INTERIM DRAFT NORTH DAKOTA COVID-19 VACCINATION PLAN Updated December 11, 2020 Version 2.0 1 Significant changes from previous version: • Information regarding ancillary supplies provided by federal government • Additional tabletop exercises and other exercises • Updated information regarding the data use agreement with CDC • Tribal sovereignty to determine priority groups • Redistribution guidance • Vaccine finder inventory reporting • Revised phases for vaccination based on ACIP meetings • Long term care federal pharmacy partnership program • Updated tribal preferences for federal or state allocations • Federal pharmacies for Phase 2 • Updated ultra-cold freezer capacity • Revised assumptions for vaccines A and B • Federal government hold of second doses 2 Contents Significant changes from previous version: ......................................................................................... 2 Acronyms ......................................................................................................................................................... 7 Introduction .................................................................................................................................................... 8 Lessons Learned from H1N1 ................................................................................................................ 9 Response Goals for Pandemic Vaccination ................................................................................... 11 COVID-19 Vaccination Planning Assumptions ............................................................................ 12 Logistical Assumptions ......................................................................................................................... 13 Organizational Structure and Partner Involvement ................................................................... 14 Unified Command Planning Team ............................................................................................... 15 Internal COVID-19 Vaccination Planning Team ...................................................................... 15 Internal/External COVID-19 Vaccination Planning Committee ......................................... 15 CDC/HHS Microplanning ................................................................................................................ 15 Tabletop Exercises ............................................................................................................................. 16 Current Unknowns and Contingency Planning ........................................................................... 16 How persons who have tested positive for COVID-19 will be prioritized. .................... 16 Type of vaccine that will be available and cold chain requirements of vaccines. ....... 16 Potential adverse effects of a vaccine. ....................................................................................... 17 Vaccine amounts. ............................................................................................................................... 17 Vaccine Timing. ................................................................................................................................... 17 Use of adjuvant. .................................................................................................................................. 18 Multiple FDA approved products with different specifications. ....................................... 18 Packaging. ............................................................................................................................................. 18 Current Gaps ............................................................................................................................................ 19 Provider Recruitment and Enrollment ................................................................................................. 20 Potential Providers ................................................................................................................................. 23 Vaccine Administration Capacity ...................................................................................................... 24 3 Vaccination of Out-of-State Residents ................................................................................................ 25 Vaccine Prioritization and Critical Populations ................................................................................. 26 Critical infrastructure workforce ........................................................................................................ 26 People at increased risk for severe COVID-19 illness ................................................................ 26 People at increased risk of acquiring or transmitting COVID-19 .......................................... 26 People with limited access to routine vaccination services .................................................... 27 Estimates of Priority Groups ............................................................................................................... 27 Vaccination of Special and Dependent Populations.................................................................. 30 Homebound ......................................................................................................................................... 30 Long Term Cares ................................................................................................................................ 30 Custodial institutions and special populations ....................................................................... 33 American Indians ................................................................................................................................ 34 New Americans/Foreign Born/Immigrant Populations ........................................................ 35 Priority Vaccination of Infrastructure .............................................................................................. 36 Advisory Committee on COVID-19 Vaccination Ethics ............................................................. 37 Vaccine Allocation....................................................................................................................................... 37 Vaccine Ordering and Processing ......................................................................................................... 39 Physical Vaccine Management and Cold Chain ............................................................................... 39 Management of Priority Vaccine Unstable at Zero Degrees or Higher .............................. 39 Vaccine A: ....................................................................................................................................................... 39 Vaccine B: ....................................................................................................................................................... 40 Models for Distribution of Ultra-Cold Vaccine (Vaccine A) ................................................ 40 Three Phase Distribution .......................................................................................................................... 41 Scenarios for Vaccine Distribution ........................................................................................................ 44 Scenario 1 Background ......................................................................................................................... 45 Vaccine A: Ultra-cold with minimum quantity of 975 doses only .................................... 45 Phase 2 General Population ........................................................................................................... 48 PHASE 3 Distribution with Reduced Uptake ............................................................................ 48 4 Scenario 2 .................................................................................................................................................. 48 Vaccine B: Frozen vaccine only with minimum quantity of 100 doses ........................... 48 Scenario 3 .................................................................................................................................................. 49 Assumptions: ....................................................................................................................................... 49 Distribution: .......................................................................................................................................... 50 State Vaccine Storage ................................................................................................................................ 50 Local Vaccine Storage ............................................................................................................................... 52 State Warehouse Vaccine Processing .................................................................................................. 53 Vaccine Administration Fees ................................................................................................................... 55 Vaccine Program Communication ........................................................................................................ 56 Public ..........................................................................................................................................................