SARS-CoV-2/COVID-19 Mass Vaccination Planning Information

This draft doc is designed to help Native Well being Departments in planning for vaccine distribution in response to the COVID-19 pandemic. Info contained on this doc relies on restricted and preliminary steerage from the Facilities for Illness Management and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) and can be constantly up to date as that steerage evolves. All data on this doc is topic to alter.

The Illinois Division of Public Well being (IDPH) Workplace of Well being Safety (OHPt) Immunization Part and IDPH Workplace of Preparedness and Response (OPR) Medical Countermeasures Program have led the collaborative efforts of the COVID-19 Vaccination Part in creating this State of Illinois COVID-19 Vaccination Plan, as an attachment to the Vaccination Annex 3.0 of the State of Illinois Pandemic Plan. This plan ought to be utilized by state and native companions to tell planning efforts for the administration of SARS-CoV-2/COVID-19 vaccines. IDPH will guarantee high quality enchancment by soliciting suggestions from companions and stakeholders all through the implementation of this plan and as new data turns into obtainable.

The IDPH/OPR Medical Countermeasures Program develops and maintains plans for request, receipt, distribution, mass shelling out and administration of life-saving emergency medical provides and gear throughout a catastrophe the place the general public’s well being is in danger. This consists of plans in response to human- precipitated and pure occasions. The Medical Countermeasures Program consists of the Strategic Nationwide Stockpile (SNS) Program, the CHEMPACK Program, the Illinois Pharmaceutical Stockpile (IPS), and the Cities Readiness Initiative (CRI). The SNS Program is a federal cache of emergency medical provides and gear that may be deployed to states throughout a catastrophe. The CHEMPACK Program is the ahead placement of nerve agent antidotes. IPS is a state-owned cache of emergency medical provides and gear. CRI is a program designed to make sure cross-border collaboration of municipalities, counties, and states throughout incidents the place emergency medical provides and gear are deployed.

The IDPH/OHPt Immunization Part maintains the Illinois Complete Automated Immunization Registry Alternate (I-CARE), a system for vaccine administration and operations, which incorporates ordering, delivery, dealing with, and storing procedures for all vaccine purchases within the state.

This can be a state degree plan; nonetheless, the Metropolis of Chicago will obtain direct allocation of vaccine from the federal authorities. IDPH has labored with CDPH to make sure each the state and city-level plans are in sync and complementary.

To perform the objective of offering SARS-CoV-2/COVID-19 vaccines to sufficient of the inhabitants to elicit herd immunity, as provide of vaccines permits, the State of Illinois will accomplish the next:

  • Present technical help to Native Well being Departments (LHDs) to tell native planning and guarantee native plans align with state plans and/or steerage and keep accountability.
  • Intently monitor actions on the native degree to make sure the COVID-19 vaccine administration plan is carried out all through every native jurisdiction in adherence with federal and state steerage and necessities and that there’s equitable entry to COVID-19 vaccination throughout the state.
  • Activate the State Emergency Operations Middle (SEOC) to coordinate ordering, administration, and monitoring of the SARS-CoV-2/COVID-19 vaccine within the state.
  • Guarantee expanded scopes of observe for healthcare licenses as mandatory to permit sure medical professionals the chance to help within the vaccination marketing campaign when working underneath the authority of the native public well being jurisdiction or a healthcare entity.
  • Present a statewide system for monitoring vaccine administration and for notifying purchasers of the necessity for a second dose of the vaccine if a second dose is required.
  • Present a statewide system for volunteer administration and monitoring, i.e., Illinois Helps.
  • Present a statewide system for disseminating data to vaccine suppliers and others with direct involvement within the COVID-19 vaccination administration mission, i.e., Well being Alert Community—HAN/SIREN.
  • Present oversight of supplier enrollment, monitoring, and vaccine location.
  • Determine and map precedence populations and decide sub-allocations of vaccine for distribution throughout the state.
  • Observe related knowledge to tell the statewide vaccination technique and guarantee federal necessities are met.
  • Present steerage and coaching to vaccine suppliers on the next:
    • Obtainable for CDC sources, and vaccine suggestions, when obtainable
    • Ordering and receiving the COVID-19 vaccine
    • Vaccine storage and dealing with, together with transportation necessities, particular to COVID- 19 vaccines
    • Vaccine administration, together with reconstitution, use of adjuvants, diluents, and so forth.
    • Documenting and reporting vaccine administration through I-CARE and/or EMTrack
    • Managing and reporting vaccine stock through I-CARE
    • Documenting and reporting vaccine wastage and spoilage.
    • Procedures for reporting to the Vaccine Opposed Occasion Reporting System (VAERS)
    • Offering Emergency Use Authorization (EUA) reality sheets and/or vaccine data statements (VISs) to vaccine recipients
  • Collaborate with native Public Info Officers (PIOs) to conduct a statewide media marketing campaign to share information in regards to the vaccine and to encourage residents to be vaccinated.
  • Activate a statewide hotline to deal with questions concerning vaccination administration marketing campaign and to offer steerage on reporting vaccine-adverse occasions to the CDC.

COVID-19 Vaccination Planning Assumptions

  • Vaccine distribution
    • Restricted COVID-19 vaccine doses could also be obtainable in December 2020.
    • COVID-19 vaccine provide will enhance considerably in 2021, permitting common shipments to states.
    • Vaccine suppliers can be required to enroll within the Illinois Complete Automated Immunization Registry Alternate (I-CARE) as a COVID-19 Vaccine Supplier.
    • Vaccine suppliers can be required to comply with observe CDC steerage on vaccine administration, storage, and dealing with by signing the CDC COVID-19 Vaccination Program Supplier Settlement.
    • Vaccine suppliers can be allotted vaccine because it turns into obtainable primarily based on the general jurisdiction’s inhabitants measurement and illness burden, whereas making certain fairness.
  • Vaccine can be delivered through the Vaccines for Kids (VFC) mannequin, i.e., shipped on to suppliers, when doable.
  • Within the early phases of vaccine distribution for vaccines requiring ultra-cold (-80° C) temperature controls and the shortcoming to distribute lower than 975 doses, IDPH and IEMA will coordinate a centralized distribution mannequin, by modifying the state’s SNS plan.
  • Vaccine suppliers can be required to enroll in Vaccine Finder and report stock every day.
  • Precedence teams (see Part 3 “Phased Method” for extra data)
    • All persons are assumed prone to the virus. Preliminary populations prioritized for COVID-19 vaccination can be as follows primarily based on federal steerage and pending ACIP suggestions and topic to alter primarily based on ACIP steerage:
  • Healthcare personnel and residents from Lengthy-Time period care Services (LTCF)
  • Frontline important staff together with first responders
  • These with high-risk medical circumstances and adults over 65 years of age
  • These individuals aged 16-64 years with medical circumstances that enhance the chance for extreme COVID-19
  • Suggestions for teams on which to focus will probably change after vaccine is on the market, relying on traits of every vaccine, vaccine provide, and illness epidemiology.
  • Due to the uncertainty of COVID-19 vaccine manufacturing, plans should be versatile and will embody high-demand and low-demand eventualities.
  • Vaccination
    • Vaccination can be voluntary.
    • Sufficient federal funding can be obtainable to implement a large-scale vaccination response.
  • Preliminary doses of COVID-19 vaccine could also be licensed to be used underneath an EUA issued by the Meals and Drug Administration (FDA) primarily based on obtainable security and efficacy knowledge.
  • Chilly-chain storage and dealing with necessities for every COVID-19 vaccine product will differ from refrigerated (2°C to eight°C) to frozen (-20°C) to ultra-cold (-60°C to -80°C).
  • Frozen and refrigerated vaccines can be shipped in 100-dose increments kitted with ancillary provides. Extremely-cold vaccine can be shipped in 975-dose increments.
  • Two doses of COVID-19 vaccine separated by roughly 21 or 28 days can be wanted for immunity for some vaccine candidates. Each doses of the vaccine can be with the identical vaccine sort, produced by the identical producer, however not the identical lot of the vaccine. This may require stringent monitoring of vaccine administered and affected person reminders.
  • Per CDC steerage, the vaccine ought to be supplied to sufficient of the inhabitants to elicit herd immunity as provide of vaccines permits.
  • Vaccination will happen over many months and supplied in phases as extra vaccine turns into obtainable.
  • Vaccine-administration planning should replicate the 4 kinds of vaccines being manufactured:
    • mRNA or messenger ribonucleic acid: Encodes the protein of the virus, which is inserted into cells to set off an immune response and create antibodies to the virus.
    • Nonreplicating vector: Solely sure proteins of the virus are administered to stimulate the immune system. Makes use of a innocent viral vector to ship the protein into the cells.
    • Protein Adjuvant: Virus protein is packaged right into a nanoparticle and delivered into cells with an adjuvant to reinforce the immune response.
    • Dwell Attenuated: The virus is modified to be inactive however continues to be alive. The virus can infect the cells however not replicate to trigger illness.
  • CDC will present customary communication supplies on the EUA for most of the people just like the Vaccine Info Assertion (VIS) and particular communication to vaccine suppliers on the EUA.
  • Monitoring for opposed occasions can be mandatory and vital.
  • Vaccine distribution for widespread vaccine-preventable ailments is not going to alter from routine procedures.
  • Seasonal influenza vaccine manufacturing and marketing campaign will proceed.
  • Demand for the pandemic vaccine could also be excessive all through the response.

Necessities for COVID-19 vaccine administration will proceed to evolve over time. Extra steerage is forthcoming pending ACIP suggestions.

IDPH’s COVID-19 response is organized underneath the Incident Command System (ICS) (see organizational chart in Determine 1). The Director of IDPH and the Director of the Illinois Emergency Administration Company (IEMA) function underneath a Unified Command Response. The IDPH response is led by the Incident and Deputy Incident Commanders. In Determine 1, features that interface with IEMA are marked in pink bins. For Vaccination, that is led underneath the Vaccination Part, which is led by a Part Chief and Deputy. There are features that interface with native jurisdictions at each the command workers and in particular person part ranges.

Inside the Vaccination Part, every field represents a perform that has a lead and assist workers, as required, thus creating redundancy. This core workforce works in tandem with all stakeholders from throughout the state. The Vaccination Part regularly holds advert hoc conferences and/or webinars to have interaction companions corresponding to LHDs, native Emergency Administration Companies (EMAs), personal business, associations, pharmacies, correctional amenities, and institutes of upper studying.

Determine 1: Illinois Division of Public Well being Organizational Chart

Pandemic vaccination planning is a mixed state and native accountability that requires shut collaboration and coordination amongst public well being entities, exterior businesses, and group companions. An inside COVID-19 Vaccination Program planning and coordination workforce is important to make sure that the vaccination response to COVID-19 is thoughtfully deliberate and efficiently executed.

Attributable to altering vaccine provide ranges at varied factors through the COVID-19 Vaccination Program, planning can be versatile however as particular as doable to accommodate quite a lot of eventualities. It’s anticipated that vaccine provide can be restricted initially, so the allocation of doses should take into account vaccination suppliers and settings for vaccination of restricted important populations. The vaccine provide is projected to extend shortly, permitting vaccination efforts to be expanded to incorporate further important populations and most of the people. Moreover, suggestions on the assorted inhabitants teams for preliminary doses of vaccine might change after vaccine is on the market, relying on every vaccine’s traits, vaccine provide, illness epidemiology, and local people elements.

IDPH is adopting the Nationwide Academies of Science, Engineering, and Medication’s (NASEM) A Framework for Equitable Allocation of COVID-19 Vaccine. This framework focuses on lowering extreme morbidity and mortality and destructive societal affect as a result of transmission of SARS-CoV-2. Emphasised within the framework is that the objective of the COVID-19 vaccination program is to vaccinate all those that select to be vaccinated and who do not need medical contraindications to the vaccine.

The next explains the phased method per CDC and ACIP steerage, that are really useful primarily based on “science, implementation, and ethics.” Additional ACIP suggestions are anticipated after the issuance an EUA for vaccine candidates, which can alter the phased method by including phases or shifting of populations from section to section. See Part 4 “Crucial Populations” for extra particulars about particular populations lined in every section.

Part 1: Restricted and/or scarce provide of COVID-19 vaccine doses can be found. Preliminary efforts concentrate on reaching important populations. Guarantee vaccination places chosen can attain populations, handle cold-chain necessities, and meet reporting necessities for vaccine provide and uptake. Vaccine administration methods in Part 1 are divided into three sub-phases:

Part 1a

  • Healthcare Personnel
  • Lengthy-term care facility residents and workers

Part 1b

  • Individuals aged 75 years and older
  • Frontline important staff (as outlined by ACIP and directed by the State of Illinois)
  • Sheltered inhabitants, homeless/day applications, and inmates

Part 1c

  • Individuals aged 16 to 59 years outdated with high-risk medical circumstances
  • Individuals aged 65 to 74 years outdated
  • Different important staff (as outlined by ACIP and directed by the State of Illinois)

Part 2: Bigger variety of vaccines can be found. The main target is on making certain entry to vaccine for members of Part 1 important populations not but vaccinated and prolong efforts to succeed in Part 2 important populations. Attainable teams might embody, pending further ACIP suggestions:

  • Attainable teams might embody: The remainder of the inhabitants.

As every section progresses the vaccine administration planning workforce will start planning to vaccinate the subsequent inhabitants of focus, the vaccine administration planning workforce can concentrate on reaching the subsequent inhabitants of focus within the succeeding section. IDPH hopes to realize the overarching objective of herd immunity for the state. All through every section of COVID-19 vaccine administration, jurisdictions and suppliers should guarantee equitable allocation and administration of the vaccine to all recognized precedence teams. IDPH will proceed to watch COVID-19 vaccine orders by assessing ordering reviews equipped by the immunization program. IDPH can even monitor vaccine uptake and protection and reassess methods to extend uptake in populations and/or communities with low vaccine protection. IDPH will use vaccine wastage reviews supplied to attenuate waste. In conditions the place there’s low COVID-19 vaccine demand, jurisdictions ought to monitor their provide and alter methods to keep away from vaccine waste. Lastly, IDPH will present COVID- 19 vaccine administration reviews to CDC as requested.

See Part 4 “Crucial Populations” for extra data together with estimate inhabitants numbers.

Determine 2: Instance of Phased Method Offered by the ACIP

The CDC has established an ACIP work group to assessment proof on COVID-19 epidemiology and burden, vaccine security, vaccine efficacy, proof high quality, and implementation points to tell suggestions for a COVID-19 vaccination coverage. NASEM has developed a framework to find out populations of focus for COVID-19 vaccination and guarantee fairness in entry to COVID-19 vaccination throughout the US. IDPH is utilizing the NASEM framework for preliminary allocation and prioritization, however ACIP could difficulty further steerage that might shift precedence populations. The precedence populations listed beneath are for planning functions and are topic to alter as extra is realized in regards to the results of COVID-19 and the effectiveness of vaccines in several populations and as additional federal steerage could also be issued.

Ariadne Labs and the Surgo Basis have developed a free Vaccine Allocation Planner for COVID-19, which pulls knowledge for every of the important populations from varied federal, state, and different datasets. The methodology for these allocation calculations will be present in that planning doc. The State of Illinois will use this device to tell important inhabitants sizes.

IDPH will regularly assessment further steerage supplied by the federal authorities and updates to ACIP suggestions concerning allocation priorities and the populations that can be served successively as vaccine provides enhance. Among the many elements that IDPH is anticipating to contemplate are well being disparities and different health-access points; people at greater danger (e.g., aged and people with underlying well being circumstances), occupations at greater danger (e.g., healthcare personnel and important industries), populations at greater danger (e.g., racial and ethnic teams, incarcerated people, and residents of nursing houses), and geographic distribution of lively virus unfold. IDPH’s suggestions for vaccine prioritization will replicate suggestions set forth by ACIP with minimal adjustments. IDPH acknowledges the potential for alterations of those suggestions primarily based on the evolving epidemiology of COVID-19 and can monitor nationwide suggestions for adjustments which will happen.

After the goal precedence teams have been vaccinated and extra vaccine shares turn into obtainable, IDPH will make sure that communities struggling disproportionately from COVID-19—together with communities of shade, older adults, individuals with disabilities, and folks with comorbidities—are prioritized appropriately for vaccination. IDPH will work with local people companions and suppliers to strategically goal underserved populations for vaccinations. IDPH will phase-in vaccination for the rest of the inhabitants primarily based on age or different standards to make sure truthful, equitable, and orderly distribution.

Prioritization of Vaccine Allocation and Administration

Native public well being jurisdictions ought to plan to collaborate with their regional healthcare coalition, hospitals, long-term care and/or assisted residing amenities, and different potential vaccine suppliers that serve frontline important staff of their jurisdiction to make sure full protection of vaccine first to the designated precedence teams after which to most of the people. LHDs ought to attain out to those teams now to find out quantity, sort, and placement of every precedence group within the public well being jurisdiction. LHDs ought to coordinate with their healthcare coalition, emergency administration, and different response companions to develop a listing of entities serving precedence teams, decide their capabilities to function websites for vaccine administration (i.e., closed Factors of Distribution [PODs]), or develop plans for the LHD to service these teams at a basic POD designed for these teams.

Through the beforehand talked about planning, LHDs also needs to handle the next;

  • Refrigerated, frozen, and ultra-cold storage for vaccine throughout the section
    • Native plans for the several types of vaccine, corresponding to transporting vaccine saved at 2°C to eight°C from the Regional Hospital Coordinating Middle (RHCC) to the LHD and/or to the vaccination web site, and/or constructing partnerships to make use of ultra-cold storage functionality within the county
  • Numbers of populations to be served in every precedence group throughout the section
  • Safety of vaccine
  • Projected vaccination throughput to find out time wanted to make use of the overall vaccine allocation
  • Native communication and public outreach
  • Companions that can be mandatory to perform all features of the native plan (e.g., native regulation enforcement, native emergency administration, native hospitals)

Suggestions for Part 1 subset teams embody the next (adjusted for ACIP suggestions and tailored from the NASEM Framework).

Part 1a:

  • Lengthy-term care residents, outlined by the CDC as adults who reside in amenities that present a variety of providers, together with medical and private care, to individuals who’re unable to stay independently, and workers at Expert Nursing Services, Assisted Dwelling Services, Residential Therapy Facilities for Substance Abuse, and so forth.
    • LTCF Employees: Nurses and Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Dentists and Hygienists, LTCF Facility Employees, Pharmacists, Psychological Well being Clinicians, Environmental Providers Employees, Reception Employees, Medical Facility Surveyor, Dietary workers, Interpreters, Laundry & safety workers.
  • Healthcare personnel are outlined by the CDC as paid and unpaid staff in healthcare settings who’ve the potential for direct or oblique publicity to sufferers or infectious supplies. Inclusion in Part 1a just isn’t dependent upon fee for an individual’s work or job title. Conditions related to greater danger of transmission embody caring for COVID- 19 sufferers. This consists of;
    • Hospital Settings: Nurses & Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Pharmacists, Emergency Medical Providers (EMS), together with Hearth Departments workers appearing as EMS & Air Medical Transport (Rotor & Mounted Wing), COVID Pattern Lab staff, Organ Harvesters & College students on Scientific Rotations. Different staff in hospital settings at elevated danger, corresponding to Environmental Providers Employees, Reception Employees, X-Ray Technician’s, Phlebotomists, Infectious Waste Employees, Dietary workers, Laundry workers, safety workers, Disaster intervention workers, Interpreters, Clergy/pastoral/chaplains.
    • Non-hospital healthcare: Clinicians, corresponding to Nurses & Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Dentists & Hygienists, Pharmacists, Plasma and Blood Donation Employees, Morticians, Public Well being Nurses, House Well being, Faculty Nurses, Optometrist, COVID Testing Employees, Dermatologist, Dialysis workers, Pressing care staff, Corrections nurses/aides, Bodily/occupational/speech therapists, Vaccine clinic staff, Emergency

Medical Providers (EMS), together with Hearth Departments workers appearing as EMS & Air Medical Transport (Rotor & Mounted Wing).

  • Different Congregate Care: Nurses and Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Group House/Residential Employees, Pharmacists, Environmental Providers Employees, Reception Employees, House Aide/Caregiver, Corrections nurses/assistants, Congregate Care Surveyor, Hospice & palliative care workers, group well being staff when appearing as well being support or well being translator.
  • When vaccine is restricted, precedence ought to first be given to high-risk healthcare staff concerned in direct affected person care and people working in transport, environmental providers, or different healthcare facility providers the place the chance of publicity to bodily fluids or aerosols exists. As extra vaccine turns into obtainable, all healthcare personnel in Part 1a ought to have the chance to be vaccinated.

Desk 1: Part 1a Eligible Places and Personnel

Hospital Settings:

Non-hospital Settings:

  • Medical outpatients
  • Public Well being Clinics
  • Native Well being Division Factors of Distribution (PODs)
  • Federally Certified Well being Middle (FQHCs)

Lengthy Time period Care Services:

  • Expert Nursing Services (SNFs)
  • Assisted Dwelling Services
  • Intermediate Care Services for Individuals with Developmental Disabilities
  • Intermediate Care Services for Individuals with Extreme Psychological Sickness
  • State-run Veterans’ Properties
  • State-operated Facilities for Individuals with Developmental Disabilities
  • State-operated Psychological Well being Facilities
  • Residential Therapy Facilities for Substance Abuse

Different Congregate Care:

  • Persevering with Care Residential Services
  • Residential Care Grownup Properties
  • Help Housing for Seniors
  • Supportive Residential Services for Individuals with Developmental Disabilities
  • Supportive Residential Services for Individuals with Extreme Psychological Sickness
  • Group Built-in Dwelling Preparations
  • Supervised Residential Services for Individuals with Developmental Disabilities
  • Supervised Residential Services for Individuals with Extreme Psychological Sickness

The continuing phases are broadly seen as the subsequent potential teams to be eligible to be vaccinated. These phases have been ready to help LHDs to be ready with a plan, which will be up to date as additional ACIP steerage is launched.

Part 1b: (additional updates to be launched for Part 1b for the context of Illinois)

  • Individuals aged 75 years and older
  • Frontline important staff, outlined as these staff who’re important for the functioning of society and together with the next:
    • First responders: Firefighters (together with volunteers) & Legislation Enforcement Officers (LEOs). (EMS personnel are thought of underneath Part 1a)
    • Corrections Officers
    • Meals and Agriculture Employees
    • Postal Service Employees
    • Manufacturing Employees
    • Grocery Retailer Employees
    • Public Transit Employees
    • Schooling sector, together with lecturers and Help Employees
    • Daycare Employees

Part 1c: (additional updates to be launched for Part 1c for the context of Illinois)

  • Individuals aged 16 to 59 years outdated with medical circumstances that enhance the chance for extreme COVID-19. Situations embody weight problems, diabetes, pulmonary illness, coronary heart situation together with hypertension, kidney illness, most cancers, immunocompromised, sickle cell and being pregnant.
    (Notice: As of the date of this plan, solely Pfizer has been licensed for these underneath 18, from the age’s 16 & up, whereas Moderna is eighteen & up)
  • Individuals aged 65 to 74 years outdated

Different important staff:

  • Employees in transportation & logistics, water & wastewater, meals service, shelter and housing (e.g., development), finance (e.g., financial institution tellers), data know-how & communications, vitality, authorized, media, and public security (e.g., engineers), and public well being staff.

Part 2: (extra steerage to return pending ACIP suggestions):

  • It’s doable that Part 2 will embody the remainder of the inhabitants aged 16 & up.
  • ACIP will make particular age suggestions as knowledge turn into obtainable.

Desk 2 lists the estimated inhabitants sizes for the teams listed above by section.

  • Determine 3 exhibits important inhabitants by vaccine allocations. Part allocations could change primarily based on additional CDC and/or ACIP suggestions.

Desk 2: Estimated Inhabitants Measurement by Group

Part Inhabitants Group Statewide, together with Chicago
1a Healthcare personnel

Est. 490,000

1a Lengthy-term care facility residents

Est. 360,000

1b Frontline important staff together with first responders Est. 1,200,000
1b Individuals aged 75 or older Est. 800,000
1b Individuals aged 65–74 Est. 1,100,000
1b Individuals aged 60–64

Est. 700,000

1c Different important staff

Est. 700,000

1c Individuals with excessive danger comorbid circumstances aged 16–59

Est. 2,800,000

2 Remainder of Inhabitants (aged 16+) Est. 1,700,000

Inhabitants estimates are tailored from the Vaccine Allocation Planning Instrument (methodology), together with 2020 IL employment statistics, ACIP estimates, Federal estimates of LTC populations and 2019 Labor Power Statistics from Present Inhabitants Survey. Inhabitants-group classes should not unique and will not add to the overall inhabitants (e.g., inside Part 1a, a person could fall underneath Lengthy-Time period Facility Employees” and underneath “Healthcare Personnel”).

Determine 3: Crucial Populations for Vaccine Allocations

An ample community of educated, technically competent COVID-19 vaccination suppliers in accessible settings is important to the COVID-19 Vaccination Program success. IDPH’s first precedence was to enroll LHDs. Enrollment then expanded to incorporate hospitals within the state in order that they might present vaccine to qualifying workers. After hospitals, IDPH will concentrate on Federally Certified Well being Facilities (FQHCs) and pharmacies, particularly these in rural areas that do not need hospitals or different alternatives to entry vaccines outdoors of the well being departments. By enrolling these pharmacies, IDPH is ready to present vaccine to many precedence sufferers. In coordination with LHDs, the State of Illinois can even assist the deployment vaccination cellular vaccination groups in a position to conduct on-site vaccination occasions for focused populations that won’t have prepared entry to a different vaccine supplier. As soon as hospitals and pharmacies are on-boarded, IDPH will start specializing in pharmacies, pressing care clinics, and group suppliers that can have the ability to attain further people inside these precedence populations, in addition to different personal medical suppliers. Geographic Info System (GIS) mapping can be used to determine gaps in protection, and focused recruitment efforts can be carried out to fill these gaps. IDPH will use an digital database to enter newly enrolled suppliers and replace it every day and submit it to the CDC.

Supplier necessities, together with native public well being jurisdictions, hospitals, and others eager to administer the COVID-19 vaccine, are as follows:

  • All vaccine suppliers should to register in I-CARE and signal and return the CDC COVID-19 Vaccination Program Supplier Settlement and Profile type electronically via I-CARE. LHDs, hospitals, and different vaccine directors will order and obtain the SARS-CoV-2/COVID-19 vaccine through I-CARE. Vaccine can be shipped immediately from the producer or distributor to the supplier or, within the case of early distribution of the ultra-cold Pfizer vaccine, from IDPH to the LHDs.
  • Native public well being jurisdictions ought to collaborate with their RHCCs, hospitals, and long-term care and assisted residing amenities throughout the county and with different potential vaccine suppliers that cater to important infrastructure and/or frontline important staff of their jurisdiction to make sure full protection of vaccine first to designated precedence teams after which to most of the people.
  • All entities should present coaching to workers assigned as vaccinators and to different workers members assigned to help with vaccine-administration operations.
  • As a part of the CDC COVID-19 vaccine supplier settlement, the enrollee should attest and comply with with the ability to obtain the vaccine and report back to the Immunization Info System (IIS) (I-CARE) inside 24 hours of vaccine administration. Website visits should not required for COVID-19 vaccine suppliers, however the Chief Medical Officer related to every web site that indicators the vaccine supplier settlement is testifying that she or he meets the necessities listed within the settlement. For vaccine administration monitoring and reminders of a second dose, if wanted, all vaccine suppliers should plan to make use of I-CARE or EMTrack.
  • All vaccine suppliers should every day report vaccine administration and on-hand stock to IDPH for monitoring and reporting knowledge components as outlined by the CDC. The CDC is utilizing VaccineFinder to assist facilitate reporting of COVID-19 vaccine provide and, as acceptable, to assist direct individuals to places providing vaccine. All suppliers should report provide data into VaccineFinder (directions from CDC can be forthcoming). The choice for a web site to be seen on the VaccineFinder public-facing web site can be obtainable when and/or if suppliers wish to enhance entry to vaccine to the general public.
  • All vaccine suppliers should share with vaccine recipients the required EUA reality sheets and/or VIS on the vaccine administered.
  • All suppliers’ plans should embody procedures for reporting clinically vital opposed occasions. Opposed occasions additionally can be monitored via Digital Well being Information (EHR) and claims-based techniques corresponding to Vaccine Security Datalink.
  • All vaccine suppliers should be registered within the Illinois Well being Alert Community–HAN/SIREN to obtain vaccine steerage and significant updates on the COVID-19 vaccination administration mission.

State of Illinois Speedy Digital Notification System (SIREN)

SIREN is a safe web-based persistent messaging and alerting system that leverages e-mail, telephone, textual content, pagers and different messaging codecs to offer 24/7/365 notification, alerting, and move of important data. This technique offers fast communication, alerting and affirmation between state and native businesses, private and non-private companions, and goal disciplines and licensed people in assist of state and native emergency preparedness and response.

To register for SIREN, go to

SIREN, initially carried out because the core alerting service for the Illinois Division of Public Well being’s Well being Alert Community, has been broadened in scope and utility to make it a strong device for all state businesses and companions with alerting, notification and collaboration wants and is on the market to all businesses and companions.

SIREN is used for focused alerting primarily based on members’ skilled roles or features. It’s not supposed to be used as a public warning system at the moment. Throughout registration, collaborating entities might want to enter contact data and choose a particular group and performance. IDPH, all public well being companions, and different members could contact SIREN at [email protected]; IEMA and emergency administration companions could contact SIREN at [email protected]. Emails ought to embody an in depth message, together with details about the place you’re employed and your function or title.

With the help of quite a few state businesses {and professional} organizations IDPH is recruiting and enrolling COVID-19 vaccination suppliers. These suppliers will differ in varieties and settings to deal with every of the beforehand described phases of vaccine availability.

IDPH will use GIS mapping to determine the places of organizations expressing preliminary curiosity in turning into pandemic vaccine suppliers. Moreover, IDPH will use maps to point populations with the next prevalence of circumstances or circumstances that enhance the chance of great morbidity and mortality from COVID-19. Specific consideration can be paid to these recognized areas to make sure vaccine suppliers are recruited in these geographic areas in ample quantity to vaccinate at-risk populations. This may enable the planning workforce to visualise gaps in entry and recruit suppliers in particular areas.

Preliminary onboarding will concentrate on LHDs and all hospitals, with precedence given to these with emergency departments and/or intensive care models.

Native pharmacies can be used to offer expanded entry to quite a lot of communities. Pharmacists should not solely extremely accessible, however they’re additionally generally obtainable for longer hours and for extra days than non-pharmacy suppliers. Up to now, 99 % of the long-term care suppliers within the State of Illinois are utilizing the partnership program established by CDC with Walgreens and CVS pharmacies to make sure their residents and workers are vaccinated.

IDPH plans to assist the usage of cellular vaccination groups to assist and supply vaccination clinics to outlined focused teams and populations and to deploy to areas affected by well being inequity, also known as areas with “at-risk” or “weak” populations. This will happen in every of the phases, when mandatory.

To help with vaccination operations at POD websites, COVID-19 vaccine suppliers can use Illinois Helps to seek for certified volunteers.

  • Illinois Helps (www.illinoishelps.web) is a state registry of volunteers for each medical and non- medical occupations who will be requested in a catastrophe or public well being emergency.
  • Thirty-eight states use a platform just like Illinois Helps, constructed on the federal customary Emergency System for Advance Registration of Volunteer Well being Professionals (ESAR-VHP).
  • Illinois Helps is a decentralized system whereby every group (e.g., LHD, hospital, Medical Reserve Corps [MRC], long-term care amenities) manages particular person volunteers that want to work with that particular group.
  • A volunteer registers within the system, offers his or her data (together with licensure and abilities), and chooses from as much as 15 organizations with which to work.
  • The group utilizing the volunteer follows its personal protocols, together with background checks, if acceptable, to onboard the volunteer.
  • This isn’t an event-based system however quite a holistic volunteerism program whereby every group works with volunteers in quite a lot of methods.
  • Roughly 270 qualifying organizations, together with LHDs, MRC, hospitals, and long-term care amenities, are registered in Illinois Helps to request volunteers.
  • Any healthcare group wishing to entry and handle volunteers could request to take action at [email protected]

The IDPH Immunization Part will use established I-CARE protocols to coordinate ordering and monitoring use of the pandemic vaccines from the CDC, or from the designated distributors. Suppliers will log into I-CARE to order the vaccine. IDPH workers will approve orders in I-CARE and transmit requests into CDC’s Vaccine Monitoring System (VTrckS). LHDs would be the first to order whereas vaccine is scarce. IDPH will work with LHDs to find out which suppliers ought to be prioritized of their jurisdiction. As soon as the availability of vaccine will increase and later phases are entered, orders will be processed immediately with all suppliers.

Determine 4: Illinois Division of Public Well being COVID Vaccination Allocation Steps

For refrigerated and/or frozen vaccine, authorised vaccine orders—together with the adjuvant, if mandatory, and all ancillary provides—can be shipped on to suppliers’ designated places. This cargo is executed by McKesson or the vaccine producer and is predicted to ship inside 24 hours of the order being acquired via VTrckS. Nonetheless, this timeframe depends on vaccine availability and on McKesson and the vaccine producers to satisfy this timeline.

On preliminary distribution, Illinois will activate the State Emergency Operations Middle (SEOC) to assist and monitor distribution of the vaccine. To make sure success of the mission, ICS could also be expanded as wanted, to probably embody however not restricted to, the next positions:

  • The IDPH Immunization Group is the lead for processing and approving vaccine orders in I-CARE. The Immunization Group can even be liable for monitoring affected person monitoring and for monitoring opposed occasions reporting. This group is headed by the Vaccines for Kids Administrator and workers.
  • The Vaccine Administration Division is liable for liaising with vaccine suppliers in every of the healthcare coalition areas and public well being jurisdictions, by supplier sort. This group can be led by regional workers who’ve expertise working with LHDs, hospitals, long-term care amenities, and the healthcare coalitions.
  • I-CARE administration workers is liable for COVID-19 vaccine supplier enrollment and technical assist. This group can be led by the I-CARE Administrator and workers.
  • The RSS/Distribution Group is liable for monitoring COVID-19 vaccine orders shipped immediately from the producer to suppliers. IDPH workers accustomed to distribution operations will lead.

Grownup ancillary provide kits shipped by McKesson will embody the next:

Moderna Vaccine ancillary provide equipment for 100 doses:

  • 85 needles (22-25G x 1”)
  • 20 needles (22-25G x 1.5”)
  • 105 syringes (1mL or 3mL)
  • 210 alcohol pads
  • 100 vaccination file playing cards, for every vaccine recipient
  • 1 needle gauge and size chart
  • Restricted provide of non-public protecting gear (PPE), corresponding to surgical masks and face shields for vaccinators. Every ancillary equipment incorporates 4 surgical masks and a couple of face shields.

Pfizer Vaccine ancillary provide equipment for 975 doses:

  • 829 needles (22-25G X 1”)
  • 200 needles (22-25G X 1.5”)
  • 205 mixing needles (21-25G X1.5”)
  • 1,024 syringes (1mL)
  • 205 syringes (3mL or 5mL)
  • 2,458 alcohol pads
  • 1000 vaccination file playing cards, for every vaccine recipient
  • 200 Diluent vials
  • 10 needle gauge and size charts
  • Restricted provide of non-public protecting gear (PPE), corresponding to surgical masks and face shields for vaccinators. Every ancillary equipment incorporates 40 surgical masks and 20 face shields.

Provides not included in shipments from McKesson or the vaccine producer and to be procured by the supplier embody sharps containers, gloves, and bandages. Suppliers could have to plan for extra PPE, relying on vaccination web site wants.

Minimal order measurement for CDC–distributed vaccine can be 100 doses per order for vaccines saved at refrigerated (2°C to eight° C) or frozen (-20° C) temperatures. Minimal orders for ultra-cold vaccines which might be shipped immediately from the producer can be 975 doses per package deal and can be shipped in particular delivery containers containing dry ice. Because of the restricted allocations of the preliminary doses of ultra-cold vaccine, IDPH will obtain most preliminary orders at a central location and re-distribute to LHDs, relying on their allocation, at refrigerated (2°C to eight°C) temperatures. Suppliers ought to use the whole dose allocation and never maintain vaccine again for a second dose, because the second dose can be supplied nearer to the time of its anticipated administration, per CDC steerage. (Notice: For the Pfizer vaccine, the CDC has issued steerage permitting the usage of sixth and even seventh doses which might be being drawn from the 5-dose vial, so long as they’re full doses. Vaccine from a number of vials shouldn’t be pooled, per the CDC, to make full doses)

Vaccine Allocation

The federal authorities will decide the quantity of COVID-19 vaccine designated for every state. Utilizing this allotment, IDPH will handle and approve orders from enrolled suppliers. Throughout preliminary allocations when vaccine is scarce, LHDs decide the allocation for his or her jurisdiction primarily based on their native vaccination plan. The quantity allotted will change over time and could also be primarily based on important populations really useful for vaccination, COVID-19 vaccine manufacturing and availability, and total inhabitants of the jurisdiction. Federal businesses and extra industrial companions can even obtain allocations immediately from the CDC as soon as bigger volumes of vaccine can be found. The CDC is at the moment creating procedures to make sure that jurisdictions have full visibility into COVID-19 vaccine provide and vaccination actions amongst these entities positioned inside their boundaries. Native public well being jurisdictions ought to plan outreach to their regional healthcare coalition, hospitals, long-term care/assisted residing amenities, and with different potential vaccine suppliers of their jurisdictions to find out every entity’s capability to order and obtain vaccine to help with vaccination operations for his or her inhabitants.

  • IDPH will estimate total allocations of COVID-19 vaccine primarily based on the scale of important inhabitants teams inside every native public well being division’s jurisdiction and weighted utilizing the COVID- 19 Group Vulnerability Index (CCVI).
  • The Metropolis of Chicago will obtain a separate, professional rata allocation of SARS-CoV-2/COVID-19 vaccine immediately from the CDC.
  • Tiberius, a vaccine allocation device used on the state degree developed by Operation Warp Velocity (OWS), is designed to calculate every jurisdiction’s allocation and can be used for this occasion. The device will checklist public well being jurisdictions, all eligible suppliers within the jurisdiction, and their vaccine- administration capability to effectively allocate the vaccine in real-time as data is acquired from the CDC.
  • Jurisdictions ought to anticipate that allocation methods could shift through the response primarily based on provide, demand, and wishes throughout the state.
  • The next federal entities will obtain direct allocation of COVID-19 vaccines from the CDC: the Federal Bureau of Prisons, U.S. Division of Protection, the U.S. Division of State, the U.S. Division of Veterans Affairs, and the Indian Well being Service. Federal businesses are planning to implement ACIP suggestions and can be included in early vaccine allocation and distribution. Vaccine allocation to those federal entities is not going to depend towards a jurisdiction’s vaccine allocation. Federal businesses which might be concerned within the response however not listed above ought to work with the state immunization program to make sure their workers is included within the plans for vaccination.

Vaccine Arrival and Distribution

All suppliers will need to have plans in place to obtain vaccine and ancillary provides shipped on to the designated websites and a centralized distribution of vaccine the place relevant. Every LHD’s plan can be submitted to IDPH for assessment to make sure it’s consistent with the state technique and to determine further alternatives for technical help to offer to the LHDs. Plans should replicate and cling to the CDC’s necessities for storage and dealing with of the several types of vaccines. Suppliers keen to manage the vaccine proceed to be enrolled within the Immunization Info System (IIS) and comply with necessities for receiving, storing, administering, and monitoring vaccine administration. Enrolled suppliers will place orders for the vaccine with the state immunizations program. (See Part 11 for extra particulars.) The CDC is predicted to offer every state an allocation of vaccine primarily based on inhabitants, and states can prioritize and fill orders towards these allotments. Orders are then despatched to the CDC and vaccines can be shipped on to the supplier via a centralized vaccine distributor. Notice: Extremely-cold vaccine can be initially distributed via a centralized “hub and spoke” mannequin; see Tier 2 Distribution beneath.

Determine 5: COVID-19 Vaccinations Transportation

The state of Illinois has developed a two-tiered technique to make sure vaccine supply:

  • Tier 1: for refrigerated and frozen vaccines
    • Personal carriers at the moment carry out distribution and supply to every supplier. Vaccine can be despatched on to vaccination suppliers for administration or to designated depots for secondary distribution to administration websites. As soon as a load of vaccine is shipped to a supplier web site, the federal authorities is not going to redistribute the product.
    • Underneath the present vaccine-delivery processes, the CDC contracted McKesson, a third- get together distribution firm, to conduct the service.
    • Suppliers should guarantee correct gear is in place and have developed plans to obtain the vaccine immediately from McKesson or the vaccine producer at their designated web site(s).
    • To scale back waste, if a supplier has vaccine that can not be utilized within the given precedence inhabitants, the supplier shall contact their LHD to allocate further doses with ample shelf life for transportation and administration for redistribution.
  • LHD could redistribute vaccines whereas sustaining the chilly chain. With the problem of assembly chilly chain, LHDs ought to restrict any redistribution to refrigerated vaccines solely.
  • Any mandatory additional distribution to sub-sites throughout the native jurisdictions is decided by the LHD and its group companions as a part of that company’s pandemic response plan.
  • If redistribution just isn’t doable for a supplier, or if the vaccines shelf life doesn’t facilitate a protected switch, suppliers ought to administer the vaccine to the subsequent precedence group within the following section to stop vaccination waste; i.e., if in Part 1a with a scarcity of 1a populations to make the most of the excess vaccine, the supplier ought to then transfer to Part 1b, so as to not waste the vaccine. If this happens, the supplier shall notify the LHD for the given jurisdiction.
  • Tier 2: for ultra-cold vaccines
    • A centralized distribution mannequin (“hub and spoke”) can be executed for preliminary distribution of ultra-cold vaccine utilizing a modified model of the State Strategic Nationwide Stockpile Plan. With the preliminary shortage of vaccine provide to the state of Illinois and the minimal order measurement of 975 doses, this was the mannequin to make sure widescale vaccine distribution with out vaccine waste. This mannequin additionally ensures the next;
      • Vaccines are maintained on the acceptable temperature of -80°C, upon arrival, to make sure vaccine integrity.
      • Logistical and useful resource complexity on native jurisdictions are decreased.
      • The integrity of the vaccine throughout delivery because of ultra-cold necessities is ensured.
      • Vaccines needing to be held and/or saved can be saved in ultra-cold vaccine freezers to lower the quantity of dry-ice consumption wanted for native operations and to make sure vaccine integrity.
      • Jurisdictions not assembly the 975 minimal dose allocation, can nonetheless obtain vaccine.
    • For suppliers that can be allotted a minimum of 975 doses and/or in increments of 975, and may keep the ultra-cold vaccine provide chain, IDPH could approve shipments on to these suppliers’ amenities.
    • Operations can be coordinated via the SEOC, as wanted, and supported by the Illinois Emergency Administration Company (IEMA). The Illinois State Police will present safety for supply autos, the place indicated.

Distribution will happen as follows (excluding Chicago):

  • Preliminary shipments, and subsequent second doses of Pfizer ultra-cold vaccine, can be direct shipped to the Strategic Nationwide Stockpile (SNS) for Illinois. This mannequin can be utilized till the availability of vaccine to the state of Illinois permits for direct shipments to all suppliers.
  • Vaccine can be transferred into ultra-cold freezers to keep up vaccine integrity on the SNS.
    • Upon arrival on the SNS-RSS facility, the logistics workers will conduct an in-depth inventorying of the vaccine towards supplied packing slips and add data into the state’s stock administration system to start monitoring motion and supply of the vaccine. The vaccine can be saved in ultra-cold storage freezers till it’s time to repackage it for cargo. IDPH will present the logistics workers and SNS-RSS incident command, the allotments of vaccines for supply to start repackaging the vaccine for supply.
  • Vaccine can be ready for cargo to 10 RHCCs within the state (excluding Chicago) at 2°C to eight°C.
    • IEMA Logistics will coordinate transport with the Illinois State Police to safe the SNS- RSS and the transport of every cargo of every vaccine to every of 10 state RHCCs.
    • Vaccine could also be shipped in an ultra-cold state to jurisdictions receiving vaccine which have ultra-cold functionality to offer extra time for native plan execution. Vaccine allocation can be primarily based on allocation measurement, functionality, and availability of ultra-cold shippers.
  • As soon as vaccine arrives on the RHCCs, every LHD who’s receiving a vaccine allotment will decide up its allotment from its respective RHCC. The cargo can even embody ancillary provides. LHDs will transport the cargo again to their jurisdiction for vaccination operations. This may “begin the clock” and be the primary day of the 5-day window to make use of the Pfizer vaccine on the refrigerated temperature of two°C to eight°C. Vaccine can’t be re-frozen.
  • As soon as LHDs arrive of their jurisdiction, the vaccine can be positioned right into a vaccine fridge within the jurisdiction to keep up the vaccine temperature. (Notice: Transport bins and different delivery gear, corresponding to ice packs and the information logger, can be returned to IDPH through a return delivery label that can be included with the cargo.)

Determine 6: Vaccine Distribution

The state carried out an preliminary baseline survey of ultra-cold storage functionality throughout the State of Illinois, figuring out functionality and capability in places corresponding to hospitals, LHDs, universities, and schools. These places have been recognized to behave as contingency ultra-cold storage places ought to further capability be wanted. Moreover, state ultra-cold freezers have been staged in varied areas throughout the state to extend statewide functionality.

Stock Administration

IDPH will keep on a real-time foundation a database stock of every dose of vaccine that’s shipped from the producer or distributor and acquired at every ship-to web site. Ship-to websites will keep on a real-time foundation a list of vaccine in inventory, producer title, lot numbers, expiration dates for every lot, and a file of every dose of vaccine transferred to any clinics designated to conduct the vaccination clinics. COVID-19 vaccination suppliers can be required to report stock of COVID-19 vaccines in I-CARE and in VaccineFinder.

Unplanned Repositioning

IDPH plans to attenuate redistribution of COVID-19 vaccine to each extent doable by making certain acceptable allocation to vaccination companions; nonetheless, some redistribution can be unavoidable. Redistribution for preliminary shipments of ultra-cold vaccine can be distributed and coordinated centrally to make sure the integrity of the ultra-cold chain. (See “Tier 2 – For Extremely-cold Vaccines” above).

Determine 7: Illinois Division of Public Well being Surplus Vaccine Redistribution Steps

Refrigerated and frozen vaccine will solely be redistributed with the approval and involvement of IDPH and the steerage from the LHD. Relying on the circumstances, vaccine could also be transported by regional immunization workers or the native or regional well being division. IDPH will observe current VFC Program protocols to coordinate protected switch of vaccine in conditions of unplanned repositioning. Suppliers are anticipated to contact their LHD and program workers within the occasion unplanned repositioning is important to stop waste of vaccine. All suppliers will obtain an academic packet that features the expectation and program contact data as soon as enrolled into the COVID-19 Vaccination Program. All COVID-19 vaccine transfers can be carried out with the help of the immunization program. Immunization area workers are positioned throughout the state and are educated in conducting VFC Program actions, together with protected switch of vaccines. Digital Knowledge Loggers (DDLs) will all the time stay with the vaccine earlier than, throughout, and after switch. All transport necessities and proposals outlined in Part 6 of the CDC’s Storage and Dealing with Toolkit can be adopted. As vaccine is being initially retrieved, a remaining stock reconciliation can be carried out and documented within the IIS. As soon as vaccine switch is full, the reconciled stock can be transferred to the receiving facility’s stock and accepted by the brand new COVID-19 vaccine supplier.

IDPH plans to attenuate redistribution of COVID-19 vaccine to each extent doable by making certain acceptable allocation to vaccinating companions; nonetheless, some redistribution can be unavoidable. Redistribution can be coordinated centrally for preliminary shipments of ultra-cold vaccine to make sure the integrity of the chilly chain, and, a minimum of initially, vaccine will solely be redistributed with the approval and involvement of IDPH and LHDs. Relying on the circumstances, vaccine could also be transported by regional workers, the LHD, or different designated and authorised suppliers.

COVID-19 vaccine merchandise are temperature-sensitive and should be saved and dealt with appropriately to make sure efficacy and maximize shelf life. Correct storage and dealing with practices are important to attenuate vaccine loss and restrict danger of administering COVID-19 vaccine with decreased effectiveness. Jurisdictions ought to work with workers at every COVID-19 vaccination supplier web site to make sure acceptable vaccine storage and dealing with procedures are established and adopted. Suppliers want to offer fridge and/or freezer certificates to the IDPH Immunization Program. Moreover, suppliers should assessment data-logging gear logs frequently and add them to I-CARE to validate compliance. Suppliers should additionally file the minimal and the utmost temperature within the morning and the temperature as soon as within the morning and as soon as within the afternoon. Suppliers should add temperature logs into the IIS, and IDPH will solely enable websites to order vaccines if they will assure acceptable temperatures are maintained. IDPH and CDC necessities can be shared with suppliers through the enrollment course of.

It’s anticipated that cold-chain storage and dealing with necessities for COVID-19 vaccine merchandise will differ in temperature from refrigerated (2°C to eight°C) to frozen (-15°C to -25°C) to ultra-cold (-60°C to -80°C) within the freezer or inside a dry-ice delivery container. Ongoing stability testing could have an effect on these necessities.

The chilly chain begins on the COVID-19 vaccine manufacturing plant, consists of supply to and storage on the COVID-19 vaccination supplier web site, and ends with administration of COVID-19 vaccine to an individual. Jurisdictions and vaccination suppliers are liable for sustaining vaccine high quality from the time a cargo arrives at a vaccination supplier web site till the dose is run. IDPH will decrease alternatives for breaks within the chilly chain. Most COVID-19 vaccine can be delivered from CDC’s centralized distributor on to the situation the place the vaccine can be saved and administered, though some vaccine, corresponding to preliminary shipments of ultra-cold vaccine, can be distributed via a centralized “hub and spoke” mannequin. IDPH has a method to retailer vaccine if an “unplanned repositioning” of vaccine is required. IDPH has procured sources to help in adherence to all cold-chain necessities, together with ultra-cold storage capability.

Suppliers ought to use the whole dose allocation and never maintain vaccine for a second dose, because the second dose can be supplied nearer to the time of its anticipated administration by the Federal Authorities, per CDC steerage.

Satellite tv for pc, Non permanent, and Off-site Clinics:

Satellite tv for pc, short-term, and off-site vaccination clinics play an vital function in enhancing vaccination protection charges and vaccinating hard-to-reach populations. Suppliers are inspired to debate and coordinate these clinics with their LHDs. Vaccination clinics held in these settings have distinctive challenges, and suppliers should observe particular tips supplied by the CDC for managing publicly equipped vaccine in these nontraditional settings. IDPH has procured ultra-cold storage freezers, which can be used for a centralized distribution of ultra-cold vaccine and may also act as contingency ought to ultra-cold vaccines must be saved.

To raised help with this case, the next can be required:

  • The amount of COVID-19 vaccine transported to a satellite tv for pc, short-term, or off-site COVID-19 vaccination clinic can be primarily based on the anticipated variety of COVID-19 vaccine recipients and the power of the vaccination supplier to retailer, deal with, and probably transport the vaccine appropriately. That is important to minimizing vaccine wastage and spoilage.
  • COVID-19 vaccines could also be transported—not shipped—to a satellite tv for pc, short-term, or off-site COVID-19 vaccination clinic setting utilizing vaccine transportation procedures outlined within the COVID-19 addendum to CDC’s Vaccine Storage and Dealing with Toolkit. The procedures will embody transporting vaccines to and from the supplier web site at acceptable temperatures, utilizing acceptable gear, and monitoring and documenting temperatures.
  • Upon arrival at a COVID-19 vaccination clinic web site, vaccines should be saved appropriately to keep up acceptable temperature all through the clinic day.
  • Temperature knowledge should be reviewed and documented based on steerage within the upcoming COVID-19 addendum to CDC’s Vaccine Storage and Dealing with Toolkit.
  • On the finish of the clinic day, temperature knowledge should be assessed previous to returning vaccine to fastened storage models to stop administration of vaccines which will have been compromised.
  • As with all vaccines, if COVID-19 vaccines are uncovered to temperature excursions at any time, the temperature tour ought to be documented, reported, and acted upon based on the immunization program’s procedures.

Unplanned Vaccine Repositioning

Earlier than motion of any vaccine for redistribution, suppliers should submit a request to the immunization program by filling the I-CARE Redistribution Type, obtainable in Appendix B, and call their LHD. This system will present the CDC redistribution type to the location. Earlier than the approval of the motion of vaccines, cold-chain administration should be secured. IDPH will observe current VFC Program protocols to coordinate the protected switch of vaccine in conditions of unplanned repositioning. Suppliers are anticipated to contact program workers within the occasion unplanned repositioning is important to stop the waste of vaccine. All COVID-19 vaccine transfers can be carried out with the help of IDPH workers. DDLs will stay with the vaccine always earlier than, throughout, and after the switch. DDL reviews can be evaluated for temperature excursions, previous to vaccine transport, and after transport to the receiving facility is accomplished. (See Determine #7 Above “Surplus Vaccine Redistribution Course of”)

Temperature Tour Reporting

Chilly-chain upkeep at particular person supplier places would require acceptable vaccine storage and temperature-monitoring gear, educated supplier workers, and constant, correct stock administration as already mentioned. All enrolled suppliers can be required to report temperature excursions by the subsequent enterprise day to IDPH. Suppliers are additionally anticipated to label vaccine that has undergone a temperature tour as “Do Not Use” and stop administration of the vaccine till stability has been decided by this system. Employees can be assigned to deal with incoming temperature excursions per program protocols, and assist can be supplied by the immunization area workers ought to the scenario require help. Suppliers that fail to report temperature excursions inside 1 enterprise day can be at excessive danger for losing vaccine and the necessity to re-vaccinate sufferers. Services failing to report a temperature tour and amenities with repeated temperature excursions can be carefully monitored and required to submit weekly knowledge logger reviews to this system. Services recognized as having these points can be reviewed on a case-by-case foundation and can danger having their vaccines reallocated to different amenities if these points should not corrected or whether it is decided that the power is negligent in its dealing with of vaccines.

Illinois will use I-CARE, the State’s Immunization Info System (IIS), to gather details about COVID-19 vaccine doses administered by suppliers. The immunization program manages the IIS and helps its customers. COVID-19 vaccine data can be collected via the IIS and despatched to the CDC through the IZ Gateway. Guaranteeing that every COVID-19 vaccination supplier is prepared and in a position to report required COVID-19 vaccine administration knowledge components to IIS is a part of the COVID-19 provider-onboarding course of. As COVID-19 suppliers undergo the onboarding course of, the onboarding workforce ensures that each supplier meets three total necessities: the COVID-19 Supplier Settlement and Profile has been accomplished and signed, the power the place the vaccine can be saved meets storage and dealing with necessities, and the power and its workers are registered as IIS customers.

Vaccine Administration Reporting

  • Suppliers are required to submit every day accountability reviews to IDPH within the format requested. Experiences should be submitted by 8:00 p.m. CST every day. Reporting frequency and required knowledge metrics can be up to date as extra steerage is acquired from CDC.
  • IDPH is required to submit every day stock reviews to CDC. Each day reviews should be submitted to CDC by 4:00 p.m. CST. Reporting frequency and required knowledge metrics can be up to date as extra steerage is acquired from CDC.
  • IDPH will create reviews that consider timeliness and completeness of reporting of COVID-19 vaccine administration on the group and facility degree. These groups will attain out to COVID-19 suppliers who should not reporting each 24 hours and assist with troubleshooting obstacles to profitable reporting. All suppliers should abide by CDC program necessities to be licensed to obtain vaccine.
  • IDPH will frequently pull reviews from I-CARE figuring out what number of vaccines have been administered, how a lot vaccine is readily available, and vaccination administration versus documentation entry timestamps. This may present perception into correct and full documentation.

Vaccine Administration Monitoring

  • On the supplier degree, two techniques can be obtainable in Illinois for affected person vaccine administration monitoring:
    • I-CARE: For total affected person monitoring in Illinois, I-CARE is used to trace particular person affected person data and conduct and/or recall notification for extra doses.
    • EMTrack: EMTrack is at the moment being utilized in Illinois by EMS techniques for affected person monitoring. The EMTrack Mass Testing and Vaccination Module was used for vaccination clinics/PODs through the H1N1 pandemic and is frequently used at seasonal flu clinics. The module allows purchasers to schedule appointments and be pre-screened for vaccination previous to coming to the vaccination web site. EMTrack is an elective system that can be supplied to state companions for free of charge.
  • All suppliers should plan to make use of I-CARE or EMTrack for vaccine-administration monitoring and reminders to recipients of a second dose if wanted. Suppliers could use their Digital Medical Document (EMR) techniques if they’ve their techniques related and reporting to I-CARE.
  • Vaccine administration monitoring is important to the SARS-CoV-2/COVID-19 vaccine marketing campaign for a number of causes. Every particular person could have to obtain two doses of the identical vaccine separated by 21 or 28 days, and the vaccine administration file will help suppliers for the second dose with figuring out the right vaccine for the affected person. Moreover, to make sure reporting of opposed occasions to the vaccine, administration knowledge must be tracked. Lastly, this offers assurance that each one precedence teams have ample entry to the vaccine and that sufficient of the inhabitants will be vaccinated in a well timed trend.
  • One of many wanted outputs from the IIS is to find out gaps in vaccine administration throughout geographic or demographic populations to tell targeted outreach efforts.

All suppliers ought to make the most of their whole allocation from the state vaccine distribution program utterly with out the priority of preserving the second dose. The objective for IDPH is to restrict waste and provides entry to vaccine to as many individuals as doable with the primary spherical of vaccine. If a supplier is finished with the present section of the Vaccination Program inside their jurisdiction to the suitable precedence group, they need to use the remaining allocation for the subsequent precedence group within the subsequent section, so as to not waste vaccine.

For an ample immune response, people could also be required to take two doses of the COVID-19 vaccine administered roughly 21 to twenty-eight days aside. If two doses are required, it will likely be mandatory to make sure that the vaccinated particular person return for the second dose. IDPH, together with LHDs, will prepare for details about the necessity for a second dose to be supplied to recipients on the time of preliminary vaccination. Per CDC steerage, the second dose can be supplied and distributed by the federal authorities decided by the documentation and file of first the dose.

Suppliers will be sure that every particular person receives documentation of vaccination on the time of administration that features the vaccine producer title, lot quantity, dose, web site, and date of vaccination for the affected person’s information and the date when the second dose is due. This documentation could also be a COVID-19 vaccination file card supplied as a part of vaccine ancillary kits by CDC, a vaccination file card supplied by IDPH, or a printed copy of proof of vaccination from the supplier’s EHR and/or I-CARE.

COVID-19 vaccine suppliers are inspired to schedule the affected person’s second-dose appointment on the time of delivering the primary dose. The CDC has acknowledged that vaccination verifications and reminder playing cards can be included with the vaccine shipments. Suppliers can be required to offer vaccination playing cards to these receiving their COVID-19 vaccination.

Suppliers utilizing EMTrack can have the power to remind sufferers about their second dose inside that system. IDPH can even encourage all suppliers to make use of the reminder/recall performance in I-CARE as nicely.

Immunization registries, often known as Immunization Info Methods (IIS), are outlined by the CDC as confidential, population-based, computerized databases that file all immunization doses administered by collaborating suppliers to individuals residing inside a given geopolitical space. Immunization registries supply a consolidation of affected person immunization information. Compiling all immunizations in a single database permits easy accessibility for healthcare suppliers. Certificates for proof of immunization are additionally simpler to acquire for the needs of college and childcare facilities. The registry additionally presents well timed reminders for vaccines coming due for sufferers.

  • CARE is a web-based immunization record-sharing software developed by IDPH that enables private and non-private healthcare suppliers to share immunization information of Illinois residents with different physicians statewide. I-CARE is ready to seize customary knowledge components submitted through an HL7 message, together with affected person demographic data corresponding to title, date of delivery, race, ethnicity, handle, and intercourse. I-CARE can also be in a position to seize and retailer detailed vaccine administration data corresponding to CVX, lot quantity, vaccine expiration date, precautions and contraindications, and extra knowledge necessities set by the CDC. IDPH plans to seize two further fields—race and ethnicity—through the COVID-19 vaccination marketing campaign. All suppliers ought to plan to strictly adhere to the usage of I-CARE for monitoring vaccine administration and to report on-hand stock again to IDPH and the CDC.
    • I-CARE is the state’s IIS and would be the major system used to order and monitor SARS-CoV-2/COVID- 19 vaccine administration throughout an occasion.
    • I-CARE works by taking in knowledge from quite a lot of sources, consolidating knowledge into high-quality affected person immunization information, making use of vaccine analysis and forecasting algorithms, and reworking this knowledge into actionable data for clinicians, public well being practitioners, and different IIS customers to assist immunization observe and enchancment in a single secured system.
    • Some features assist total operations, corresponding to establishing interoperable connections with different techniques and deduplication performance for attaining excessive knowledge high quality. Different performance helps scientific resolution making for a person affected person, evaluation of vaccine protection charges for teams of sufferers or populations, reminder and/or recall outreach to enhance vaccination charges, and administration of vaccine stock.
    • For entry, all I-CARE suppliers should be pre-authorized through the IDPH Immunization Program.
    • Enrolling in I-CARE to obtain COVID-19 vaccine is a two-step course of:
      • Step 1: Full the required enrollment kinds to turn into an I-CARE supplier.
      • Step 2: Full the fillable CDC COVID-19 Vaccine Supplier Settlement and Profile type inside I-CARE to order and obtain the vaccine. This consists of agreeing to observe correct storage and dealing with procedures for every vaccine acquired.
    • Three paperwork are required to register a corporation for I-CARE entry:
      • The Supplier Website Enrollment type
      • The Net Portal Registration Authority Settlement (PRA registration)—every supposed person might want to observe the IDPH net portal on-line registration course of to create a username and password
  • The Particular person Person Settlement type stating and agreeing to IDPH safety and confidentiality insurance policies
  • The COVID-19 Vaccine Suppliers Program Course of and Steering doc is in growth. The aim of this doc is to stipulate necessities for approval to entry I-CARE, ranges of entry obtainable, roles in I-CARE, recommendations on who ought to have I-CARE entry, regularly requested questions, and an internet I-CARE coaching video.
  • The Mass Immunization Module is an integral a part of and is constructed into the IIS, eliminating the necessity to construct an interface. The Mass Immunization Module permits for sooner knowledge entry throughout vaccination occasions as lot quantity defaults are added previous to conducting these occasions. Setting the default lot quantity(s) ends in the lot quantity being mechanically populated within the affected person’s file. When the administered vaccine and lot quantity are added to the affected person file, the vaccine dose is subtracted from the stock, sustaining vaccine dose accountability and correct stock administration.

Within the occasion that I-CARE is unavailable, vaccine administration data can be recorded on paper logs or in Excel spreadsheets that can be transcribed into the IIS when entry returns. Deliberate contingencies for community outages or different entry points ensures that clean vaccine administration sheets can be found in laborious copy (i.e., as paper copies) and in delicate copy on the vaccination person desktops and laptops (i.e., in Excel spreadsheets). All knowledge gathered about vaccine administration is confidential and topic to state and federal privateness legal guidelines (e.g., the Well being Info and Portability and Accountability Act [HIPAA], the Communicable Illness Code, and so forth.).

All vaccine suppliers should be registered within the Illinois Well being Alert Community—HAN/SIREN to obtain vaccine steerage and significant updates on the COVID-19 vaccination administration mission. The Illinois Well being Alert Community—HAN/ SIREN is a statewide, web-based resolution for shortly and successfully disseminating well being data, emergency notifications, and alerting workers. It serves as a central level within the State for locating, creating, and sharing data. All COVID-19 vaccine suppliers should make sure that key workers members are registered in SIREN to make sure that they’re receiving data and updates on the COVID-19 vaccination mission. Moreover, COVID-19 vaccine supplier organizations can use SIREN to speak on organization-specific data with workers members and companions.

IDPH can even monitor its web site to make sure that the next can be found on-line:

  • Common data and schooling for the general public concerning vaccination places
  • Suppliers’, vaccinators’, and public well being division schooling and coaching data, together with EUA reality sheets for suppliers and vaccine recipients and a spot for Vaccine Info Statements (VISs)
  • Federal vaccine name heart data and a regularly requested query part
  • An information repository permitting Illinois residents to remain knowledgeable with up-to-date statistics

The CDC Vaccine Finder web site hyperlink can even be positioned on the vaccine data webpage, and pandemic suppliers can be requested to take part.

Public data could also be disseminated through social media, web site postings, interviews, newspaper editorials, flyers, billboards, tv and radio broadcasts. Messages could embody understanding the important thing variations between U.S. Meals and Drug Administration (FDA) emergency-use authorization and FDA approval, a timeline of vaccine availability, authorization, distribution, focused populations, why the vaccine is important, and that conditions are regularly evolving. One of many major objectives can be to make sure public confidence within the approval and authorization processes, security, and efficacy of COVID-19 vaccines. This system can even use conventional schooling supplies for countering myths in regards to the vaccine and data concerning protected dealing with, storage, preparation, and administration of the particular vaccine to make sure schooling for suppliers.

IDPH is within the strategy of organizing a vaccine communication technique. Various pathways are being explored that can probably lead to a multifaceted communication technique to make sure efficient messaging throughout all populations. To know attitudes about potential COVID-19 vaccines, IDPH can also be contemplating working with exterior companions to develop a statewide evaluation of public and supplier attitudes and beliefs surrounding the COVID-19 vaccine. This survey can be used to gather data from the general public that may very well be used to maximise COVID-19 vaccination uptake, together with data particular to subpopulations. Info and knowledge obtained through the survey can be used to develop acceptable messaging for the general public and healthcare suppliers.

Suppliers will obtain an academic packet upon enrollment within the COVID-19 Vaccination Program. Steering paperwork will embody product-specific EUA reality sheets for COVID-19 vaccination suppliers and EUA reality sheets for vaccine recipients or VISs as soon as they’re made obtainable by CDC. Suppliers can be instructed to learn each kinds of EUA reality sheets and VISs and attain out to the IDPH Immunization Program with any questions previous to starting administration of COVID-19 vaccine. Suppliers can even be told of the federal requirement to offer the recipient reality sheet or VIS to every affected person previous to vaccine administration. Truth sheets and VISs can even be linked on IDPH’s COVID-19 web site, positioned the place different related data for suppliers is contained. Updates to EUAs or VISs can be distributed through SIREN or a COVID-19 supplier distribution e-mail group and posted to the COVID-19 web site.

Emergency Use Authorization (EUA) Truth Sheets

The EUA authority permits the FDA to authorize both the usage of an unapproved medical product (e.g., drug, vaccine, or diagnostic system) or the unapproved use of an authorised medical product throughout an emergency primarily based on sure standards. The EUA will define how the COVID-19 vaccine ought to be used and any circumstances that should be met to make use of the vaccine. FDA will coordinate with the CDC to substantiate these circumstances of authorization. Vaccine circumstances of authorization are anticipated to incorporate distribution necessities, reporting necessities, and security and monitoring necessities. The EUA can be licensed for a particular interval (i.e., at some stage in the COVID-19 pandemic) to satisfy response wants. Extra data on EUAs, together with steerage and regularly requested questions, is positioned on the FDA web site.

Product-specific EUA reality sheets for COVID-19 vaccination suppliers can be made obtainable by the FDA that embody data on the precise vaccine product and directions for its use. The FDA will develop EUA reality sheets for vaccine recipients. EUA reality sheets will probably be made obtainable on the FDA web site and thru the CDC web site. IDPH will use a number of communication media to succeed in COVID-19 vaccine suppliers, corresponding to e-mail distribution lists, webpages, and SIREN alerts to contact enrolled suppliers and make them conscious of the suitable EUA reality sheets. Moreover, IDPH will present coaching webinars on the EUA reality sheets and the VISs to make sure that suppliers perceive the knowledge, and are clear on the requirement to offer the recipient reality sheet to every consumer or affected person previous to administering vaccine.

Vaccine Info Statements (VIS)

VISs are required provided that a vaccine is added to the Vaccine Damage Desk. Optionally available VISs could also be produced however solely after a vaccine has been licensed (e.g., corresponding to with zoster vaccines). Plans for creating a VIS for COVID-19 vaccine should not recognized at the moment however can be communicated as further data turns into obtainable. IDPH will disseminate VISs equally to the best way EUA reality sheets can be disseminated.

In response to vaccine security, IDPH will use the Vaccine Opposed Occasion Reporting System (VAERS) to report and examine opposed occasions following immunization with the COVID-19 vaccine. VAERS is a nationwide passive surveillance reporting system that’s co-sponsored by the CDC and the FDA. Experiences are accepted from anybody, together with vaccine recipients, healthcare suppliers, and vaccine producers. Affected person id is saved confidential. VAERS complies with all U.S. Authorities safety requirements and protections regarding well being data.

VAERS reviews ought to go on to the VAERS web site. Suppliers will obtain an academic packet upon enrollment into the COVID-19 Vaccination Program. Steering paperwork will embody data on required reporting of vaccine opposed occasions to VAERS. IDPH will present technical help and talk with the CDC on all features of vaccine opposed occasion reporting. Vaccine security and schooling can be supplied by the CDC and the IDPH to suppliers statewide and the hyperlink to the VAERS web site can be posted on the IDPH COVID-19 web site, positioned the place different related data for suppliers is contained.

The CDC is working to develop security surveillance via new techniques and extra data sources and by scaling up current security monitoring techniques. Extra data on security monitoring can be shared when it turns into obtainable from the CDC.

Supplier Enrollment

Supplier enrollment is monitored via a database that tracks progress via the three levels of onboarding: enrollment, storage and dealing with capabilities, and submission of the finished CDC Supplier Settlement and Profile. Location of suppliers can be mapped through GIS in order that geographic protection of suppliers could also be monitored and suppliers recruited in areas the place gaps are recognized.

High quality Management

IDPH performs high quality management critiques of 25 % of vaccine suppliers enrolled within the VFC program. It’s anticipated {that a} comparable protocol can be used to assessment COVID-19 vaccine suppliers throughout this mission.

Monitoring Communication

IDPH will make sure that supplier coaching paperwork are acquired and reviewed by requiring acknowledgement of receipt and attestation of assessment. Pandemic-related communications which might be important to the healthcare workforce can be shared through SIREN. Public communications could also be monitored via social media web site metrics.


Tiberius integrates COVID-19 vaccine distribution planning, monitoring, modeling, evaluation, and different knowledge from federal businesses, state and native companions, private-sector companions, and open knowledge suppliers to create a complete widespread working image of COVID-19 vaccine planning, distribution, and administration efforts. Tiberius offers versatile and real-time data-backed functions that allow customers of all kinds to make data-driven selections.

Supplier-level Knowledge Reporting

Epidemiologists will monitor and report timeliness and completeness of reporting of COVID-19 vaccine administration on the group and facility ranges. Employees will assessment this regularly to make sure completeness, accuracy, and timeliness of reporting knowledge.

Employees can even monitor provider-ordering and inventory-management practices and consider adherence to COVID-19 vaccine reconciliation and stock necessities. Employees will run every day reviews utilizing IIS knowledge to generate a listing of suppliers who haven’t accepted an order into their stock inside 7 enterprise days. This data can be despatched to ordering workers for follow-up with the supplier. The workers will generate a month-to-month report utilizing IIS knowledge to determine suppliers who should not reconciling their stock each 30 days. This data can be despatched to ordering workers for follow-up with the supplier as nicely.

Monitoring Fiscal Sources for Incoming Grants

The Illinois Jurisdiction strategies and process for monitoring finances sources embody by grant quantity and classes monitoring through an digital ledger. Invoices are processed electronically, and requests for purchases will need to have a number of ranges of approval and ample justification. All authorised invoices and wage funds should be documented within the ledger previous to fee. This system supervisor critiques contracts and displays and modifies grants and contracts with ample justification. This system supervisor additionally assesses, reconciles, and modifies the finances accordingly. This system supervisor and/or different acceptable workers plan and implement related competency coaching for workers (Microsoft package deal, Smartsheet, and so forth.) as wanted.

The Illinois Jurisdiction strategies and procedures for monitoring staffing sources embody monitoring workers efficiency via common conferences and efficiency critiques. The Immunization Part meets each morning with administration, and priorities for the day are reviewed. As workers assignments change, ample workers to assist the mission are assigned to duties needing to be accomplished.

The Illinois Jurisdiction strategies and procedures for monitoring provides embody electronically and manually monitoring stock of provides, annual complete handbook stock evaluation, and real-time and common digital monitoring.


All suppliers also needs to make sure that their vaccinators and different workers concerned in vaccination operations obtain coaching. Coaching and train modules are regularly being developed by the COVID-19 Vaccination Part. The Vaccination Part will conduct technical help webinars, assessment vaccine allocation instruments, assessment the CDC PanVax Instrument for pandemic vaccination planning, and reply questions of native supplier workers. Observe-up conferences and/or webinars can be scheduled as mandatory. Moreover, IDPH plans to conduct workshops, webinars and/or tabletop/practical workouts for state companions as mandatory. It’s anticipated that the majority coaching and train choices can be executed just about or on-demand.

Coaching matters could embody however should not restricted to the next:

  • I-CARE coaching for suppliers
  • Vaccine administration and monitoring
  • Vaccine name down drills and workouts
  • Simply in time coaching for Tier 2 distribution is developed and checklists are discovered within the SNS Plan
  • Obtainable CDC sources, and vaccine suggestions, when obtainable
  • Ordering and receiving COVID-19 vaccine
  • Vaccine storage and dealing with, together with transportation necessities, particular to COVID-19 vaccine
  • Vaccine administration, together with reconstitution, use of adjuvants, diluents, and so forth.
  • Documenting and reporting vaccine administration through I-CARE or EMTrack
  • Managing and report vaccine stock through I-CARE
  • Documenting and reporting vaccine waste and spoilage
  • Procedures for reporting to VAERS
  • Offering EUA reality sheets and/or VISs to vaccine recipients
  • Public messaging
  • Outreach to precedence teams, weak populations, and hard-to-reach populations


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