storing and transporting the COVID-19 vaccine. We have provided below a high-level overview of the required information for the various states.

COVID-19 Vaccination Plans Alabama

Distribution (Section 7)

  • As per the proposed COVID-19 vaccination plan, the COVID‐19 vaccine and ancillary supplies will be procured and distributed by the federal government at no cost to enrolled COVID‐19 vaccination providers.
  • CDC will use its “current centralized distribution contract to fulfill orders for most COVID‐19 vaccine products as approved by jurisdiction immunization programs. Some vaccine products, such as the ones with ultra‐cold temperature requirements, will be shipped directly from the manufacturer” for distribution purposes.
  • Subject to the available supply, all vaccine orders will be shipped within 24 hours of ordering for distribution. Ancillary supply kits and diluent will be shipped separately to arrive with or before the vaccine.
  • For secondary distribution to administration sites such as chain drugstores’ central distribution, the vaccine will be sent directly to vaccination provider locations for administration or designated depots.
  • Also, once vaccine products have been shipped to a provider site, the federal government will not redistribute product. However, jurisdictions will be allowed to redistribute vaccines while maintaining the cold chain.

Storage (Section 8)

  • The providers must sign the CDC Provider Agreement and Profile agreeing to store and handle the vaccine properly. Immunization Division (IMM) staff will follow up with large providers via in-person or WebEx to confirm their storage capacity and to ensure that providers have the correct equipment (Digital Data Loggers) to store the vaccines at the proper temperatures.
  • All COVID‐19 providers will be provided either refrigerator or freezer digital data loggers by IMM to ensure the capability to monitor the vaccine. Cold chain storage and handling requirements for each COVID‐19 vaccine product will vary from refrigerated (2 degrees to 8 degrees Celsius) to frozen (-20 degrees Celsius) to ultra‐cold (-60º to ‐80ºC) temperatures.
  • IMM will provide in‐person, WebEx, and written materials/videos on the ADPH website to train providers on vaccine storage. If providers fail to provide proper cold chain capacity and documentation of proper temperatures after receiving education, they will be unable to receive the vaccine until they demonstrate proper cold chain capacity and documentation to ADPH.

Prioritization/Hierarchy of Who Receives Vaccine (Section 4)

  • The federal government will issue guidance on groups to prioritize for initial COVID‐19 vaccination. However, the focus for initial COVID‐19 vaccination will likely be critical population groups such as healthcare personnel, people 65 years of age and older, people from racial and ethnic minority groups, people from tribal communities, people who are incarcerated/detained in correctional facilities, people experiencing homelessness/living in shelters, people attending colleges/universities, people living and working in other congregate settings, people with disabilities, people with an underlying medical condition, and long‐term care facility residents, among others, will be prioritized for the administration of the vaccine.
  • The allocation of the COVID-19 vaccine to jurisdictions will be based on multiple factors, including populations recommended by the Advisory Committee on Immunization Practices (with input from the National Academy of Medicine), current local spread/prevalence of COVID-19, and COVID-19 vaccine production and availability, among others.
  • Center for Emergency Preparedness (CEP) will work with AEMA, OSHA, and other organizations to collect and define data for critical infrastructure priority groups.

Data & Reporting (Sections 9, 11)

  • Jurisdictions “will be required to report CDC defined data elements related to vaccine administration daily (i.e., every 24 hours). CDC will provide information on these data elements to jurisdictions.”
  • All data reporting will be done using a large, robust, lifespan registry called ImmPRINT. The providers will receive training from the field staff on reporting vaccines in ImmPRINT.
  • The data on the vaccine coverage rates will be shared with the Internal Implementation Committee and Executive Committee. Reports will be generated based on provider inventory reporting and provider input of doses used.
  • Alabama plans to use ImmPRINT for all data reporting and sending bi-weekly de-identified vaccine data to CDC’s Data Lake.

Governance (Section 2)

  • The Alabama State Health Officer (SHO) has designated the Bureau of Communicable Disease Director (BCDD) to lead the COVID‐19 Vaccination Plan. BCDD has identified expert staff and external partners as members of the ADPH Executive Committee and an Internal Implementation Committee, which is responsible for executing the Vaccination Plan. These members include physicians, nurses, emergency planners, pharmacists, EMS, administrators, and epidemiologists.

Technology Infrastructure

Security

  • There was minimal information available in the plan regarding this. All adverse events impacting the vaccine safety and security will be monitored through electronic health records (EHR) and claims‐based systems such as Vaccine Safety Datalink. The Medical Officer for Disease Control and Prevention will sign CDC’s COVID-19 Non-disclosure Agreement.

COVID-19 Vaccination Plans Arizona

Distribution (Section 7)

  • The Arizona Department of Health Services (ADHS) will utilize the guidance of the Vaccine and Antiviral Prioritization Advisory Committee (VAPAC) to determine who will be eligible to receive vaccines and at what point in the distribution cycle.
  • The state will allocate to all 15 county health departments and 638 facilities that have elected to be local allocators. The local allocators will then be responsible for distributing those vaccines, based on VAPAC guidance, to enrolled vaccinators in their communities. Local allocators will be provided access to the lists of enrolled vaccinators in their community pulled from the onboarding tool.
  • The onboarding tool will be a mandatory requirement for any agency, site, or group wishing to be a COVID-19 vaccinator. For the redistribution of vaccines, ADHS will continue to work with CDC and vaccinators to understand the requirements and implement possible strategies.

Storage (Section 8)

  • ADHS requires the use of Digital Data Loggers (DDLs) and the requirement for hourly temperature checks to ensure the vaccine is being properly maintained at the appropriate temperature. DDLs will be required for permanent and temporary cold storage units. Transported and redistributed vaccines must also have DDL tracking.
  • Partners will be educated through LMS training on the requirements for vaccine storage and handling, traditional cold storage units, and DDL requirements.
  • Vaccinators, to be eligible for providing services, must have the proper equipment, complete storage, and undergo handling training. Additionally, all vaccinators will be required to maintain 24/7 temperature monitoring utilizing DDLs.

Prioritization/Hierarchy of Who Receives Vaccine (Section 4)

  • ADHS will primarily consider the recommendations from the CDC and the Advisory Committee on Immunization Practices (ACIP) to identify critical populations statewide that should be prioritized to receive the vaccination. Other key guidance and sources of information will include the framework developed by NASEM and the National Institutes of Health.
  • The Vaccine and Antiviral Prioritization Advisory Committee (VAPAC) will be responsible for providing recommendations regarding the prioritization of critical populations to the ADHS Director to develop specific vaccine allocation strategies.

Data & Reporting (Sections 9, 11)

  • Arizona State Immunization Information System (ASIIS) will be primarily utilized for all aspects of COVID-19 vaccine reporting including ordering, administration, and reconciliation.
  • All the providers participating in the COVID-19 vaccination program will be required to make real-time reporting. ASIIS has additional features including vaccine forecasting and patient reminder/recall, which make it a useful tool for providers to track 2- dose vaccination series when data entry is real-time or up-to-date.
  • If real-time direct data entry is not feasible for a site, the program will utilize a spreadsheet that will capture all the required data elements. The provider will send the spreadsheet to AIPO staff who will convert it into HL7 and upload it into ASIIS.

Governance (Section 2)

  • ADHS’s Health Emergency Operations Center (HEOC) will be used to manage the statewide vaccination campaign and ensure coordination across the department and other agencies.
  • ADHS will also partner closely with 15 county health departments and 21 federally recognized tribes, which are responsible for administering local immunization programs in their respective jurisdictions.

Technology Infrastructure

  • ADHS has developed a GIS dashboard that shows where providers are located in relation to areas highly impacted by COVID-19. GIS mapping is also used to support local jurisdictions and tribal 638 facilities in gathering information on reaching priority populations.
  • ADHS is also working on the implementation of the IZ Gateway, which after approval, will be connected with ASIIS directly for data transmission.
  • Arizona Immunization Program Office (AIPO) has developed a training module in the LMS, AIPO TRAIN, that “will include all the information vaccinators need to understand, locate, and share with vaccine recipients prior to vaccine administration as required.”

Security

  • There was minimal information available in the plan regarding this. ADHS will utilize CDC and Cybersecurity and Infrastructure Security Agency’s (CISA) guidance, as well as Executive Order 2020-12, to define the critical infrastructure workforce.
  • Any adverse events can be reported by the providers using Vaccine Adverse Event Reporting System (VAERS). Additionally, the Vaccine Task Force will create a Vaccine Safety, Monitoring, and Messaging workgroup to further identify needs and messaging.

COVID-19 Vaccination Plans Alaska

Distribution (Section 7)

  • Alaska has formed an Allocation Committee to oversee the allocation, ordering, and distribution of the COVID-19 vaccine.
  • The Alaska COVID-19 Vaccination Program Task Force “will work collaboratively with local communities by coordinating with local emergency management, community leaders, municipal leaders, tribal leaders, tribal health organizations, and others to ensure efficient distribution of the vaccine.”
  • Alaska is planning for three phases of vaccine distribution. In the first phase, the same will be distributed to the critical populations, followed by general and entire populations in Phase-2 and 3, respectively.

Storage (Section 8)

  • The plan requires that organizations must store and handle COVID-19 Vaccine under proper conditions, including maintaining cold chain conditions and chain of custody at all times. Additionally, they must continually monitor vaccine-storage-unit temperatures and comply with COVID-19 vaccine expiration dates.
  • Also, organizations must preserve all records related to COVID-19 vaccine management and storage for a minimum of 3 years. Alaska also plans to develop storage and handling training based on CDC’s Vaccine Storage and Handling Toolkit.

Prioritization/Hierarchy of Who Receives Vaccine (Section 4)

  • Alaska has formed an Advisory Committee on Immunization Practice (ACIP) to help with the determination of critical populations to be prioritized for the purpose of vaccine administration. It is yet to determine the subset groups within the critical populations to whom the vaccine will be administered in Phase 1A and 1B.
  • The state is leveraging various data sources to help identify the overall number of individuals who meet the critical population descriptions in the CDC guidance. These include the Alaska Department of Labor and Workforce Development, Alaska Division of Insurance, Alaska Division of Healthcare Facilities, Alaska Native Tribal Health Consortium, etc.

Data & Reporting (Sections 9, 11)

  • Alaska vaccine providers will use PrepMod, an end-to-end system to manage all aspects of a pandemic, public health emergency, and core public health functions, to collect the COVID-19 vaccine doses administered data.
  • Further, COVID-19 vaccine administration data will be submitted to the IZ Gateway via VacTrAK or PrepMod. Also, COVID-19 vaccination coverage reports by age, borough/census area, and race/ethnicity will be generated using VacTrAK.

Governance (Section 2)

  • The Alaska Department of Health and Social Services (DHSS) is the primary body for the governance of COVID-19 vaccination planning. The Division of Public Health within DHSS has been further tasked with standing up a task force and creating an organizational structure to direct these efforts.
  • The Alaska COVID-19 Vaccination Program Task Force has been created to work “collaboratively with local communities by coordinating with local emergency management, community leaders, municipal leaders, tribal leaders, Tribal Health Organizations, and others to ensure efficient distribution of the vaccine.”
  • The taskforce is jointly led by a State of Alaska Nurse Consultant and an ANTHC Nurse Immunization Coordinator and two deputy co-leads. It consists of seven teams headed by SOA and ANTHC co-leads.

Technology Infrastructure

  • The vaccine plan involves Alaska Coronavirus Response Hub, a platform that houses individual dashboards which may include the COVID vaccine dashboard and the vaccine locator tool.
  • The plan mandates the use of VacTrAK’s Vaccine Ordering and Management System (VOMS) for placing all COVID-19 vaccine requests.
  • PrepMod, the reporting tool, is connected to VacTrAK and all data entered in PrepMod will be sent real-time via HL7 to VacTrAK. Alaska’s current data storage will meet the needs of the COVID-19 Vaccination Program. Both PrepMod and VacTrAK are cloud-hosted.

Security

  • There was minimal information available in the plan regarding this. The enrolled COVID-19 vaccination providers will be required to complete a COVID-19 Vaccine Adverse Event Reporting System (VAERS) training to report any report adverse events following COVID-19 vaccination.
GLENN TREVOR
Glenn is the Lead Operations Research Analyst at The Digital Momentum with experience in research, statistical data analysis and interview techniques. A holder of degree in Economics. A true specialist in quantitative and qualitative research.

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