New Jersey is working on following the three-phased approach with ‘Phase 1’ having a period of vaccine scarcity, ‘Phase 2’ having supply meet demand, and ‘Phase 3’ is the effective slowing down of the demand. Across each phase, New Jersey is planning on maintaining clear communication and providing equitable access. New Mexico’s COVID-19 Vaccination Plan has its Department of Health partnering with various Native American communities to ensure the best possible services are provided to all who are affected. New York State’s Vaccination Plan has been drafted based on ten specific aspects – safety, effectiveness, expert-approved, equitable, transparency, use of data, privacy, and partnership.
- The New Jersey Immunization Information System (NJIIS) is the central reporting, ordering, and registry system. The process will begin with the federal government deciding the amount of vaccine that will be made available to New Jersey. The state will then place location/site-level vaccine orders through NJIIS and will be transmitted via the External Information System (ExIS) to the Vaccine Tracking System (VTrckS) set up by the CDC.
- McKesson (CDC’s distributor), along with the Federal government will be in charge of the distribution of COVID-19 vaccines to the state’s enrolled providers. The providers who are currently enrolled in the system are local health departments, acute care hospitals, community health centers, and pharmacies.
- New Jersey’s Vaccine Command Center (VCC) will oversee the delivery of COVID-19 vaccines to each distribution point and will collaborate closely with various local partners, the New Jersey Office of Homeland Security and Preparedness, the National Guard, state and county offices of emergency management, New Jersey State Police, and the New Jersey Department of Health. The VCC will represent the base for all relevant information related to the delivery, transport, and deployment of vaccines across the state.
- One of the major functionalities of the NJIIS is the integration of data concerning vaccine storage units. Enrolled providers will have to enter all information related to their storage units into the system. The NJIIS will track each provider’s storage unit’s temperature monitoring data, specifically for frozen and refrigerated vaccines, and will ensure COVID-19 vaccines are maintained at the right temperature.
- So far, there has been no plan developed to ensure ultra-cold storage and handling of vaccines.
- New Jersey will follow the guidelines set in the CDC Vaccine Storage and Handling Toolkit which will also be provided to each enrolled provider. The guidelines provide a detailed description of the critical roles and responsibilities needed for each site.
- New Jersey reports that it will follow the Phased Approach framework set up by the CDC. The first phase concentrates on the healthcare workers and other critical populations (high-risk groups) and has been estimated to require over “one million doses of a two-dose COVID-19 vaccine”. According to this framework, the second and third phases will cover the rest of the critical population and the general population.
- The need for sub-population prioritization in New Jersey will be decided based on public demand and vaccine supply reliability. The state plans to include anyone who lives, works, and is being educated in New Jersey.
- During these phases, any high-profile individual in the state who wants to be vaccinated “will be administered the vaccine publicly in the interest of building public trust”. Such individuals include New Jersey’s Governor, New Jersey Department Of Health (NJDOH) Commissioner for Public Health Services, NJDOH Deputy Commissioner, members of NJDOH COVID-19 PAC, etc.
Data and Reporting
- The state reports that the NJIIS will ensure transparent data reporting to facilitate an efficient and fair process of communication. According to the CDC Provider Agreement, each site in New Jersey will report every administered vaccine dose through NJIIS. Any additional data can be gathered through other reporting solutions such as the Vaccine Administration Management System (VAMS).
- Any and all reporting will be done based on the CDC’s requirements for the timeliness of data reporting.
- In terms of the state’s overall COVID-19 response, New Jersey will attach vaccination reporting covering a larger set of response measures that include public health interventions, healthcare capacity, and disease surveillance and progression. Mapping of the state’s vaccine coverage will be done by population type, vaccine type, and provider type.
- The planning and delivery of New Jersey’s COVID-19 vaccine program are taken care of by the state’s Vaccine Task Force (VTF). The VTF reports to the state’s Coronavirus Task Force, composed of key Cabinet officials, which in turn, reports to the Governor of New Jersey.
- The Professional Advisory Committee (PAC) provides guidance that includes New Jersey-specific resources that cover demographic, geographic, and professional diversity. The PAC provides expert guidance to ensure the state’s COVID-19 response is directed with respect to the latest public health, medical, scientific, and ethical evidence.
- NJIIS has been set up as the lead registry that will oversee vaccine orders, delivery, storage, handling, inventory management, administration data, temperature monitoring, and reporting.
- New Jersey will utilize its existing technology to develop a large health network alert system for effective communication among healthcare providers.
- The NJDOH will decide if a vaccine app needs to be developed to educate, outreach, and notify people of the first and second vaccine doses. If such an app is deployed, it will also have provision to request feedback on efficiency, locations, access, and quantity of Point of Dispensing (PODs).
- The Domestic Security Preparedness Task Force, a subdivision of the state’s Office of Homeland Security is responsible for the coordination of the CISA (Cybersecurity and Infrastructure Security Agency) database for New Jersey.
- High safety protocols will be in place to ensure safe vaccine dispensing at each site.
- New Jersey will set up fusion centers that will operate as focal points for the analysis, receipt, sharing, and gathering of threat-related data among territorial, tribal, local, state, and federal partners.
- Distribution of COVID-19 vaccines will be tracked via the New Mexico Statewide Immunization Information System (NMSIIS).
- According to the NMDOH, the agency is constrained by limited information on the number of vaccine doses the state will receive. Its distribution plans are expected to significantly change depending on the demand and the availability of vaccines.
- During the first phase of the administration of the COVID-19 vaccine, a large percentage of the vaccine will be directly shipped to the state’s largest providers such as hospitals, NMDOH, community health centers, and sites with the ability to obtain large amounts of vaccine.
- As outlined in the Provider Agreement, each provider will be trained to adhere to the storage and handling requirements. Some storage indicators that will be monitored include vaccine transfers, ordering frequency, and wastage.
- Guidance on ultra-cold storage capacity and its management will be provided by the manufacturer and the CDC to each provider.
- New Mexico will administer the COVID-19 vaccine in three phases. The first phase is carried out under the assumption that there will be limited doses available. The target population in this phase includes the entire healthcare workforce or anyone with a high risk of exposure to COVID-19.
- The second phase will cover the elderly and people who show underlying conditions. Based on the demand, multiple community groups and vulnerable sections of the society will be offered the vaccine. Phase three is the expansion of the vaccine administration to the rest of the population.
Data and Reporting
- New Mexico will use Operation Warp Speed Tiberius system to identify and assess the state’s critical population. Due to certain unique reporting requirements of New Mexico, demographic information will be taken from different public sources and will be stored in a centralized unit.
- Tiberius reporting will enable data reporting based on educational institutions, special populations, and other demographics.
- NMDOH is awaiting further information concerning CDC’s reporting and tracking system. NMDOH is working on using several systems to track its vaccine administration. Providers who are not enrolled in the state’s NMSIIS could be introduced to the VAMS application to document the administration of the vaccine.
- New Mexico Department of Health (NMDOH) is the central registry system that is responsible for the effective planning, operating, and executing procedures and strategies of the COVID-19 response plan. NMDOH’s Public Health Division is tasked with activities that relate to the registering of vaccine providers, organizing the vaccine distribution system, and working on the documentation requirements.
- The NMDOH’s Epidemiology and Response Division leads the response’s surveillance, contact tracing, case investigation, reporting, and research activities.
- The ordering, distributing, and tracking of COVID-19 will be done through the state’s NMSIIS registry along with an online electronic analyst system.
- New Mexico is yet to develop a data platform for analyzing, collecting, and monitoring COVID-19 vaccine administration in real-time.
- NMDOH will use existing technology to map and analyze provider data such as dry ice locations, COVID-19 testing sites, public health offices with cold chain capacity, independent community pharmacies, and assisted living and nursing homes.
- The state’s Homeland Security and Emergency Management along with the state’s Joint Information Center and Emergency Operations Center collaborates with the NMDOH to ensure safe execution of each step of the COVID-19 response plan.
- COVID-19 vaccine will be distributed and administered across the state only when the New York’s Clinical Advisory Task Force has deemed the vaccine effective and safe. The Governor of New York formed a Vaccine Distribution and Implementation Task Force to guide the process of setting up the vaccination program.
- The state’s distribution of the vaccine will depend entirely on the equitable and clinical standards.
- Currently, the state is not sure if the federal government will distribute the required amount of vaccines directly to the state government to be administered to its 19.5 million residents.
- It is expected that some private providers will be allowed to distribute certain COVID-19 vaccines under the federal government’s vaccine distribution plans. McKesson is the current CDC’s vaccine distributor and is expected to have Moderna vaccine available for distribution. Also, due to certain storage and handling requirements, Pfizer will be shipped directly to the end-users.
- Vaccine storage and management is a critical component in the distribution and delivery of COVID-19 vaccines. New York will collaborate with various local agencies to determine and engage essential storage locations in strategic regions. Each of these locations will have to comply with both the manufacturer and CDC’s recommendations for vaccine storage.
- Flat box containers with dry ice will be used for ultra-cold vaccine storage. The capacity needed to store vaccines will be evaluated based on the enrolled provider’s process. The state is actively looking for more information on the inventory management and storage needs from private vaccine developers and the federal government.
- New York will prioritize vaccine administration based on clinical evidence, federal guidelines, and expert advice. COVID-19 vaccine will be offered in five stages. The first phase of the vaccine will be administered to the critical population (high-risk population) and this will be identified by the state’s Advisory Committee on Immunization Practices.
- The second phase will cover the lower risk population and other essential workers. The third, fourth, and fifth phases will see the general population being administered the COVID-19 vaccine.
- Phase one covers all healthcare workers both clinical and non-clinical in nature. Phase two covers all the first responders and other front-line personnel such as the national guard, the police, and the fire department. Phase three includes people with high-risk conditions and those who are over 65 years of age.
- Phase four takes care of the other essential workers who were not administered with the vaccine in the previous stages. Phase five includes a population containing healthy adults and children.
- The creation of sub-populations within each phase will be determined based on the vaccination rates and vaccine availability.
Data and Reporting
- Precise collection and reporting of vaccination administration data will be tracked through the state’s New York State Immunization Information System (NYSIIS). This system will “ensure seamless integration once the vaccine begins to be administered”. The enrolled providers will be able to order vaccines through NYSIIS at each phase of the administration process.
- The New York State Department of Health is the lead agency in the planning and execution of the vaccination plan. The NYSDOH will also include the state’s tribal organizations as a section of the planning efforts.
- New York plans on developing a robust analytic infrastructure to effectively support all procedures of the vaccination program which includes distribution and inventory logistics, scheduling of appointments, monitoring vaccine administration, and tracking surveillance to map and guide clinical decisions.
- The experts at the New York State Office of Information Technology Services (OITS) in collaboration with the New York State Department of Health and third-party IT providers, will oversee the development of the infrastructure system.
- The NYSIIS is a secure, confidential, online system that collects and stores immunization and demographic information for all of New York State’s residents. NYSIIS will be used by providers to pre-order vaccines, to manage tracking, to collect vital information, and to report.
- New York State will ensure all the data that is collected and reported over time will prioritize cybersecurity, patient privacy, and will provide the required information to the CDC under secure means.
- The state will also comply with all safety measures needed in the containment of the coronavirus (washing hands, wearing masks, and maintaining social distancing). New York will make sure that all vaccination procedures will prioritize the safety of a patient and will maintain patient privacy.