COVID-19 Vaccine Provider Webinar12/22/2020

DISCLAIMER

The information presented today is based on recent guidance and MAY change.

December 22, 2020

1. COVID-19 Critical Populations for Vaccination2. Reporting Adverse Events in VAERS and v-safe3. VAOS Refresher & FAQs4. Provider Resources

Agenda

Today’s webinar presentation and recording will be available on the COVID-19 Vaccine Management Resources page

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COVID-19 Critical Populations for Vaccination

• Texas has convened a team of appointed external and internal subject-matter experts (SME) into the COVID-19 Expert Vaccine Allocation Panel (EVAP) to develop vaccine allocation strategies as recommendations to the Texas Commissioner of Health.

• The panel will develop and apply guiding principles in their recommendations.

• The recommendations from the EVAP will be sent to the Texas Commissioner of Health for final approval.

• EVAP voting members https://www.dshs.texas.gov/coronavirus/immunize/evap.aspx

COVID-19 Expert Vaccination Allocation Panel (EVAP)

Texas Guiding Principles

• Protecting health care workers who fill a critical role in caring for and preserving the lives ofCOVID-19 patients and maintaining the health care infrastructure for all who need it.

• Protecting front-line workers who are at greater risk of contracting COVID-19 due to the nature of their work providing critical services and preserving the economy.

• Protecting vulnerable populations who are at greater risk of severe disease and death if they contractCOVID-19.

• Mitigating heath inequities due to factors such as demographics, poverty, insurance statusand geography.

• Data-driven allocations using the best available scientific evidence and epidemiology at the time, allowing for flexibility for local conditions.

• Geographic diversity through a balanced approach that considers access in urban and rural communities and in affected ZIP codes.

• Transparency through sharing allocations with the public and seeking public feedback.

https://gov.texas.gov/news/post/governor-abbott-dshs-announce-covid-19-vaccine-distribution-plan

CDC Critical Populations for COVID-19 Vaccination

Essential workers

• Healthcare personnel (i.e. EMS, hospital staff, vaccinators, pharmacy and long-term care staff)

• Other essential workers (i.e. first responders, education, others with critical roles who cannot easily socially distance)

People at increased risk for severe COVID-19 illness

• People 65 years of age and older• LTCF residents (i.e., nursing home, assisted living, others)• People with underlying medical conditions that are risk factors for severe

COVID-19 illness

People at increased risk of acquiring or transmitting COVID-

19

• People from racial and ethnic minority groups • People from tribal communities • People who are incarcerated/detained in correctional facilities • People experiencing homelessness/living in shelters • People attending colleges/universities • People living in other congregate settings

People with limited access to routine vaccination services

• People living in rural communities • People with disabilities • People who are under- or un-insured

Groups and individuals may fall into multiple categories. Prioritization recommendations among and within groups are in development.

Texas Population Estimates

Group Population

People 16 years of age and older 22,448,443

Healthcare Workers 1,591,562Long-term Care Residents 275,541

Adults 65+ 3,912,028Total Medical Conditions 9,499,038

Incarcerated 158,057Homeless Adults 22,706

Colleges and Universities 1,455,533

Black/African-American, Hispanic, and American Indian/Alaska Native 10,889,530

Adults with Disabilities 2,855,529

Un and Under Insured 8,526,320

COVID-19 Critical Population UpdatePhase 1A Healthcare Workers – First Tier

1. Hospital staff working directly with patients who are positive or at high risk forCOVID-19. Includes:

a. Physicians, nurses, respiratory therapists and other support staff (custodial staff, etc.)b. Additional clinical staff providing supporting laboratory, pharmacy, diagnostic and/or

rehabilitation services2. Long-term care staff working directly with vulnerable residents. Includes:

a. Direct care providers at nursing homes, assisted living facilities, and state supported livingcenters

b. Physicians, nurses, personal care assistants, custodial, food service staff2. EMS providers who engage in 9-1-1 emergency services like pre-hospital care and

transport3. Home health care workers, including hospice care, who directly interface with

vulnerable and high-risk patients5. Residents of long-term care facilities

1. Staff in outpatient care offices who interact with symptomatic patients. Includes:a. Physicians, nurses, respiratory therapists and other support staff (custodial staff, etc.).b. Clinical staff providing diagnostic, laboratory, and/or rehabilitation services.c. Non 9-1-1 transportation for routine care.

2. Direct care staff in freestanding emergency medical care facilities and urgent care clinics.

3. Community pharmacy staff who may provide direct services to clients, includingvaccination or testing for individuals who may have COVID.

4. Public health and emergency response staff directly involved in administration of COVID testing and vaccinations.

5. Last responders who provide mortuary or death services to decedents with COVID-19. Includes:• Embalmers and funeral home workers who have direct contact with decedents.• Medical examiners and other medical certifiers who have direct contact with decedents.

6. School nurses who provide health care to students and teachers.

COVID-19 Critical Population UpdatePhase 1A Healthcare Workers – Second Tier

Phase 1A Healthcare Workers in Texas

Healthcare Workers Estimated Population

Hospital Personnel 327,028

EMS Personnel 66,033

LTC Personnel Total 202,070

Home Health Workers 257,922

Ambulatory/Outpatient 490,000

Pharmacy Personnel 231,987

Last Responders 10,416

School Nurses 6,106

Total 1,591,562

Older adults in long-term care are disproportionately affected by COVID-19

As of November 19, 2020

High Risk Populations By Region

Public Health Region

At least one High Risk Medical Condition*

Adults 65+

1 290,135 134,264

2/3 2,671,602 1,103,089

4/5N 592,868 295,987

6/5S 2,476,882 949,259

7 1,067,255 462,672

8 1,058,860 450,704

9/10 513,205 211,456

11 828,231 304,597

Total 9,499,038 3,912,028

With estimated 39% overlapbetween adults 65+ and high-risk conditions, total ~7,912,529

*Heart disease, asthma, COPD, bronchitis, emphysema, chronic kidney disease, diabetes, obesity (BMI>30)

COVID-19 Critical Population UpdatePhase 1B

• People 65 years of age and older• People 16 years of age and older with at least one chronic medical

condition that puts them at increased risk for severe illness from the virus that causes COVID-19, such as but not limited to:

• Cancer • Chronic kidney disease • COPD (chronic obstructive pulmonary disease) • Heart conditions, such as heart failure, coronary artery disease or cardiomyopathies • Solid organ transplantation • Obesity and severe obesity (body mass index of 30 kg/m2 or higher) • Pregnancy • Sickle cell disease • Type 2 diabetes mellitus

Population Estimate 1A and 1B

Group Population

High risk healthcare workers 1,402,648

Older adults in congregate settings 303,374

People with at least one high-risk condition 9,251,040

People age 65 and over 3,337,805

Sum of groups above 14,294,867

Estimated overlap 3,587,975

Total people to vaccinate in 1A and 1B 10,706,892(Note for illustration purposes. These estimates differ slightly from those previously shown due to different data sources, but this tool allows estimation of overlap of these different populations).

Source:Ariadne Labs: A Joint Center for Health Systems Innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health and The Surgo Foundation.

https://covid19vaccineallocation.org/

Safety Reporting

VAERS Reporting for COVID-19 Vaccinations

Vaccine Adverse Event Reporting System

Vaccine Adverse Event Reporting System

• National program to monitor vaccine safety and collect reports of adverse events after vaccination

• Texas DSHS Immunization Unit Vaccine Safety Coordinator is primary liaison to VAERS and assists with investigations as needed

Who Can Report to VAERS?

• CDC and FDA encourage anybody who experiences any problems after vaccination to report to VAERS.

• Parents • Patients • Healthcare Providers • Others

• Healthcare providers are required by law to report certain problems such as serious adverse events

• Knowingly filing a false VAERS report is a violation of Federal law (18 U.S. Code§ 1001) punishable by fine and imprisonment.

Adverse Events

Adverse event - Any health problem that happens after a vaccine. Might be truly caused by a vaccine or might be coincidence.Types of adverse events include:• True reactions to the vaccine• Side effects• Unrelated health problems• Health problems where relationship to vaccination can’t be determined

Serious adverse event - life-threatening illness, hospitalization, prolongation of an existing hospitalization, permanent disability or death that happens after a vaccination.

What Should be Reported to VAERS?

• Healthcare providers are required by law to report1

• Any adverse even listed in the VAERS Table of Reportable Events following vaccination • An adverse event listed by vaccine manufacturer as contraindication to further doses of the vaccine

• Healthcare providers are encouraged to report1

• Any adverse event that occurs after the administration of a vaccine licensed in the U.S., whether it is or is not clear that a vaccine caused the adverse event

• Vaccine administration errors

• Through the CDC COVID-19 Vaccination Program Provider Agreement, providers are2

• Required to report adverse events following COVID-19 vaccination• Should report clinically important adverse events even if they are not sure if the vaccination caused the

event

1https://vaers.hhs.gov/reportevent.html2CDC COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations

How to Report to VAERS

1. Online (preferred) - 2. Fillable PDF Upload –

Adverse events can be reported two different ways:

https://www.youtube.com/watch?v=sbCWhcQADFE

VAERS Video Tutorial

VAERS Summary

• A VAERS report does not mean the vaccine caused the adverse event

• VAERS is only one of several waysvaccines are monitored for safety in the United States

• Knowingly filing a false VAERS report is a violation of Federal law

For more information about VAERS:

E-mail: info@vaers.org Phone: 1-800-822-7967

Web site: www.vaers.hhs.gov

V-Safe, the after vaccinationhealth checker

Additional Vaccine Safety Monitoringv-safe | after vaccination health checker

V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after someone receives a COVID-19 vaccination.

Vaccine recipients can quickly tell the CDC if they have any side effects. The CDC may follow up with them by phone to get more information.

V-safe will also remind them to get their second COVID-19 vaccine dose, if needed.

v-safe | after vaccination health checker

How long do v-safe check-ins last? • During the first week after you get your vaccine,

v-safe will send you a text message each day to ask how you are doing.

• Then you will get check-in messages once a week for up to 5 weeks.

• The questions v-safe asks should take less than 5 minutes to answer.

• If you need a second dose of vaccine, v-safe will provide a new 6-week check-in process so you can share your second-dose vaccine experience as well.

• You’ll also receive check-ins 3, 6, and 12 months after your final dose of vaccine.

v-safe | your role as a provider

• Give patients a v-safe information sheet at the time of vaccination

• Encourage them to enroll and fill out the surveys when prompted

https://vsafe.cdc.gov/

V-safe now available in Spanish https://espanol.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html

v-safe info poster v-safe info sheets

Poll: Which of the topics covered today do you want more information on?

VAOS Refresher & FAQs

Refresher: Accepting Allocations

Step 1: Log in and locate your facility

1. Log into VAOS and navigate to the Accounts tab.

2. From the drop-down menu, select All Accounts to view all your facilities. Select the facility location that will be accepting the allocation.

3. In the bottom right corner, you will see the Vaccine Allocationspane. New allocations thatneed to be accepted will have the Status “Created.”

Step 2: Select your “Created” Allocation

4. In the Vaccine Allocations pane, select View All.

5. Select the allocation number for the allocation which has the status Created.

Step 3: Accept Allocation

6. Once you’ve selected the allocation, you’ll see the status page. If this allocation has not yet been accepted, the Status will read Created, and the Total Amount Accepted field will be blank.

7. Select Accept toaccept yourallocation.

Allocations Acknowledged

This is what you’ll see if your allocation was successfully acknowledged.

The status will now readAcknowledged, and theTotal Amount Acceptedfield will reflect the number of allocations you accepted.

Need the detailed instructions?

Accepting Allocations2-minute Training Video

Provider VAOS Guide and Training Videos for the Vaccine Allocation & Ordering System (VAOS) are now available on the Vaccine Management Resources Site

Provider VAOS GuideStep-by-step instructions

Poll: Can you currently order vaccines through VAOS?

Provider FAQs

How can I order COVID-19 vaccine?The COVID-19 vaccine is currently being allocated to providers due to limited supply and cannot be directly ordered at this time.

To be eligible for a COVID-19 vaccine allocation, organizations must be approved to be COVID-19 vaccine provider through the enrollment process described here.We do not currently have an expected timeline when specific facilities may receive COVID vaccines.• Initial vaccine amounts are extremely limited and restricted to prioritized populations.• Once approved, no further action is needed to receive an allocation.• Once vaccines for your facility are available, your primary and secondary contact listed

in your registration will receive an email notification asking them to accept the allocations and instructions will be included in that notification.

Poll: Who can accept allocations for your organization in VAOS?

Provider FAQs

Who in my organization will receive emails pertaining to VAOS access and allocations?Only approved COVID-19 Vaccine Providers will receive access to VAOS.Once you’ve been approved through the enrollment process, the primary and backup vaccine coordinator for your organization will receive emails regarding VAOS.Your organization provided information for these coordinators when completing COVID-19 Vaccine Provider enrollment.

Please look for invitations to additional COVID-19 Provider Webinars in the coming days and weeks

No webinar on Thurs 12/24

COVID-19 Vaccine Resources (today’s webinar, training materials, videos): https://www.dshs.texas.gov/coronavirus/immunize/vaccine-manage-resources.aspx

COVID-19 Vaccine Provider Enrollment Information: www.dshs.texas.gov/coronavirus/immunize/provider-information.aspx

DSHS COVID-19 Vaccine Provider hotline: (877) 835-7750, 8 a.m. to 5 p.m., Monday through Friday or Email: COVID19VacEnroll@dshs.texas.gov

For questions about training materials or webinars, please email us at COVID19VacMgmt@dshs.texas.gov

Key Resources

Thank you!