WIN, Wisconsin Immunization Neighborhood, immunizations, SWIC

COVID-19-Vaccine-Planning

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Covid-19 Vaccination Tools & Resources

Three W's

We are still learning about the vaccines and until enough people are vaccinated, we need to continue to practice the three W's.

Download PDF Resources

Vaccine Planning
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Word Document (Updated 12/3/2020, information subject to change.)

COVID-19 Response Status Flyer
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Training/ References for Healthcare Professionals
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CDC Information

The role of non-clinical staff in COVID-19 clinics
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   Presentation PDF

Activity

Additional Resources/Information

Lead

Date Completed
(tentative)
ENROLLMENT/GENERAL PLANNING

Enroll your providers in your organization to be a COVID-19 Provider

For additional information: https://www.dhs.wisconsin.gov/covid-19/vaccine-program.htm


Begin Planning for Ensure your facility has submitted a signed section A and section B(s) of the CDC COVID-19 Vaccination Program Provider Agreement

Next Steps:

• Complete the allocation survey
• WIR training
• Complete the storage and handling training: https://livestream.com/dhswebcast/events/9399519


Review Wisconsin COVID-19 Vaccine Program: Information for Health Care Providers
Wisconsin COVID-19 Vaccine Program: Information for Health Care Providers


Coordinate with your local health department to vaccinate all people in your local area (i.e. group homes, county jails, home health agencies)



Designate a minimum of two COVID-19 Vaccine Coordinators who will be trained to receive deliveries of COVID-19 vaccine and are available to receive phone calls from delivery personnel



Review the education modules provided by the Public Health Foundation that has collected the Center for Disease Control and Prevention’s COVID-19 Vaccination Training Programs for Healthcare Professionals
Search for “4870” or use this link to log into TRAIN: https://www.train.org/main/training_plan/4870


WISCONSIN IMMUNIZATION REGISTRY (WIR)
WIR ADMINISTRATORS New vaccinators should complete WIR Security and Confidentiality Agreement. Existing vaccinators should update WIR Security and Confidentiality Agreement


Confirm the electronic health record interacts with WIR.
CDC’s Guidance: COVID-19 vaccination providers must document vaccine administration in their medical record systems within 24 hours of administration, and use their best efforts to report administration data to WIR as soon as practicable and no later than 72 hours after administration


If contacted by WIR staff, submit all corrected information requested by WIR staff to successfully finish provider verification.


VACCINE ADVERSE EVENTS REPORTING
Review Vaccine Adverse Events Reporting System (VAERS) reporting policy with all staff

NOTE: ACIP is planning to provide guidance on what will happen with exposure and a possible low fever within 24 hours

Interim guidelines are available here: https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19/clinical-considerations.html




Train Staff to Enroll Patients on V-Safe

NOTE: Staff to use V-Safe a new smartphone-based opt-in bi-directional safety monitoring program through CDC

TRACKING OF VACCINE/VACCINE MANAGEMENT
Develop tracking system for both the vaccine and diluent

Rubber bands holding both boxes together may work well in refrigerated settings; this system should NOT be used in freezers as the diluent cannot be frozen at those temperatures.

Consider taking daily inventory as you go with full inventory weekly to prevent exposure and potential thawing



PLAN COLD STORAGE
Review your vaccine management plan and make sure it is up to date

Have a written cold chain plan and procedures in place for receiving, storing, and handling vaccine. Train all relevant staff on routine and emergency storage and handling Storage and handling training providers are required to complete through DHS. You can complete this while your application has been approved: https://livestream.com/dhswebcast/events/9399519 https://www.cdc.gov/vaccines/hcp/admin/storage-handling.html

Review Storage and Handling Guidance and Tips:

Resource: Immunize.org

COVID-19 information will be released here: https://www.cdc.gov/vaccines/covid-19/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Fvaccination-resources.html



Review current policy for “What happens if the temperature in my storage unit goes out of range?” and plan of action.

Resource:

Ask the Experts: Storage and Handling (immunize.org)



Review temperature monitoring practices for frozen and refrigerated vaccines




Develop plan for cold-storage for specific vaccines
  • Be prepared for several vaccine candidates in the next several months Johnson and Johnson and AstraZeneca vaccines are also in phase three
  • The vaccines are not interchangeable
  • It is not recommended to purchase ultra-cold storage
  • Wisconsin DHS is working on a HUB and SPOKE model for onsite cold-storage; work with your HERC regional coordinator for more information


Pfizer Vaccine
  • Storage is needed only for the first doses. CDC will store the second doses until the 2nd dose is ready to be administered
  • If not using ultra-cold storage:

Stable thawed in a refrigerator for 120 hours or 5 days
Thermal shipper can hold with re-icing up to 30 days
First dry ice recharge will be shipped along with Pfizer vaccine, CDC is anticipated to ship dry ice PPE
Dry ice contacts may be available via CDC or Pfizer recharge at minimum every 5 days
Thermal shipper should only be opened twice a day for 1 minute
Recommend opening shipper at the end of each day and removing vaccine for the next day to the refrigerator
Vaccine takes 3 hours to defrost in the refrigerator, making it ready to use in the morning/30 minutes at room temperature

  • Using the ultra-cold freezer:

Temperature (-70C)

These storage requirements are what was submitted to the FDA for EUA. They are subject to changes once Emergency Use Authorization ( EUA) is granted and/or if more data is collected post-EUA



Moderna Vaccine

  • Refrigerated conditions of 2° to 8°C (36° to 46°F) for up to 30 days
  • Room temperature stable for 12 hours
  • If freezing the vaccine, the vaccine must be stored in a freezer approved for vaccine use. It must maintain (-20 C) and MUST NOT have a thaw cycle
  • Vaccine is stable in the freezer for up to 6 months 30 days

  • Ensure adequate space in appropriate vaccine freezer for 100 doses or in refrigerated temperature

The vaccine will not require onsite dilution https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-longer-shelf-life-its-covid-19-vaccine

These storage requirements are what was submitted to the FDA for EUA. They are subject to changes once EUA is granted and/or if more data is collected post-EUA



Coming Soon
The CDC will be releasing vaccine product specific resources
  •  A fact sheet on storage and handling
  • One on vaccine administration
  • Once the vaccine is authorized by the FDA it will have a sheet similar to a vaccine information statement (VIS). Your staff MUST provide it to patients and/or their caregivers. This will be “informed consent.”



ADMINISTRATION OF VACCINE

Identify who will be administering vaccine in your healthcare organization: Provider, RN, LPN, MA, Pharmacist


Review Vaccine Skills
See Example of COVID-19 Vaccine Administration Skills Checklist ( IM administration in arm)


Provide education on COVID-19 vaccine specifics
  • Possibility of a strong immune reaction with low fever, fatigue and sore arm, particularly after a second dose
  • NSAIDs are helpful in mitigating these reactions
  • Example: Pfizer will have 6 hours post-reconstitution and Moderna is 6 hours after the vial is punctured
  • Recommendation from the CDC is to stagger unit staff vaccine in case of strong reactions.
  • EUA Fact Sheets before administration and consent – these will not be available until the FDA’s Vaccine and Related Biologic Advisory Committee (VRBPAC) meeting (Dec 10/Dec 17)
  • Screening, education, preparing vaccine, administering vaccine, and documenting vaccine, PPE
  • COVID-19 vaccination record cards will be provided as part of vaccine ancillary kits. Vaccination providers must complete these cards with accurate vaccine information (i.e., vaccine manufacturer, lot number, date of first dose administration, and second dose due date), and give them to each patient who receives vaccine to ensure a basic vaccination record is provided in addition to WIR reporting
  • Implement COVID-19 infection prevention control measures in clinics for vaccine.
  • Ensure your staff can recommend COVID-19 vaccine confidently
  • Help staff understand new COVID-19 vaccines 

mRNA vaccines are NOT live vaccines
https://www.cdc.gov/vaccines/covid-19/hcp/mrna-vaccine-basics.html



    Identify first group of employees willing to get vaccine

    CDC will be releasing a toolkit for these workers in the early part of December

    Review Interim Guidance for Vaccinating Health Care Personnel: https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19/clinical-considerations.html



    Develop a reminder system for 2nd dose of vaccine if applicable (Pfizer recall at 21 days; Moderna 28)
    • Reminder card will be included in the ancillary kit supplies
    • Reminder call
    • Scheduling appointment before they leave



    Identify Location for Vaccinating Healthcare Personnel
    • Consider if planning on sending employees to a central vaccine clinic, or bringing vaccine to staff?
    • Mass vaccination of healthcare personnel, or several days?
    • Set up reminders:

    Maintain 6 foot distancing with areas marked off
    Masks
    Schedule vaccination appointments in a timely manner to use vaccine in the period that is needed
    Have a backup plan in case vaccine does not come on the day anticipated



    Develop Plan for Vaccinating Later Phases (1b, 1c, and 2)
    • Plan how to communicate vaccine availability to patients. You can plan to use vaccinefinder.org to help patients understand your vaccine availability
    • Estimate number of patients at increased risk for severe COVID-19 illness (including people 65 years of age or older)

    PAYMENT
    Review newly released CPT Codes
    		American Medical Association


    STAFF EDUCATION
    IMPORTANT: PLAN FOR JUST IN TIME TRAINING
    • Vaccine Fact Sheets and Training Programs are part of the just in time training conducted immediately after the FDA approves the vaccine
    • The FDA will meet for Pfizer on Dec. 10 and Moderna Dec. 17, 2020
    • Please plan for just in time staff training in the next days no later than within the next several working days for training on these vaccines

    Begin to train staff on frequently asked questions and concerns


    CDC Provider Education Resource
    		https://www.cdc.gov/vaccines/covid-19/downloads/COVID-19-Clinical-Training-and-Resources-for-HCPs.pdf


    COMING SOON
    Standing orders for COVID-19 vaccine are anticipated to be created at the CDC



    CDC will provide guidance on How to manage Employee Systemic Reactions with the COVID-19
    		Will include information on what to do if an employee presents with a low-grade fever after vaccination


    FAQ from the CDC







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