Welcome to the Orange County COVID-19 Vaccine Taskforce

Planning for a COVID-19 Vaccine Orange County Health Care Agency Introductions & Opening Remarks

Dr. Clayton Chau HCA Director Task Force Group Members

Ellen Ahn, JD, MSW Candi Kern Philip Robinson, MD, FIDSA Executive Director President Medical Director of Infection Prevention and Hospital Epidemiology KC Services Fourth District PTA Hoag Hospital Lisa Armony Aaron Kheriaty, MD Jasjit Singh, MD President OC interfaith Network Director, Medical Ethics Program Pediatric Infectious Disease, CHOC Director Community Relations Jewish Federation OC UCI Health, Psychiatry & Human Behavior Chair, HCA Vaccine Coalition UCI School of Medicine Isabel Becerra Ann Light, MD Michelle Steele Chief Executive Officer Medical Director Chairwoman OC Coalition of Community Clinics Orange County Social Services Agency OC Board of Supervisors Margaret Bredehoft, Ph.D. Adam Loeser Sora Park Tanjasiri, DrPH, MPH Deputy Agency Director, Public Health Services Fire Chief Department of Epidemiology Orange County Health Care Agency City of Brea University of California, Irvine Clayton Chau, M.D., Ph.D Olivia Longhetto Lisa Wright Jenkins Director Student Health and Wellness Commissioner President & CEO Orange County Health Care Agency University of California, Irvine Council on Aging – Southern California Dan Cooper, MD Al Mija​res, Ph.D. Rebecca Yee Associate Vice Chancellor for Clinical and Translational Research County Superintendent of Schools Ensign Services University of California, Irvine OC Board of Education Jason Cord, MD Mario Ortega Matt Zahn, MD President Elect Chief Operating Officer Medical Director of the Division of Epidemiology and Assessment Orange County Medical Association Abrazar Incorporated Orange County Health Care Agency Joy Anne Fumera Jeff Pagano OCHCA Staff Support: Critical Care Nurse Convener Program Manager • Deb Diaz De Leon, Manager, Office of Project Management and Quality OC Veterans & Military Families Collaborative Improvement • Casey Dorman, Special Projects, Director’s Office Office of the Vice Chancellor, Student Affairs • Jessica Good, Public Information Manager Laura Gomez Karen Pavic-Zabinski, PhD RN, MSN, MBA, MA, MS • Karin Kalk, Director of Office Project Management and Quality Improvement Teacher Regional Director Of Ethics • Tammi McConnell, Division Manager, Emergency Medical Services Santa Ana Unified School District Providence St. Joseph Health Southern California • Jenny Qian, Chief, Special Projects and Strategy • Chi Rajalingam, Chief Compliance Officer Stu Greenberg David Ramirez, M.D. • Rachel Selleck, Assistant to the Director OCHCA Chief of Police Chief Medical Officer Tustin Police Department CalOptima Agenda

4:00 PM Introductions & Opening Remarks 4:10 PM Importance of the COVID-19 Vaccine (Matthew Zahn, MD) 4:25 PM Purpose of the Vaccine Task Force Tasks Of the Task Force Attitudes about Vaccination Prioritization of Vaccination Role of the Task Force 5:00 PM Next Steps Communication Tools and Expectations Questions & Open Discussion 5:30 PM Meeting Concluded The Role of Vaccine in Responding to the COVID-19 Pandemic Matt Zahn, MD Medical Director Communicable Disease Control Division Orange County Health Care Agency

Case Investigation and Contact Tracing

• OCHCA can trace about 1000 cases a day • Currently OCHCA is attempting to contact all COVID-19 cases • OCHCA reaches out to a confirmed case 24-48 hours after we receive the lab report But: • Lag time from illness starting to testing to public health follow up • 33% of cases are not reached by OCHCA • CDC estimates that only about 10% of cases are confirmed by testing In Certain Situations, Is Not Possible: • Healthcare facilities • Inpatient care where patients may be most infectious but PPE generally is available • Outpatient settings where patients will still be infectious but PPE is often not available • Restaurants • Food manufacturing plants • Mass transit • Schools • Skilled nursing facilities • Family members • Staff We Are Nowhere Near “Herd Immunity” in Orange County • OC’s community prevalence of immunity is estimated to be 10-15% • For some communities, immunity rates will be much lower COVID-19-Related Deaths in Orange County by Age COVID-19 Related Deaths in Orange County by Race/Ethnicity What Will COVID-19 Epidemiology Look Like Long Term? • At this point, COVID-19 reinfection is rare but has been identified • Multiple human coronavirus strains circulate regularly in the community, generally cause common cold symptoms • HCoV-OC43, HCoV-HKU1, HCoV-229E, HCoV-NL63 • Infection with other coronaviruses confers protection for years but not lifelong Travel Will Pose an Ongoing Risk

• As long as the virus is present anywhere in the world, international travel may reintroduce it here COVID-19 Vaccine Will Not Be Intended for Outbreak Control • Initial focus will be on community groups that have had persistently higher disease burden • Skilled nursing facilities • Essential workers • The elderly and persons with underlying medical conditions • Not directed to work sites, schools, etc, where outbreaks occur • Vaccine will be used to protected everyone Purpose of Vaccine Taskforce

What is the COVID-19 Vaccine Taskforce? (“What have I got myself into?”)

GOAL: Getting to 100% Eligible and Priority Groups Vaccinated The Tasks of the Taskforce

1. Be a source of input from the community on attitudes and questions about Orange County’s COVID-19 vaccination program 2. Provide recommendations on prioritizing who gets vaccinated first when not everyone can be vaccinated 3. Help understand community attitudes toward vaccination and develop and implement strategies for encouraging people to be vaccinated 4. Explain vaccine program decisions to the community Understanding Attitudes about Vaccination in Different Segments of the Community

1. Listen to Community Representatives from Various OC Communities

2. Survey Attitudes Toward Vaccination Across OC Communities

• Confidence: trust in the effectiveness and safety of vaccines, trust in healthcare system • Complacency: vaccination is not deemed a necessary preventive action • Constraints: physical availability, affordability, geographical accessibility, language barriers • Calculation: engagement in extensive information searching • Collective responsibility: the willingness to protect others by one’s own vaccination Current Volume on Survey Results

As of Oct 7, 2020 = 6,727 Arabic 6

Farsi 10

Chinese 37

Vietnamese 43

Spanish 48

Korean 69

Khmer 79 English 6,435 What Kind Of Message Do We Deliver To Whom And How Do We Deliver It?

National Academy of Science, Engineering and Medicine

“Communication and community engagement are essential to the COVID-19 vaccination strategies. Those communications must be (1) consistent with the evidence; (2) consistent with one another; (3) responsive to public needs; (4) tested for comprehension by members of target audiences; and (5) delivered by trusted sources through effective channels.”

In Other Words

What Do We Say And How Do We Say It?

Who Are the Best Source For Delivering The Messages and How Should They Be Delivered? Prioritizing Who Gets Vaccinated

1. The vaccine will be distributed in successive phases

2. CDC and CDPH will provide prioritization guidelines, which will have an unknown degree room for local input and modification

3. Each phase will reach a wider section of the population until everyone is vaccinated The Phased Approach to Vaccine Rollout How Do We Choose Priority Groups During Early Phases?

1. CDC will designate broad priority groups (probably these are fixed and well- defined for first phase 1a).

2. CDC designations might produce groups that exceed our supply of vaccine

3. We may need to subdivide CDC designations

4. CDC may leave some decisions to local health department (unique needs)

5. It’s important that health professionals partner with the community on decisions related to vaccination A Framework For Making Prioritization Decisions

Allocation Framework: Population Group by Risk What is the role of the taskforce in the overall vaccination planning structure for Orange County?

HCA COVID-19 Steering Committee

Logistics Communications Sub Task Force Procurement / Technology / Data Committee Administration

Community Community Community Sub Group Sub Group Sub Group

Orange County Community Members Next Steps

Future Taskforce meetings will address:

Ethical issues involved in allocating a limited vaccine Evidence on risk factors for different population groups Prioritization Addressing inequities

Recommendations to Health Care Agency

Taskforce contacts with communities Gathering information Addressing Vaccine Survey of vaccine hesitancy Media Hesitancy Communication Face-to-face Devising strategies Context of vaccine delivery

Explaining vaccine For information allocation and distribution decisions To counter misinformation Communication Tools

Task Force Communication- • What information would you like sent to you? • When you have questions email Deb [email protected]

Community Communication- • HCA COVID-19 Website • Your names / Organization • Email address [email protected]

Who should we work with to communicate to your stakeholders? Chat in or send email to [email protected] What questions do you want answered in future meetings? Thank you!