3 Ways Health Systems Are Preparing for a COVID-19 Vaccine

With an emergency use authorization just around the corner for a COVID-19 vaccine, health systems are preparing to receive and manage the drug to stop the spread of the novel coronavirus. But most system leaders do not feel ready to take on the drug when it becomes available.

More than 90 percent of attendees of a Premier webcast earlier this month said state and federal governments either have not or only somewhat prepared them for receiving and managing a COVID-19 vaccine.

Another 43 percent of attendees also cited a lack of communication from the government as their largest readiness gap, followed by a lack of storage and administrative guidance (33 percent).

Health system preparedness – or lack thereof – could spell trouble for the country’s COVID-19 response efforts. Without a comprehensive vaccination strategy in place, there could be long delays in vaccinating communities, especially those with vulnerable populations.

However, pharmacy leaders from leading health systems, including Bon Secours Mercy Health, University of Louisville Health, Henry Ford Health System, Northwell Health, and Riverside Health System told Premier that health system preparation hinges on a storage and distribution plan.

Health system leaders will need to accommodate extreme cold conditions since both of the leading COVID-19 vaccines require sub-zero temperatures – -70 degrees Celsius for the Pfizer-BioNTech vaccine and -20 degrees Celsius for the Moderna vaccine.

Since both vaccine candidates have proven to be 95 percent effective at preventing COVID-19, health systems should invest “in at least one large ultra-cold freezer in each of their markets/acute-care sites, as well as the creation of dry ice policies and procedures for storage compliance,” pharmacy leaders stated.

Systems should also have ancillary supplies, such as special gloves, to be able to remove the vaccine safely from such low temperatures, pharmacy leaders added.

Cross-departmental coordination will be especially critical to executing a strong storage and distribution plan. Supply chain, logistics, and leadership teams across acute and ambulatory sites will be needed to review challenges, select appropriate vaccination sites, and determine storage and transportation capabilities, the leaders explained.

Smart refrigerators that can track the location of contents, quantity, and temperature data of doses in real-time can also boost storage and distribution efforts.

Secondly, health system leaders need to address administration of the vaccines, according to pharmacy leaders.

While the healthcare industry awaits further guidance from CDC and other government agencies on proper COVID-19 vaccine administration, health system leaders should develop “detailed workflows” on vaccine administration scheduling based on guidelines in the CDC’s COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations, as well as those put forth by respective state health departments. Another pharmacy leader also stressed “the importance of staggered and pre-scheduled appointments for healthcare workers to receive the vaccine to avoid unsafe congregations or lines.”

Frontline workers, as well as the country’s most vulnerable patient populations, are the most likely to get a COVID-19 vaccine first. But health system leaders should still understand the needs of their patient populations and communities by developing risk scores and using data to decide on vaccine prioritization, the pharmacy leaders agreed.

Just-in-time reconstitution will also be key since vials will contain five COVID-19 vaccine doses that must be given within a six-hour window. Health system leaders will need to have an administration plan in place to minimize waste, they explained.

Finally, health system leaders will need to prepare COVID-19 vaccine documentation guidelines for effective reporting.

Documentation should be linked to the EHR system, pharmacy leaders agreed, and providers should be able to leverage automated technologies to ease reporting burdens. This may call for a complete review of health IT systems to ensure they can accommodate more robust reporting.

Additionally, the pharmacy leaders advised health system leaders to stress patient engagement and perhaps real-time appointment scheduling since the first approved COVID-19 vaccines will require at least two doses administered during different appointments.