December 23, 2020

DHS Secretary COVID-19 Vaccine Update

I hope you all are staying well and having a good week. Please see the following updates regarding COVID-19 vaccinations.

Moderna Approval

On Friday, the Food and Drug Administration granted an emergency use authorization for Moderna’s COVID-19 vaccine. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommended its use for people ages 18 or older soon after and on Sunday, the CDC accepted this recommendation. The Moderna vaccine joins the Pfizer-BioNTech vaccine (which is approved for people ages 16 and older) as the two approved vaccinations for COVID-19. 

Interim Vaccination Plan

Pennsylvania continues to make progress on vaccination based on Phase 1A of Pennsylvania’s COVID-19 Interim Vaccination Plan, which is available in its current form here. This plan is being revised as additional recommendations are issued by ACIP, and we will keep you informed as the updates are published. 

Phase 1A Distribution

Supply of both the Pfizer and Moderna vaccines are being distributed as they become available for health care personnel and long-term care facilities as defined by Phase 1A. We do not know exactly how much we will receive until supplies are in our possession. Information on vaccine delivery is being made available by the Department of Health here. On December 28, skilled nursing facilities in Pennsylvania will begin vaccination through the Federal Pharmacy Partnership Program – teams from CVS and Walgreens will coordinate directly with nursing homes to schedule onsite vaccination of staff and residents.

Phase 1A is primarily two groups: health care personnel and long-term care residents. This includes:

  • Health care personnel: Physicians, nurses, nursing assistants, technicians, therapists, phlebotomists, emergency medical service personnel, direct support professionals (in-home and community-based services and adult day facilities), staff of long-term care facilities that have residents prioritized in 1A, pharmacists, clinical personnel in school-settings or correctional facilities, contractual staff working in but not employed by the health care facility, and people who are not involved in patient care who could be exposed to COVID-19 like dietary, environmental services, laundry, security, maintenance, facilities management, and other administrative staff as defined in the Interim Vaccination Plan. 
  • Long-term care facility residents: Residents of skilled nursing facilities, personal care homes, assisted living facilities, intermediate care facilities for individuals with intellectual or developmental disabilities, community group homes, residential treatment facilities for adults, long-term structured residences, state veterans’ homes, state centers, private psychiatric hospitals, and state psychiatric hospitals. 

Pennsylvania’s Interim Vaccination Plan was drafted in line with ACIP’s recommendations, which are guided by four ethical principles:

  • Maximizing benefits and minimizing harm;
  • Promoting justice;
  • Mitigating health inequities; and,
  • Promoting transparency. 

We are committed to continuing to model these values throughout our work moving forward.

Pennsylvania’s approach for Phase 1A will help redress some of the socioeconomic and racial inequities brought about the pandemic that disproportionately affect the communities of color. While racial and ethnic minorities tend to be underrepresented as clinicians, they are overrepresented as lower wage health care personnel. By including a broad definition of health care personnel, racial and ethnic minorities in forward-facing roles who would otherwise not be prioritized if there was solely a focus on clinicians are incorporated. Additionally, because COVID-19 facing health care personnel who have certain preexisting health conditions are being prioritized within Phase 1A, and racial and ethnic minorities tend to have a higher prevalence of many of these conditions, this approach further mitigates inequities.

Phase 1A Sub-Prioritization

Initial vaccine stock will not be enough to cover all included in Phase 1A. On December 1, 2020, ACIP recommended that health care personnel and residents of long-term care facilities be offered a COVID-19 vaccine in the initial phase of the vaccination program. In order to allocate resources among groups identified in Phase 1A, sub-prioritization was identified within this broader group to allocate resources as they are received. 

Among health care personnel, individuals working in COVID-19 facing units including emergency departments, intensive care units, inpatient medical and surgical wards, EMS units, respiratory care facilities, and urgent care clinics should be prioritized due to frequency of interaction with individuals with COVID-19. If there is need for further prioritization among these health care personnel, individuals who are age 65 or older or have underlying conditions that increase risk for a severe COVID-19 infection should receive priority. Vaccination of health care personnel most at risk of contracting COVID-19 is a reinforcement of our overall health care system – protecting both frontline workers, mitigating further risk for patients in their care, and preserving this critical infrastructure.

Among long-term care facilities, skilled nursing facilities will receive initial vaccine allocation through the Pharmacy Partnership Program for Long-Term Care. While congregate, long-term care settings have been challenged by this pandemic, residents of nursing homes have had the highest rates of infections and deaths nationwide. Prioritizing residents of nursing facilities gives us the best chance of saving as many lives as possible. Further sub-prioritization of facility types will take a similar, data-driven approach.

The vaccination process will take time, and there will be changes, updates, and news as we make progress. For example, the Department of Health is currently reviewing the most recent update from the ACIP and will be making edits to the COVID-19 Interim Vaccination Plan in the near future. As you have questions, I encourage you to consult the CDC’s FAQs and the Department of Health’s FAQs and additional resources, which are being updated regularly. We will continue to keep you informed, but we appreciate patience as supply is received and new guidance is issued. As we move through this process, the most important thing we can all do is remember our collective responsibility to protect ourselves and our neighbors. Please continue to wear a mask, physical distance, and stay home whenever possible in line with public health recommendations.

Thank you, as always, for your support and partnership. I hope you all have a safe and restful holiday.

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