COVID-19 Vaccination Plans: Texas, Utah, Vermont
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We’ve provided a high-level overview of the COVID-19 Vaccination Plans presented by the states of Texas, Utah, and Vermont.

Texas

Distribution

  • The Department of State Health Services (DSHS) will control the distribution of the vaccine in the state, in partnership with local stakeholders and other state agencies, following a public/private distribution model that will allow a more efficient distribution.
  • The vaccines will be distributed equitably and voluntarily among the urban and rural population.
  • All providers of the vaccine will need to complete the Centers for Disease Control and Prevention (CDC) training, enroll through EnrollTexasIZ.dshs.texas.gov, and order a minimum shipment of 100 doses.
  • The distribution of vaccines will expand as its supply increases, but providers will need to file the CDC COVID-19 Vaccine Redistribution Agreement to participate in the shipments.

Storage

  • All providers will be required to complete the storage and handling training to receive their vaccines. The DSHS will also provide webinars with instructions, a toolkit, and call center support during business hours.
  • The distributors will also need to provide evidence of their capacity to comply with the storage requirements and ability to maintain cold and custody chain integrity.
  • After receiving the vaccine, providers will need to upload the information of the amount received, lot number, presentation, and expiration.

Prioritization/Hierarchy of Who Receives the Vaccine

  • The hierarchy for vaccine distribution in Texas will start with the vulnerable and frontline population and follow with non-healthcare frontline infrastructure groups and others.
  • The vulnerable and frontline population will follow the line provided by the CDC, from start to end, healthcare personnel, other frontline workers, long-term care facility residents, people with underlying medical conditions, people 65+ years old, people from racial/ethnic minorities, people from trial communities, people detained/incarcerated, people in shelters/homeless, those attending colleges/universities, those living/working congregated, rural communities, people with disabilities, and people uninsured/under insured.
  • The EVAP will define those considered non-healthcare frontline workers.

Data & Reporting

  • The state of Texas will track the data of each provider through the Texas Immunization Registry or ImmTrac2Regular.
  • The CDC Immunization (IZ) Gateway Interface will contain the data of CDC approved distributors, pharmacies, providers, and an anonymous recollection of doses administered, not including personally identifiable or individualized data.
  • The reports will be created by region, county, provider, and include doses allocated, percentage of vaccines allocated, regional analysis for allocation, distributor distribution, doses administered, and type.
  • Providers will be required to complete training and be certified in the proper data and reporting methodology established by the DSHS.

Governance

  • The DSHS and the CDC will control the distribution of the vaccine. They will gather a team of executive staff members, immunization staff, DSHS temporary staff, etc.
  • This team will work with an Immunization Unit Office, Immunization Operations Group, Texas Immunization Registry, Vaccine Data and Finance, Vaccine Operations Group, Assessment, Compliance, and Evaluation (ACE), Public Information and Education Team, and CDC Advisor.
  • Additionally, the team will work in collaboration with the Texas Division of Emergency Management, the Texas Emergency Management Council, Expect Vaccine Allocation Panel, the Texas Commissioner of Health, Texas Hospital Association, Texas Medical Association, Pharmacy Board, and local entities.

Technology Infrastructure

  • The state’s DSHS, CDC, and Texas government will use their websites and social media for communication strategies and compilation of reports.
  • They will also use the CDC Immunization (IZ) Gateway interface, the ImmTrac2, and Electronic Health Record (EHR) systems to control and collect the data, report, and track doses by regional and local providers and users.

Security

  • The reports and data available on the websites will be secured using the Secure File Transfer Protocol (SFTP) technology.

Utah

Distribution

  • To distribute the vaccines, Utah will work with the Local Health Departments (LHDs) following the CDC structure.
  • The Utah Immunization Program (UIP) will allocate, control, and distribute the vaccines.
  • State, regional, and local providers will need to enroll and complete the training necessary to redistribute and receive the vaccines.
  • The State will adopt a distribution method combining public and private entities for faster distribution.

Storage

  • UIP and LHD will distribute to facilities and providers enrolled and with the capacity to protect the vaccine from outsiders and maintain cold-chain storage.
  • Every provider is required to provide photographic proof of their storage units, complete a visual inspection, and provide temperature control (max/min) information to be certified.
  • The temperature of the storage unit will need to be monitored 24/7, follow the VFC program, create a Vaccine Management Plan, and an emergency plan to maintain the vaccines’ temperature under any circumstance.
  • The temperature of the storage unit needs to be submitted monthly in a data logger.

Prioritization/Hierarchy of Who Receives the Vaccine

  • Utah plans to provide the vaccine to its population in four waves that will take place between November 2020 and April 2021.
  • The first wave will cover Frontline healthcare workers in hospitals treating the majority of COVID patients and population immunocompromised, at risk for severe COVID, and 65+ years old citizens.
  • Wave two includes 65+ years old residents, other critical populations, additional hospitals’ staff, LTCF staff, and a portion of the general public.
  • Wave three will cover the other portion of the general population, remaining hospital staff, non-hospital healthcare workers, LTCF residents, and people in congregate living facilities.
  • Finally, wave four will include critical infrastructure employees, tribal populations, incarcerated populations, and second doses for population 65+ years old or at risk for severe COVID.

Data & Reporting

  • Vaccine administrations will be automatically reported through EHR and USIIS by some providers. The providers without an automated system in place will report every administration in USIIS within 24 hours of its application.
  • The method of reporting will be determined by UIP during enrollment.
  • UIP will also monitor and control the reports for vaccine use, availability, administration, create surveys to evaluate coverage.
  • The report per administration of the vaccine will require patient information, doses, date, facility, race, ethnicity, insurance, language, contact information, vaccine code, lot number, etc.

Governance

  • In Utah, the vaccination plan will be in charge of UIP, the Bureau of Epidemiology (BOE), the Division of Control and Prevention (DCP), Director of Immunization, Director of Epidemiology, and Utah’s Department of Health.
  • This team will work with a Vaccination Program Coordination team, ERCs, Communication team, LHDs, Public Information Office, Department of Human Services, Healthcare Facilities, and different Prioritization groups and partners in accordance to CDC.

Technology Infrastructure

  • The UIP is working on a mobile app, Docket, to track administration and provide second dose reminders to the patients. They will also use EHRs and USIIS for the same purpose.
  • Users will be able to use a website, https://vaccinefinder.org, to find the providers with available vaccines.
  • Providers will be able to use the state and CDC websites and apps for information, enrollment, and education about the distribution and storage of the vaccines.
  • The USIIS program will collect data in CSV format and HL7 message, any standard format like web services.
  • The data exchanged will use IZGateway, Mirth integration engine, and different UDOH’s resources, including RedCap, Cognos, R Shiny, etc.

Security

  • USIIS will use Secure File Transfer Protocol (SFTP) to secure the reports and data.

Vermont

Distribution

  • The first vaccinations will be delivered through vaccination clinics, organizations, and facilities that enrolled and signed a Memorandum of Agreement to comply with the provider requirements.
  • The Local Health Offices and the Immunization Program of Vermont will be in charge of the distribution and control of the vaccine in the list of enrolled providers.
  • Every provider must comply with the list of training requirements provided by the CDC to guarantee the safety and security of the vaccine.
  • Redistributors cannot request less than 100 doses.
  • Vermont will use population data to ensure the vaccine is distributed equitable across the country and especially to critical populations.
  • Vermont will follow the allocation recommendations of the CDC Advisory Committee on Immunization Practices and the National Academies Report on Equitable Allocation.

Storage

  • Providers must comply with cold-chain capability requirements to store the vaccines and provide proof of their ability to guarantee their temperature and safety.
  • They must also complete their certification training for the storage and handling of the vaccine, provided by the CDC.

Prioritization/Hierarchy of Who Receives the Vaccine

  • The distribution of the COVID-19 vaccine in Vermont is structured in four phases, based on priority.
  • Phase 1 will include high-risk health workers, first responders, high-risk populations including older adults living in congregate, people with comorbid, and underlying conditions with a risk of severe COVID.
  • Phase 2 will include K-12/school teachers, staff, child care workers, critical workers of any essential industry. It will also include people of all ages with comorbid or underlying conditions that put them at risk of moderate COVID, homeless, people in shelters, with disabilities, people with severe mental illness, imprisoned, or older adults that didn’t participate in Phase 1, etc.
  • The third phase will include children, young adults, workers of all industries that weren’t included in the previous Phases.
  • The final phase will be for every non-citizen that didn’t apply to receive the vaccine in the previous Phases.

Data & Reporting

  • Each administration of the vaccine needs to be reported within 24 hours of its application.
  • The reports submitted by each enrolled provider to CDC will be tracked and include storage details, handling, temperature, adverse events, lot, administration, patient information, etc., through the CDC Vermont Immunization Registry (VT IIS) via HL7 messaging.
  • Providers are required to report any waste or loss of the vaccines in VIMS.

Governance

  • Vermont’s Department of Health (VDH) will be in charge of surveilling the administration and distribution of the vaccine in cooperation with the CDC regulations.
  • They will work with the Division of Health Surveillance, Public Health Statistics, Infectious Disease Program, Immunization Program Manager, Health Operations Center, Local Health Offices, etc.
  • They will also be supported by a COVID-19 Vaccine Implementation Advisory Committee and different public and private healthcare frontline partners.

Technology Infrastructure

  • The information will be collected in the Vaccine Inventory Management System (VIMS) for data and report analysis.
  • The data will be compiled from SurveyGizmo in a CSV format and submitted via SAMS-authenticated mechanism to the CDC twice a week.
  • Reports will be submitted via HL7 messaging via the IZ Gateway.
  • Providers and patients will be able to find information for enrollment and education on the CDC website, Vermont’s Health Alert Network, social media, newsletters, etc.

Security

  • As required by the CDC, Vermont will also use Secure File Transfer Protocol (SFTP) to secure the reports and data.
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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