Generally, the novel coronavirus (COVID-19) vaccine program is being managed by the Centers for Disease Control and Prevention (CDC) in Connecticut, Delaware, and Florida. Each state has created an organizational structure to manage the program and has the technological infrastructure that’s needed. The states have also determined who their critical populations are as well as how the vaccines will be distributed. When it comes to storing and handling the vaccines, all three states have put measures in place to guarantee their compliance with CDC guidelines.
- Vaccination providers who are enrolled in the state will order the COVID-19 vaccine through Connecticut’s DPH Immunization Program. Facilities that are placing orders outside of their jurisdiction will need to order the vaccine directly from the Centers for Disease Control and Prevention (CDC).
- The orders will be approved based on a number of factors including the number of vaccine doses that are available as well as if the provider is servicing persons who have been prioritized. Orders will be approved by the CDC.
- The minimum order quantity for the COVID-19 vaccine will be 100 doses. Each 100-dose kit will also contain needles, syringes, alcohol prep pads, surgical masks, face shields, and vaccination record cards.
- When distributing the COVID-19 vaccine kits, these kits will be sent directly to the area where it will be used as much as is possible. This action ensures that there is no break in the cold storage chain. In cases, where a supplemental kit is required, it will be shipped separately but should arrive at the same time as the other kit.
- If the vaccine kit cannot be shipped directly to the provider, approved third-party vendors may be used. These vendors must have adequate cold storage in place and sign the CDC COVID-19 Vaccine Redistribution Agreement.
- Immunization Program’s Vaccine Coordinator will coordinate the state’s vaccine distribution program. The distribution would take place using Connecticut’s established vaccine for children (VFC) infrastructure.
- The COVID-19 vaccine is temperature sensitive and as such must be stored properly to ensure that it remains effective.
- The required storage temperature varies depending on the product. Temperature ranges include refrigerated (2°C to 8°C) to frozen (-15 to – 25°C) to ultra-cold (-60°C to -80°C).
- The required storage temperature must be maintained and documented from the point of manufacture up until the vaccine is administered.
- Connecticut will be implementing a three-phase vaccination approach that entails focusing on getting the COVID-19 vaccine to critical populations in the first and second phases.
- Persons included in the critical populations include healthcare professionals, other essential workers, those with an increased risk of a severe COVID-19-related illness, persons over the age of 65, and those who have underlying medical conditions.
- Connecticut officials will work with state agencies and medical entities to gather information on the people who would be considered critical.
Data and Reporting
- All relevant data involving the COVID-19 vaccines must be relayed to the CDC. This information includes the storage temperatures of the vaccines, the vaccine orders, the number of vaccinations that have been done, and who has been vaccinated.
- The various state agencies will also be advised of information relevant to their position in the structure of the vaccination program.
- Adverse reactions to the vaccine will be reported using the Vaccine Adverse Event Reporting System (VAERS).
- The Connecticut Department of Public Health (DPH) is the lead agency in charge of the state’s COVID-19 vaccination program. While coordinating the vaccination activities, the DPH is working with representatives from the DPH Commissioner’s Office, Legal, Epidemiology, Public Information, Preparedness, Hospital Preparedness, Healthcare Acquired Infections, Healthcare Facility Licensing, and Emergency Medical Services (EMS).
- In Connecticut, persons will use existing programs such as the Vaccine Administration Management System (VAMS), Immunization Information System (IIS), and CT WiZ. Activities such as reporting data and order processing will take place using these systems.
- Connecticut has taken steps to ensure that all data transmitted via its various platforms are secure. Vaccine providers who are not using the approved methods of data entry or transfer must submit their information to the CDC directly.
- The COVID-19 vaccines must be shipped under secure conditions and all shipments are tracked.
- Vaccine providers will need to register and provide information regarding their equipment as well as their storage capabilities in order to be allocated the COVID-19 vaccine.
- The vaccine will be allocated using the existing influenza vaccine infrastructure. When orders are placed, these will be assessed according to the allocations.
- If the order is approved, the vaccine will be distributed based on the minimum order quantity. Where partial orders are approved, these will also be distributed and the balance documented.
- All locations that will be storing and handling the vaccine are required to submit information regarding their equipment and cold storage capabilities. Warehousing areas must also have digital temperature monitoring equipment that collects and relays temperature data.
- Third-party vendors who are handling and transporting the COVID-19 vaccine must have a signed Redistribution Agreement that details their storage capacity and compliance.
- Transfers of vaccines will be assessed by the Immunization Program Staff while large hospitals will be surveyed by the Emergency Preparedness Team.
- It’s not recommended that the ultra-cold vaccine be transported unless it’s unavoidable.
- The vaccines should also be shielded from light.
- In the beginning, Delaware will focus on providing the COVID-19 vaccine to its critical populations. The state will be using information from state agencies and epidemiologists to determine the persons who belong in this category.
- Initially, the critical populations will include healthcare workers, essential workers, and persons who have a high likelihood of being exposed to COVID-19.
- As the vaccine becomes more available, the Delaware Division of Public Health Emergency Medical Services and Preparedness Section will assess the next level of prioritized persons.
Data and Reporting
- Delaware will use its Immunization Information System (IIS), DeIVAX to collect data regarding the COVID-19 vaccines that have been distributed and administered.
- The data will be reported to the CDC Data Clearinghouse according to the COVID-19 Vaccine Reporting Specifications (CVRS).
- The vaccine providers will use the established IIS to record and report data. If they cannot use the system, they must report to the CDC directly. The off-site providers will use a mobile program that will only be updated when the device is returned to the office.
- Delaware is using the existing structure of the Division of Public Health when overseeing the COVID-19 vaccine program. The Office of the Medical Director will be in charge while being supported by the Immunizations Program and Emergency Medical Services and Preparedness Section.
- Delaware will be using established technology to govern the vaccine program. That technology includes the DeIVAX which collects information about providers, vaccine administration, and patient data. Provider enrollment and information will also be handled by VTrckS.
- Where new infrastructure needs to be created, this will be done along similar lines as the existing programs.
- The technology being used to handle the COVID-19 vaccine program is an established one with cybersecurity safeguards built-in.
- The vaccines will be kept secure through a carefully monitored supply chain infrastructure.
- Florida is using guidance from the CDC to allocate the available COVID-19 vaccines.
- When allocating the vaccines, the state will use the existing program for flu vaccines known as SHOTS.
- Providers will be uploaded on the system and provide the relevant information that confirms they are able to handle the vaccines.
- In cases where the vaccine will need to be transferred, providers must confirm that the cold chain has been maintained.
- Providers must also document and track waste.
- The COVID-19 vaccines are temperature sensitive and the state will use temperature reports ensuring that the vaccines are being stored at the correct temperature.
- Providers will upload their temperature data to the Florida SHOTS system on a weekly basis for assessment.
- Florida will be implementing a three-phase structure for administering the COVID-19 vaccine. In the first phase, they will be focusing on critical populations that mostly includes healthcare workers.
- The state will also be working with different agencies to assess persons in other critical groups such as essential workers, those with underlying medical conditions, those over the age of 65, and those with disabilities, among others.
Data and Reporting
- All the data collected regarding providers, patients, and administered vaccines must be communicated to the CDC.
- This information is currently being submitted through the Florida IIS SHOTS. The state is seeking approval to use a supplementary application, VAMS, to submit data regarding vaccine administration.
- To manage the COVID-19 vaccine program, the Florida Department of Public Health has modified its organizational structure. The team that is overseeing the program includes personnel from the immunizations program, public health preparedness, epidemiology, public health nursing, emergency medical services (EMS), emergency management, hospital and long term care associations, public information officers, and legal counsel
- Florida is using its existing technology infrastructure to manage the administration of the COVID-19 vaccine. Primarily, that means using the SHOTS program. The state is also seeking approval to use its VAMS program.