COVID VACCINE PRESENTATION DRAFT 11-221.PPTX
Extracted text (via pymupdf)
25815 characters
WeArePublicHealth.org twitter.com/Maricopahealth facebook.com/MCDPH Effective COVID-19 General Update & Interventions: The Data Marcy Flanagan, DBA, MPH, MA Executive Director COVID-19 cases increasing exponentially with anticipated peak far greater than July Epi Curve COVID hospitalizations at same level as June 21st when masks required in MC ASU & U of A Modeling Predict Healthcare Capacity Exceeded by Late December ASU & U of A Modeling Predict Additional Deaths ASU modeling: Without additional public health measures, holiday gatherings are likely to cause 600-1,200 additional deaths from COVID-19 in Arizona by February 1 beyond current scenario death projections Worldwide Data Set of Interventions Ranked in order of Effectiveness •Complexity Science Hub in Vienna classified 6,068 interventions from 56 countries using 4 methods Mar-April 2020 •Ranked them in order based on the effectiveness of the measure at reducing transmission in all 4 methods •Provided an analysis of similar strategies lumped together, e.g. all educational settings closed •Made a public data set available to drill down to specific measures http://covid19-interventions.com/CCCSLgraph/ Rankings with most effective first Highlights § #1 Cancellation of small gatherings § #2 Closing ALL educational institutions § #4 Increase availability of PPE § Contact tracing and tracking was #28 § Isolation of cases was #33 § Enhanced testing capacity is 2nd to last (completely ineffective by all methods) Interventions ranked based on 4 methods 12/4/2020 8 Haug, N., Geyrhofer, L., Londei, A. et al. Ranking the effectiveness of worldwide COVID-19 government interventions. Nat Hum Behav (2020). https://doi.org/10.1038/s41562-020-01009-0 What is "Cancellation of Small Gatherings?" • Limiting gatherings from 1 – 50 people • Reduce close physical contact in work places • Mandatory 2m distance in public • Mandatory “home-office” • Closure of restaurants, bars and cafes • Closure of non-essential shops NYC Health Department Study Identifies Household Contact & Gatherings > 10 as Major Factors In Virus Transmission • The New York City Department of Health conducted a large- scale study of New Yorkers over a 4 month span • More than 3,600 people (1200 infected cases) – Household contacts were 4X as likely to be cases – Those who attended a gathering > 10 people were twice as likely to be infected • More evidence of the importance of limiting gatherings and separating ill from well in households https://gothamist.com/news/nyc-health-department-study-identifies-household-contact-and-gatherings-10-or-more- major-factors-virus-transmission Data from Network Models • Data obtained on movement from nearly 1 million persons in 10 large US metro areas (none in Maricopa County) • Looked at 500,000 “places of interest” • Found that the highest risk was with people moving around to more densely crowded places • A small minority of “superspreader” places account for a large majority of infections Mobility network models of COVID-19 explain inequities and inform reopening https://www.nature.com/articles/s41586-020- 2923-3 Full-Service Restaurants Highest Risk Restaurant Capacity • Found that reduction of restaurant capacity reduced risk without reducing mobility • Chicago reduced max capacity to 20% which cut down new infections by 80% but only reduced 42% of overall visits • Similar trends across other metro areas- evidence that decreased restaurant capacity (enforced) works Mobility network models of COVID-19 explain inequities and inform reopening https://www.nature.com/articles/s41586-020- 2923-3 Lower SES have higher risk of infection • Study found that disadvantaged groups have not been able to reduce mobility as sharply due to work and residence • Second study in Nature reported similar conclusions • Reducing restaurant capacity decreases risk for both patrons and restaurant workers and allows people to keep working https://www.nature.com/articles/s41562-020-00998-2 Masks - how effective are they? • They keep droplets from spreading to others: source control – Cloth masks effectively block most large droplets & the exhalation of fine droplets (aerosols) that increase with speech – Multi-layer cloth masks block up to 50-70% of fine droplets and limit spread of those not captured • Multiple layers of cloth with higher thread counts can filter nearly 50% of fine particles and protect the wearer • Seven studies have confirmed the benefit of universal masking in community level analyses including Arizona Trends in COVID-19 Incidence After Implementation of Mitigation Measures - Arizona, January 22-August 7, 2020 Masks Decrease Cases and Deaths in US § Moghadas SM, Fitzpatrick MC, Sah P, et al. The implications of silent transmission for the control of COVID-19 outbreaks. Proc Natl Acad Sci U S A. 2020;117(30):17513-17515.10.1073/pnas.2008373117. https://www.ncbi.nlm.nih.gov/pubmed/32632012external icon. § Johansson MA, Quandelacy TM, Kada S, et al. Controlling COVID-19 requires preventing SARS-CoV-2 transmission from people without symptoms. submitted. 2020. § Lindsley WG, Blachere FM, Law BF, Beezhold DH, Noti JD. Efficacy of face masks, neck gaiters and face shields for reducing the expulsion of simulated cough -generated aerosols. medRxiv. 2020. https://doi.org/10.1101/2020.10.05.20207241external icon. § Fischer EP, Fischer MC, Grass D, Henrion I, Warren WS, Westman E. Low-cost measurement of face mask efficacy for filtering expelled droplets during speech. Sci Adv. 2020;6(36).10.1126/sciadv.abd3083. https://www.ncbi.nlm.nih.gov/pubmed/32917603external icon. § Verma S, Dhanak M, Frankenfield J. Visualizing the effectiveness of face masks in obstructing respiratory jets. Phys Fluids (1994). 2020;32(6):061708.10.1063/5.0016018. https://www.ncbi.nlm.nih.gov/pubmed/32624649external icon. § Bahl P, Bhattacharjee S, de Silva C, Chughtai AA, Doolan C, MacIntyre CR. Face coverings and mask to minimise droplet dispersion and aerosolisation: a video case study. Thorax. 2020;75(11):1024-1025.10.1136/thoraxjnl-2020-215748. https://www.ncbi.nlm.nih.gov/pubmed/32709611external icon. § Davies A, Thompson KA, Giri K, Kafatos G, Walker J, Bennett A. Testing the efficacy of homemade masks: would they protect in an influenza pandemic? Disaster Med Public Health Prep. 2013;7(4):413-418.10.1017/dmp.2013.43. https://www.ncbi.nlm.nih.gov/pubmed/24229526external icon. § Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nature Medicine. 2020;26(5):676- 680.https://dx.doi.org/10.1038/s41591-020-0843-2external icon. § Bandiera L., Pavar G., Pisetta G., et al. Face coverings and respiratory tract droplet dispersion. medRxiv. 2020.10.1101/2020.08.11.20145086. https://doi.org/10.1101/2020.08.11.20145086external icon. § Alsved M, Matamis A, Bohlin R, et al. Exhaled respiratory particles during singing and talking. Aerosol Sci Technol. 2020.10.1080/02786826.2020.1812502. § Asadi S, Wexler AS, Cappa CD, Barreda S, Bouvier NM, Ristenpart WD. Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep. 2019;9(1):2348.10.1038/s41598-019-38808-z. https://www.ncbi.nlm.nih.gov/pubmed/30787335external icon. § Morawska L., Johnson GR, Ristovski ZD, et al. Size distribution and sites of origin of droplets expelled from the human respiratory tract during expiratory activities. Aerosol Sci. 2009;40(3):256-269. https://www.sciencedirect.com/science/article/pii/S0021850208002036external icon. § Abkarian M, Mendez S, Xue N, Yang F, Stone HA. Speech can produce jet-like transport relevant to asymptomatic spreading of virus. Proc Natl Acad Sci U S A. 2020;117(41):25237-25245.10.1073/pnas.2012156117. https://www.ncbi.nlm.nih.gov/pubmed/32978297external icon. § Ueki H, Furusawa Y, Iwatsuki-Horimoto K, et al. Effectiveness of Face Masks in Preventing Airborne Transmission of SARS-CoV- 2. mSphere. 2020;5(5).10.1128/mSphere.00637-20. https://www.ncbi.nlm.nih.gov/pubmed/33087517external icon. § Rodriguez-Palacios A, Cominelli F, Basson AR, Pizarro TT, Ilic S. Textile Masks and Surface Covers-A Spray Simulation Method and a “Universal Droplet Reduction Model” Against Respiratory Pandemics. Front Med (Lausanne). 2020;7:260.10.3389/fmed.2020.00260. https://www.ncbi.nlm.nih.gov/pubmed/32574342external icon. § Viola I.M., Peterson B., Pisetta G., et al. Face coverings, aerosol dispersion and mitigation of virus transmission risk. 2020. https://arxiv.org/abs/2005.10720external icon. § Rengasamy S, Eimer B, Shaffer RE. Simple respiratory protection–evaluation of the filtration performance of cloth masks and common fabric materials against 20-1000 nm size particles. Ann Occup Hyg. 2010;54(7):789-798.10.1093/annhyg/meq044. https://www.ncbi.nlm.nih.gov/pubmed/20584862external icon. § Konda A, Prakash A, Moss GA, Schmoldt M, Grant GD, Guha S. Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks. ACS Nano. 2020;14(5):6339-6347.10.1021/acsnano.0c03252. https://www.ncbi.nlm.nih.gov/pubmed/32329337external icon. § Long KD, Woodburn EV, Berg IC, Chen V, Scott WS. Measurement of filtration efficiencies of healthcare and consumer materials using modified respirator fit tester setup. PLoS One. 2020;15(10):e0240499.10.1371/journal.pone.0240499. https://www.ncbi.nlm.nih.gov/pubmed/33048980external icon. § O’Kelly E, Pirog S, Ward J, Clarkson PJ. Ability of fabric face mask materials to filter ultrafine particles at coughing velocity. BMJ Open. 2020;10(9):e039424.10.1136/bmjopen-2020-039424. https://www.ncbi.nlm.nih.gov/pubmed/32963071external icon. § Aydin O, Emon B, Cheng S, Hong L, Chamorro LP, Saif MTA. Performance of fabrics for home-made masks against the spread of COVID-19 through droplets: A quantitative mechanistic study. Extreme Mech Lett. 2020;40:100924.10.1016/j.eml.2020.100924. https://www.ncbi.nlm.nih.gov/pubmed/32835043external icon. § Bhattacharjee S, Bahl P, Chughtai AA, MacIntyre CR. Last-resort strategies during mask shortages: optimal design features of cloth masks and decontamination of disposable masks during the COVID-19 pandemic. BMJ Open Respir Res. 2020;7(1).10.1136/bmjresp-2020- 000698. https://www.ncbi.nlm.nih.gov/pubmed/32913005external icon. § Maurer L, Peris D, Kerl J, Guenther F, Koehler D, Dellweg D. Community Masks During the SARS-CoV-2 Pandemic: Filtration Efficacy and Air Resistance. J Aerosol Med Pulm Drug Deliv. 2020.10.1089/jamp.2020.1635. https://www.ncbi.nlm.nih.gov/pubmed/32975460external icon. § Hill WC, Hull MS, MacCuspie RI. Testing of Commercial Masks and Respirators and Cotton Mask Insert Materials using SARS-CoV-2 Virion-Sized Particulates: Comparison of Ideal Aerosol Filtration Efficiency versus Fitted Filtration Efficiency. Nano Lett. 2020;20(10):7642- 7647.10.1021/acs.nanolett.0c03182. https://www.ncbi.nlm.nih.gov/pubmed/32986441external icon. § Whiley H, Keerthirathne TP, Nisar MA, White MAF, Ross KE. Viral Filtration Efficiency of Fabric Masks Compared with Surgical and N95 Masks. Pathogens. 2020;9(9).10.3390/pathogens9090762. https://www.ncbi.nlm.nih.gov/pubmed/32957638external icon. § Hao W, Parasch A, Williams S, et al. Filtration performances of non-medical materials as candidates for manufacturing facemasks and respirators. Int J Hyg Environ Health. 2020;229:113582.10.1016/j.ijheh.2020.113582. https://www.ncbi.nlm.nih.gov/pubmed/32917368external icon. § van der Sande M, Teunis P, Sabel R. Professional and home-made face masks reduce exposure to respiratory infections among the general population. PLoS One. 2008;3(7):e2618.10.1371/journal.pone.0002618. https://www.ncbi.nlm.nih.gov/pubmed/18612429external icon. § Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020.10.1016/S0140-6736(20)31142-9. https://doi.org/10.1016/S0140-6736(20)31142-9external icon. § Clase CM, Fu EL, Ashur A, et al. Forgotten Technology in the COVID-19 Pandemic: Filtration Properties of Cloth and Cloth Masks-A Narrative Review. Mayo Clin Proc. 2020;95(10):2204-2224.10.1016/j.mayocp.2020.07.020. https://www.ncbi.nlm.nih.gov/pubmed/33012350external icon. § Zhao M, Liao L, Xiao W, et al. Household Materials Selection for Homemade Cloth Face Coverings and Their Filtration Efficiency Enhancement with Triboelectric Charging. Nano Lett. 2020;20(7):5544-5552.10.1021/acs.nanolett.0c02211. https://www.ncbi.nlm.nih.gov/pubmed/32484683external icon. § Parlin AF, Stratton SM, Culley TM, Guerra PA. A laboratory-based study examining the properties of silk fabric to evaluate its potential as a protective barrier for personal protective equipment and as a functional material for face coverings during the COVID-19 pandemic. PLoS One. 2020;15(9):e0239531.10.1371/journal.pone.0239531. https://www.ncbi.nlm.nih.gov/pubmed/32946526external icon. § Hendrix MJ, Walde C, Findley K, Trotman R. Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After Exposure at a Hair Salon with a Universal Face Covering Policy – Springfield, Missouri, May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(28):930- 932.10.15585/mmwr.mm6928e2. https://www.ncbi.nlm.nih.gov/pubmed/32673300external icon. § Wang Y, Tian H, Zhang L, et al. Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Glob Health. 2020;5(5).10.1136/bmjgh-2020-002794. https://www.ncbi.nlm.nih.gov/pubmed/32467353external icon. § Doung-Ngern P, Suphanchaimat R, Panjangampatthana A, et al. Case-Control Study of Use of Personal Protective Measures and Risk for Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Thailand. Emerg Infect Dis. 2020;26(11).10.3201/eid2611.203003. https://www.ncbi.nlm.nih.gov/pubmed/32931726external icon. § Payne DC, Smith-Jeffcoat SE, Nowak G, et al. SARS-CoV-2 Infections and Serologic Responses from a Sample of U.S. Navy Service Members – USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):714- 721.10.15585/mmwr.mm6923e4. https://www.ncbi.nlm.nih.gov/pubmed/32525850external icon. § Schwartz KL, Murti M, Finkelstein M, et al. Lack of COVID-19 transmission on an international flight. Cmaj. 2020;192(15):E410.10.1503/cmaj.75015. https://www.ncbi.nlm.nih.gov/pubmed/32392504external icon. § Freedman DO, Wilder-Smith A. In-flight Transmission of SARS-CoV-2: a review of the attack rates and available data on the efficacy of face masks. J Travel Med. 2020.10.1093/jtm/taaa178. https://www.ncbi.nlm.nih.gov/pubmed/32975554external icon. § Wang X, Ferro EG, Zhou G, Hashimoto D, Bhatt DL. Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers. JAMA. 2020.10.1001/jama.2020.12897. https://www.ncbi.nlm.nih.gov/pubmed/32663246external icon. § Mitze T., Kosfeld R., Rode J., Wälde K. Face Masks Considerably Reduce COVID-19 Cases in Germany: A Synthetic Control Method Approach. IZA – Institute of Labor Economics (Germany);2020.ISSN: 2365-9793, DP No. 13319. http://ftp.iza.org/dp13319.pdfpdf iconexternal icon § Gallaway MS, Rigler J, Robinson S, et al. Trends in COVID-19 Incidence After Implementation of Mitigation Measures – Arizona, January 22-August 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1460-1463.10.15585/mmwr.mm6940e3. https://www.ncbi.nlm.nih.gov/pubmed/33031366external icon. § Lyu W, Wehby GL. Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Aff (Millwood). 2020;39(8):1419-1425.10.1377/hlthaff.2020.00818. https://www.ncbi.nlm.nih.gov/pubmed/32543923external icon. § Hatzius J, Struyven D, Rosenberg I. Face Masks and GDP. Goldman Sachs Research https://www.goldmansachs.com/insights/pages/face-masks-and- gdp.htmlexternal icon. Accessed July 8, 2020. § Karaivanov A., Lu S.E., Shigeoka H., Chen C., Pamplona S. Face Masks, Public Policies And Slowing The Spread Of Covid-19: Evidence from Canada National Bureau Of Economic Research 2020.Working Paper 27891. http://www.nber.org/papers/w27891external icon. § Chernozhukov V, Kasahara H, Schrimpf P. Causal Impact of Masks, Policies, Behavior on Early Covid-19 Pandemic in the U.S. medRxiv. 2020.10.1101/2020.05.27.20115139. http://medrxiv.org/content/early/2020/05/29/2020.05.27.20115139.abstractexternal icon. § Leffler CT, Ing EB, Lykins JD, Hogan MC, McKeown CA, Grzybowski A. Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks (updated August 4, 2020). medRxiv. 2020.10.1101/2020.05.22.20109231. http://medrxiv.org/content/early/2020/05/25/2020.05.22.20109231.abstractexternal icon. 45 Studies supporting use of masks in individuals, cities, states and countries https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html Evidence-based strategies to decrease COVID spread and minimize harm • Mask Mandate • Reduce indoor dining capacity to 20% maximum • Restrict gatherings of >25 persons – Encourage and support enforcement of local ordinances – Reassess previously approved gatherings (e.g. tournaments) – Post approved gatherings >25 on municipal websites for transparency • Stop group athletic activities, including club sports • Consider a curfew to limit non-essential gathering WeArePublicHealth.org twitter.com/Maricopahealth facebook.com/MCDPH COVID-19 Vaccination Plan Marcy Flanagan, DBA, MPH, MA Executive Director COVID-19 Vaccine Candidates • The CDC COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations has made planning assumptions based on the 2 leading vaccine candidates • Both vaccines are mRNA vaccines (messenger ribonucleic acid) – They do NOT contain the complete virus or the complete viral genome – They contain a segment of the viral genome that makes the recipient’s body generate an immune response as if it encountered the live virus – This results in the immune system creating antibodies to the virus without becoming infected first mRNA Vaccine mRNA vaccines are a new type of vaccine to protect against infectious diseases. To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, they teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies. Facts about COVID-19 mRNA Vaccines • They CANNOT give someone COVID-19. – MRNA vaccines do not use the live virus that causes COVID-19. • They DO NOT affect or interact with our DNA in any way. – MRNA never enters the nucleus of the cell, which is where our DNA (genetic material) is kept. – The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions. Vaccine Side Effects (Adverse Events) • Side effects are expected • When the body’s immune system mounts a response to a natural infection OR vaccination the result is local and/or systemic inflammation • Local inflammation: injection site soreness, redness, swelling • Systemic inflammation includes fever, muscle aches, headache • The stronger the immune response, the more prominent the side effects • The healthier the individual, the stronger the immune response COVID Vaccine 1st • Advisory Committee on Immunization Practices (ACIP) • Makes vaccine recommendation • Met on October 30th to decide their guidelines • Will make a recommendation after FDA reviews (can’t happen until a vaccine company applies) 2nd • CDC Director • Incorporates into the overall strategy 3rd • Arizona Vaccine and Antiviral Prioritization Advisory Committee (VAPAC) • Make recommendations to counties • Counties hold internal advisory committees (MCDPH held first one 10/30/20) Phased Approach to COVID-19 Vaccine How much? • Federal government will make allocation to state – All we know now is CDC is asking AZ to "exercise" based on a 200k dose state allocation – We know some will be taken off the top for pharmacies and tribes to immunize long term care facility staff • State will make allocation to County • State VAPAC group met on Thursday, Dec. 3rd • Slow spigot– assuming not enough at first • Phased approach based on CDC playbook PHASE 3 PHASE 2 PHASE 1b & 1c PHASE 1a Healthcare personnel* EMS Long-term care, assisted living, and skilled nursing facility staff & residents Population: ~123-300K Population: ~1M Population: ~2M General population Healthcare Not in 1a Law Enforce- ment Teachers Essential Workers Critical workers Childcare workers High-risk >65 y/o General population- priority Adults in congregate settings Dec '20-early 2021 Early '21-Spring '21 Spring '21-Summer '21 Summer '21- beyond Phase 1A COVID-19 Vaccine • Phase 1A Healthcare: – Paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials and unable to telework – Estimate varies based on local definition of who is most at risk – Initial focus is on 123,000 – Unlikely we will have enough for 123,000 – Prioritized based on risk of infection – Counties/tribes will decide sub-prioritization (MC-VPAC) Healthcare Support Functions* 200,000' Healthcare at Risk 100,000 LTC CMS Staff 10,000 EMS 20,000 Public Health 600 Phase 1A COVID-19 Vaccine Target Populations 330,600 total healthcare workers in Phase 1A Residents in LTC, SNF, AL 100,000 Planning for 1A Distribution • Vaccine availability – Vaccine A (Pfizer) is the only one available – We won’t have enough vaccine and will need to sub-tier prioritize – Minimum order is 1,000 – Must be stored at -70°C – Requires mixing of diluent prior to administration – Fragile vaccine • General Assumptions – Vaccine will be provided free of charge – Insurance can be billed an administrative fee – Vaccine will not be mandatory Planning for 1A Distribution • Smaller sites do not have the ability to vaccinate 1,000 people • Traditional vaccine distribution will not work for Vaccine A • Each site must complete the Provider On Boarding Tool with ADHS • Doses must be reported to the Arizona Immunization System within 24 hours • Pooling resources and partnering with hospitals to maximize planning Vaccine Management System • MCDPH historically has not had a technical solution to quickly provide vaccine data to ADHS • Nov 20 - ADHS has procured a vaccine management system for the state – Will contain a way to pre-register HCW and prioritize them – Will include a process to call/text people back for second dose – Will automatically upload data to ASIIS for reporting and call- back • We are now working with the state to try and get this system operational for 2 sites by Dec 11; the other 3 sites will use the hospital’s existing registration systems due to billing Early Planning § Regional planning committee for each site – Hospital, city emergency management, County Public Health, County Emergency Mgmt, EMS and tribal representatives § 7-18 days – first dose § Ultra-cold storage on site § Registration system to meet necessary eligibility, screening, consent and documentation requirements § All eligible healthcare must go to one of the 5 POD sites § MCDPH will NOT allocate to providers during this time Phase 1A Regional PODs Regional Locations Banner Del Web Abrazo West Arizona Fairgrounds NSSC - Honor Health Corporate Chandler-Gilbert Comm .College Staffing • HealthCare Staff • Hospital Volunteers • EMS • Public Health Volunteers – Medical Reserve Corps – Nursing Schools – ARMA, MCMS, AZ Nursing Association With current COVID numbers, made official request to state for National Guard for additional staffing support – orders set to expire Dec 31. Awaiting FEMA re-declaration of emergency Screening Process All healthcare workers are pre-screened through Maricopa County system Maricopa County identifies vaccine participants based on amount of vaccine available and risk factors E-mail sent to invite healthcare workers to sign up for an appointment Phase 1B & 1C Distribution Plan • Hybrid distribution strategy – Potentially utilize 1 or more POD’s, contracted vendors and traditional vaccine allocation system • Public Health begins allocating to providers who have completed the state/federal onboarding tool • Large companies (e.g. APS and SRP) with contracted closed PODs can receive vaccine and vaccinate their employees • Pharmacies will likely play a larger role in vaccination Phase 2 – Spring 2021 Traditional Vaccine Model • All those remaining in Phases 1A and 1B • General population • Regional PODs will no longer be necessary • Local providers, FQHC’s pharmacies and healthcare systems will vaccinate the remainder of the population who wants to be vaccinated Communicating this to partners • Weekly vaccine task force meetings since September • MC-VPAC meetings - Oct. 30 and Dec. 3 • Fire Chief’s briefing – Nov. 2 • Law Enforcement Briefing – Nov. 23 • POD planning meetings 2-3 times per week • Weekly Healthcare webinar since Feb. • Weekly Municipal webinar since Feb • Meetings per partner request - City of Phoenix MAC, various Emergency Managers meetings Next Steps • Support mitigation efforts that are in place to help slow spread and prevent overwhelming our healthcare system • Present our vaccine distribution plan details with local jurisdictions • Start to operationalize the COVID-19 vaccine distribution plan as vaccine becomes available in Arizona