Steps to Implement a Successful COVID-19 Vaccination Program

Premier recently released four recommendations on how the US can implement a successful COVID-19 vaccination program once a vaccine becomes available to the public.  

Currently, various potential COVID-19 vaccine candidates are pushing through clinical trials, including AstraZeneca’s AZD1222, Johnson & Johnson’s Ad26-S.PP, and Pfizer’s mRNA vaccine, BNT162b1.

Once approved, early production of a vaccine will total between one and two million doses. Therefore, Premier’s first recommendation is to prioritize who gets vaccinated first.

Currently, the federal government and public healthcare workers are evaluating many questions regarding a prioritization plan.

But a recent National Academies of Sciences, Engineering, and Medicine discussion draft talked about a four-phase approach to prioritizing the distribution of the vaccine.

The first two phases would focus on frontline worker, first responders, critical risk workers, teachers, and other with underlying health conditions, while the last two phases would include young adults, children, and workers in industries essential to the functioning of society or an increased risk of exposure and those who had not already received a vaccine.

But Premier stated that a formal segmentation of populations has not yet been approved. 

“A clear national plan will be required to maximize the impact and save the greatest number of lives – with a secondary goal of ensuring the public understands rationed choices and does not feel unfairly deprived,” a Premier spokesperson said.

The second recommendation is dynamic allocation based on hotspots and priority populations.

During previous mass vaccinations, the federal government allocated vaccines to each state based on their populations.

But Premier highlighted that taking this approach for COVID-19 will lead to shortages in some communities and an unfair supply in others.

For example, if individuals 65 years of age and older were among the first to be vaccinated, this would be 21 percent of Puerto Rico’s residents and about 10 percent of Utah’s residents.

Plans should also consider which individuals would be willing to get vaccinated first and make adjustments based on the findings. 

A recent Gallup poll found that 65 percent of Americans would get an FDA-approved and affordable COVID-19 vaccine, while 35 percent would not.

“The government should allocate vaccines in greater proportion to emerging hotspots, stopping the spread in communities where science shows it’s metastasizing. Secondary prioritization should be given to states with higher percentages of priority vaccination candidates, like those aged 65 and over,” Premier said.

Additionally, the nation will also need a distribution plan that ensures the vaccine is safely and efficiently transported to communities across the country, Premier stated.

At least one vaccine candidate must be frozen at temperature of -70° C and has a very short shelf life. This makes the vaccines challenging to scale.

Currently, there are very few distributors that can store vaccines at that temperature. Therefore, distribution partners and administration sites will need special plans to ensure they are equipped with both the vaccine and freezing capabilities.

McKesson Corporation is currently tasked with creating a distribution plan for government-owned vaccines, but the company has yet to release details.

The fourth Premier recommendation is to display accurate and methodical patient tracking.

Nearly all COVID-19 vaccine candidates in clinical trials require administration of two doses within a certain time period.

Therefore, providers must ensure that all patients receive a correct second dose of the same vaccine they did on the first visit.

Currently, there is a federal ban on the creation of unique patient IDs. But to combat any potential issues with patient data matching, Premier stated that Congress should pass legislation to override this ban and ensure that patients are linked to the correct first-dose vaccine.

The records will monitor patients who have been vaccinated, their clinical results, and the number of individuals who failed to receive their second dose.

Additionally, patients and the vaccine they receive will need to be linked together in an electronic health record. This will allow providers to easily follow up in the event of a missed second appointment. 

“The next few weeks will be critical for players across the healthcare industry and federal agencies to work together, develop a strategic and equitable plan, and communicate to states, healthcare providers and millions of Americans,” Premier concluded.