March 18, 2021

March 18, 2021

COVID-19 Vaccine Rollout Panel Discussion – Claire Hannan (AIM)

Claire Hannan, Executive Director for the Association of Immunization Managers (AIM), facilitated a panel discussion of immunization program managers providing an overview of COVID-19 vaccine rollout from the perspective of three unique jurisdictions – Alaska, Indiana, and the City of Chicago.

Claire opened the session by highlighting a few of the successes of the nation’s COVID-19 vaccination program to date. As of March 17, approximately 113 million doses of vaccine have been administered, and 40 million people (12% of the population) have completed the vaccine series. Importantly, there has been a sharp decline in COVID-19 cases and deaths in nursing homes.

New accomplishments include improving the ability to share data in almost real time and thousands of new providers being enrolled in state immunization information systems. FEMA funding for COVID vaccination has increased dramatically ($4.28 billion), and the agency has supported both existing and new vaccination sites. To help ensure vaccine equity and availability in hard-to-reach populations, 250 federally qualified health centers (FQHCs) have begun providing vaccinations, with 700 additional sites slated to begin over the next six weeks. An estimated 20 million doses per week will be available to jurisdictions by the end of March, and 22–24 million per week by the end of April.

Even with these accomplishments, challenges remain in vaccine delivery. Multiple different registration and scheduling IT solutions have resulted in confusion. In addition, only about 55% of vaccine records include the race and ethnicity of vaccine recipients, making it difficult to adequately assess vaccine coverage in different populations. Communications and messaging continue to be inconsistent, although programs such as those developed by the Ad Council are helping improve this. Immunization programs are working hard to find ways to reach homebound/disabled adults. A continuing challenge is that more vaccinators are needed to administer the increased availability of vaccines.

Looking ahead, vaccine supplies will improve each day, with the White House saying there will be enough vaccine for all adults in the United States by May 2021.

Following Claire’s introductory comments, presentations were given by the three immunization program managers in Alaska, Chicago and Indiana.

Matthew Bobo, Alaska Immunization Program

Matthew outlined the vaccination phases that the State of Alaska has implemented since the vaccine program began in mid-December. On March 10, Alaska became the first state in the country to open vaccine eligibility to all persons age 16 and older.

All communications about COVID-19 in the state have been consolidated into a single website. Matthew demonstrated the various aspects of the website, including availability of online registration for vaccine appointments. The site also includes information about a helpline used for a variety of purposes, including contact tracing, appointment reminders, and general questions about COVID-19. It also provides a dashboard with both numerical data and maps indicating vaccine allocations and the number of persons vaccinated.

Information on vaccines supplied directly from the federal government to Alaska Native corporations (through the Indian Health Service) and Veterans Affairs is included in the data. Alaska has utilized a variety of data sources to try to get a better look at vaccinations by race.

Vaccine scheduling is available through three options. Most vaccine providers in the state can be seen on a map, although some pharmacies associated with national chains are using their own system. In addition to the map, providers may be found via a listing of communities or by looking at a list of specific providers. As a third option, people searching for an appointment may call for support.

Maribel Chavez-Torres, Chicago Immunization Program

Maribel reviewed the planned COVID-19 vaccine phases for Chicago. Currently the city is in Phase 1B, providing vaccine to frontline essential workers, in non-healthcare residential settings, and for people age 65 and older. The city plans to be in Phase 2, delivering vaccine to all persons age 16 and older, by May 31.

Just over 600 providers are enrolled in the program. The type of facility affiliation for these providers is shown in both a data listing and on a map. Limited vaccine supplies have resulted in only 50% of these enrolled providers receiving vaccine so far. However, the immunization program communicates with all providers frequently to keep them updated.

Chicago is approaching administering 1 million doses of COVID-19 vaccine. To date, almost 1 in 4 Chicagoans age 18+ and 1 in 3 age 65+ have received their first dose of vaccine. However, over one-third of doses given have been administered to non-Chicagoans. As a medical hub, Chicago has a large population of healthcare personnel who work in the city but who live outside the city limits.

The city has established a new program, Protect Chicago Plus, to prioritize equity in vaccine distribution. The program partners with community leaders, organizations, providers, and members to host vaccine clinics and events to reduce barriers to vaccination. About 30% of the vaccine supply is dedicated to 15 hardest hit communities. Each area has key stakeholders who determine the best approach in their area. Importantly, anyone living in the selected area may be vaccinated, even if this does not align with the overall vaccine phases established for other locations. Because of this process, during the week through March 10, 55% of first doses for Chicagoans went to people who were Black or Latinx.

The city also has established mobile vaccination teams for 444 senior living facilities, with approximately 80% having already received their first dose. Outreach also will continue in shelters, congregate living settings, and manufacturing sites. Initially the city had invited industries to city-run pods, but these were not successful in attracting large number of people. Insufficient access to internet and an email account were seen as barriers to vaccination. To combat these challenges, the city has now established a centralized email for registration, and appointments are sent to cell phone numbers.

Vaccine allocations continue to be below the quantity needed to meet demand. The city currently receives fewer than 9,000 first dose vaccines per day, supplemented by an additional 2,800 doses sent directly to pharmacies. A FEMA mass vaccination site has been established and is providing approximately 3,000 doses/day, though that number is expected to increase to 6,000 doses/day in the near future. At the current pace of 9,000/day, 75% of Chicagoans will have received at least a first dose by late July. With a 25% increase in vaccine supply and no decrease in demand, that timetable will be reduced to late June. Last week, 95% of vaccine doses allocated were distributed, surpassing the city’s goal of 95%. Importantly, 95% of doses were administered and reported within 7 days of delivery.

The city continues to be challenged by vaccine availability, differing vaccine rollout phases between the city and state programs, and the fact that 30% of persons vaccinated in Chicago live outside the city. To deal with the latter challenge, beginning March 29, the city will vaccinate only Chicago residents in city-operated pods and at mass clinics like the one operating at the Staples Center. Individuals won’t be asked for an ID, but they will be asked to show some sort of document that verifies they are a city resident.

Dave McCormick, Indiana Immunization Program

Dave displayed Indiana’s COVID-19 vaccine website and provider portal, a centralized location for provider enrollment and weekly inventory reporting. Having this information located in a central hub has been extremely beneficial to the program as it has grown.

Like all jurisdictions, Indians has been moving through a list of vaccine priority phases. To assist this effort, Indiana established a centralized registration platform, and an ethics committee has helped the state determine these phases. During the last week, emphasis has been placed on vaccination of teachers.

Dave also demonstrated the state’s centralized vaccine platform, which shows available appointments by location and type of vaccine, including first and second dose information. The state also offers a 211 call center for persons needing assistance obtaining an appointment. The COVID-19 data dashboard offers a statewide look at all vaccine activities in the state. Currently the state is administering 93% of its vaccine allocation each week. Over a recent 4-day period, almost 17,000 doses of vaccine were administered at the Indianapolis Motor Speedway.

Online attestation for person’s seeking appointments is available. This allows persons to select a group to determine their vaccine eligibility during the currently open phase. The state also has concurrently taken an age-based approach to its vaccine phases. Currently Indiana is vaccinating all persons age 45+. Dave reviewed the appointment screens, showing the ease with which a person can select an appointment which meets their needs. Online registration has helped the state obtain race and ethnicity data for 95% of vaccinees. To date, over 1.3 million persons have received their first dose of vaccine and are awaiting their second dose, and almost 900,000 persons have been fully vaccinated.

Announcements – L.J Tan (IAC)
  • L.J reminded partners that there will be a Summit call next Thursday, March 25. Presentations scheduled for that call include an ACIP meeting summary and an overview of COVID epidemiology.


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