From:
French, Rick
Sent: 1/19/2021 11:01:17 AM
To:
Whisnant, Leeanne <lwhisnant@alexandercountync.gov>
Subject:

FW: NC Vaccine Updates, and Next Week's Allocation


Hey Leeanne, just wondering why we are not providing vaccines at the Senior Center today? Thought that was the plan, there is help through WebEOC if it’s needed. Maybe I missed something. Thanks, Rick

 

From: Gawande, Hattie <Hattie.Gawande@dhhs.nc.gov>
Sent: Friday, January 15, 2021 10:28 PM
Subject: Fw: NC Vaccine Updates, and Next Week's Allocation

 

Dear County Managers,

 

An email was sent out to local health departments and vaccine providers with their allocations tonight. I wanted to pass it along because it contains lot of helpful information about how to expend vaccine, what supports are available to your health departments and other vaccine providers, and the targets we need to hit as a state to meet the federal government's expectations.

 

In particular, I want to raise up the "lessons learned" our Operations Lead, Kody Kinsley, shared in his email:

 

From many of you, and your feedback, I have learned several things that I wanted to share that will help us meet our goals:

  • Remember that many of your community partners stand ready to assist. If you have vaccine on your shelves, please reach out and offer to transfer vaccine. Transfers can happen with both Moderna and Pfizer vaccines.  Transferring is a way you can “run-out” each week.  You can request transfers using ServiceNow
  • You are able to utilize vaccine in off-site locations for vaccination events, as long as the vaccine is not stored in that site overnight. 
  • Based on the federal allocation timelinethe “Vaccine Week” is a Wednesday-Tuesday week.  You may consider operating clinics in such a way, that you run out on Monday, where Tuesday can be your un-scheduled day to exhaust doses from no-shows and extra doses on individuals that you called the night before from your waiting list.
  • You should take all measures to minimize any buffer in vaccine. A few days of vaccine-on-hand, really adds up across the state.  Don’t stock-pile vaccine for large events down the road, work with us to plan them and the allocation accordingly.  You may consider conducting all your clinics between Thursday and Monday, to avoid the Tuesday and Wednesday shipment days. 
  • We recognize that there has not been significant projections of vaccine, and each of you continue to adapt operations in the midst of many changes.  Thank you.  We are fervently advocating to the federal government for more stability and advance notice.
  • Per CDC requirements, vaccine providers should administer vaccine to all who meet current eligibility criteria regardless of county of residence. The vaccines are paid for by the federal government and jurisdictions cannot restrict who they will vaccinate. You can target your marketing efforts to those in your county/service area – but cannot limit appointments to those only in your county/service area.
  • There are staffing resources available to assist for both clinical and clerical needs– please submit those requests through your county emergency managers into the WebEOC system. 
  • Also, we have stood up a centralized data-entry team for those that are behind on entering their vaccination records.  Please enter requests for that support in the WebEOC system as well.
  • The CVMS system is the official system of record.  If the vaccine is not entered – then it doesn’t count – and we are at risk of being docked by the federal government.  As such, we must use that system to make allocations each week.
  • As we monitor utilization rates closely, we have a team of staff actively reaching out to providers across the state, eager to provide additional support and assist you in breaking down barriers. Let us know what you need.

 

Please reach out if you have questions. Thank you for all you're doing.

 

Hattie Gawande

Deputy Director of Government Affairs

NC Department of Health and Human Services

 

Hattie.Gawande@dhhs.nc.gov

Cell: 919-906-1899

 

Help protect your family and neighbors from COVID-19. 

Know the 3 Ws. Wear. Wait. Wash.

#StayStrongNC and get the latest at nc.gov/covid19.

 


From: Kinsley, Kody <kody.kinsley@dhhs.nc.gov>
Sent: Friday, January 15, 2021 9:51 PM
Subject: NC Vaccine Updates, and Next Week's Allocation

 

Good evening,

 

Amanda is out of the office and without access to email until Wednesday. Below you will find contacts to use in her absence. As a default, you should not hesitate to reach to me as needed. 

 

As Operations Lead for our DHHS COVID-19 response, I wanted to provide you with final allocations for the week of 1-18-21, and also provide some key updates about our vaccine efforts in North Carolina.  First and foremost, thank you for your critical partnership as we move rapidly toward our shared goal of making sure the vaccine we receive and already have in the state gets into arms as quickly, efficiently and equitably as possible!  Our entire team is dedicated to assisting you in in using all the vaccine we have in North Carolina, including this shipment, by the 25th of January.  Then, we must be in a position to exhaust our entire shipments of first and second doses, each and every week.  It is a dauting task.  But we are up for it.

 

This week … and your work …  has been inspiring. In the past 7 days – we have vaccinated 137,945 residents.  That is up from 69,019 during the prior week – an increase of 100%.  And while that growth spurt is impressive, we have to keep pushing.  We need to triple our rate of vaccinations, and do so immediately.  As you know, our weekly allocations have been averaging ~120,000 first doses per week.  At our current stride, we are still behind on using up our entire first dose and planned second dose… therefore our backlog continues to grow. As of today, we have nearly 470,000 first and second doses available and have used just over 42% of our total allocation from the federal government.  As has been reported widely, and addressed in the preliminary allocation email below, the federal government has indicated that they will begin to penalize states behind on their administration rates as of the week of the 25th.  If – together – we don’t exhaust all our vaccine by then, then we will be at risk of losing this precious, life-saving, resource.

 

This could not be more serious.

 

I recognize, and deeply empathize, that standing up a complex operation so quickly, after a year of such challenging work, while things have changed so rapidly, and within such operational constraints – is daunting.  Yet, I know – and have seen countless times in just these past few days—that the best of the best is possible when North Carolinians come together.  I have seen:

 

  • Local health departments lead the convening of hospitals (and vice-versa), community volunteers, private companies, and local schools to stand up vaccination clinics overnight.
  • Volunteers work round the clock to schedule appointments, stretch hours of clinics well into the late night and early mornings, and provide free transportation to increase access to historically marginalized community members.
  • The thoughtful partnership to build trust and deliver intentionally designed and located events in service to marginalized and underserved communities.   
  • Voluntary transfers of vaccine from one organization to another, that in other situations, could considered a “competitor” – just so the vaccine is used rapidly.
  • Shared coordination across all types of providers and regions to ensure we are creatively launching the best ideas, learning from what works, and standing on the shoulders of one another.

 

I realize what I write of is your daily life – your bread and butter – the passion that drives you to your work to heal and to serve.  Thank you.  Truly. 

 

And in that, I find great hope.  And that while the stakes could not be higher, we are meant for the task.  As they say . . . where the weak grow strong, and the strong grow great.

 

From many of you, and your feedback, I have learned several things that I wanted to share, that will help us meet our goals:

 

  • Remember that many of your community partners stand ready to assist. If you have vaccine on your shelves, please reach out and offer to transfer vaccine. Transfers can happen with both Moderna and Pfizer vaccines.  Transferring is a way you can “run-out” each week.  You can request transfers using ServiceNow
  • You are able to utilize vaccine in off-site locations for vaccination events, as long as the vaccine is not stored in that site overnight. 
  • Based on the federal allocation timeline, the “Vaccine Week” is a Wednesday-Tuesday week.  You may consider operating clinics in such a way, that you run out on Monday, where Tuesday can be your un-scheduled day to exhaust doses from no-shows and extra doses on individuals that you called the night before from your waiting list.
  • You should take all measures to minimize any buffer in vaccine. A few days of vaccine-on-hand, really adds up across the state.  Don’t stock-pile vaccine for large events down the road, work with us to plan them and the allocation accordingly.  You may consider conducting all your clinics between Thursday and Monday, to avoid the Tuesday and Wednesday shipment days. 
  • We recognize that there has not been significant projections of vaccine, and each of you continue to adapt operations in the midst of many changes.  Thank you.  We are fervently advocating to the federal government for more stability and advance notice.
  • Per CDC requirements, vaccine providers should administer vaccine to all who meet current eligibility criteria regardless of county of residence. The vaccines are paid for by the federal government and jurisdictions cannot restrict who they will vaccinate. You can target your marketing efforts to those in your county/service area – but cannot limit appointments to those only in your county/service area.
  • There are staffing resources available to assist for both clinical and clerical needs – please submit those requests through your county emergency managers into the WebEOC system. 
  • Also, we have stood up a centralized data-entry team for those that are behind on entering their vaccination records.  Please enter requests for that support in the WebEOC system as well.
  • The CVMS system is the official system of record.  If the vaccine is not entered – then it doesn’t count – and we are at risk of being docked by the federal government.  As such, we must use that system to make allocations each week.
  • As we monitor utilization rates closely, we have a team of staff actively reaching out to providers across the state, eager to provide additional support and assist you in breaking down barriers. Let us know what you need.

 

Finally, attached you’ll find the allocation for the week of 1-18-21.  In response to our preliminary allocation last night, requests were made to us for an additional 120,300 doses of vaccine.  Additionally, several providers declined an allocation.  We appreciate everyone affirmatively responding to the preliminary allocation.  We see this affirmative response as your certification that you will exhaust all vaccine you have on hand, and to arrive from this allocation, no later than 1/25/2021.   We recognize that overall supply remains low each week, and we couldn’t come near meeting the requests.  However, as I have said, we actually have great amounts of vaccine in the state that needs to be used.  Please – come together – and let’s exhaust this vaccine together. 

 

In closing, with 470,00 doses currently in the state – and the shipments coming next week from this allocation – we need to be administering no less than 72,000 shots a day in our stateThat is more than 3-times our current rate of vaccination. So work to triple your daily rate, and when you exhaust it, reach out to a partner on the list, and offer to help.  Each day we don’t make the goal, is another day we have to push harder the next.  

 

Personally, after a long and hard challenging year – both personally and professionally -- I could not be more motivated and more excited to work on such an important mission, with such a remarkable team of people.  Thank you.  Truly.

 

Team Vaccine.  Team NC. 

 

We got this.  We have to.

 

Kody H. Kinsley

he / him / his

Operations Lead, DHHS COVID-19 Response

Deputy Secretary for Behavioral Health & IDD

North Carolina Department of Health and Human Services

 

Help protect your family and neighbors from COVID-19

Know the 3 Ws. Wear. Wait. Wash.

#StayStrongNC and get the latest at nc.gov/covid19

 

1Executive Assistant:  Badia Henderson

 

 

Amanda’s Out of Office Contacts:

 

·         Vaccine allocations: @Kelly Kimple (kelly.kimple@dhhs.nc.gov) and Kody.Kinsley@dhhs.nc.gov

·         Provider guidance and questions: @Dowler, Shannon

·         Provider Enrollment: @Kelly Kimple (kelly.kimple@dhhs.nc.gov)

·         LTC Program questions and needs: @Kansagra, Susan M and @Krepps, William

·         Pharmacists with pharmacy related COVID vaccine questions: @Goodwin, Dawn M

·         Hospitals related COVID vaccine questions: @Davis, Timothy

·         COVID Vaccine Prioritization questions: @Tilson, Betsey and @Wong, Charlene

·         Media Related Inquiries: @Mackey, Chris

·         CVMS Issues should be reported to the COVID-19 Vaccine helpdesk website here (NC DPH, WCH: Immunization: Providers has additional information posted related to CVMS)

 

 

//

 

***This is a detailed email and requires EVERY site to take action by way of an email detailed below not later than NOON on Friday, 1-15-21.***

 

Attached is the week of 1-18-21 baseline allocation plan – one sheet for Pfizer and one sheet for Moderna.  No doses were allocated to CVS and Walgreens this week for the Federal LTC Partnership vaccinations across NC because their current supply is sufficient to continue.  Second doses due the week of 1-18-21 have already been shipped and quantities emailed previously, but are included in the attached for reference.

 

The federal government has given us notice that they will begin to take administration rates into account when allocating to states in 2 weeks. As we have said over the last few weeks we will be factoring use into our allocations.  The goal is exhaust supply and get vaccine into the arms of our priority populations as quickly as possible.  The NC allocation will look across the board at hospitals and health departments this week and does not factor county population. 

 

For the week of 1-18-21, allocation will take into account maximum daily administration rate per site relative to the states maximum daily administration rate.  Sites that have exhausted less than 30% of the vaccine allocated to them (via transfer or administration) will receive no doses the week of 1-18-21.  In addition, sites that will not exhaust their on hand inventory by 1-25-21, calculated as their on hand inventory divided by their maximum daily administration rate also will not receive an allocation the week of 1-18-21.  Sites not receiving vaccine next week should work toward exhausting on hand inventory catch up on CVMS data entry.

 

Administration as recorded in CVMS is our single reporting tool to the federal government.  Therefore, administration must be recorded in that system in order for sites and the state to get credit for the administrations. 

 

Please review the attached spreadsheet and do the following:

 

  1. Consider the amount allocated and the amount of vaccine on the shelf at your site.
  2. Determine how many days it will take you to exhaust all first doses of the allocation and your on-hand supply.
  3. You must also do ONE of the following:
    1. If you can exhaust your on-hand supply and allocation of first doses by 1-25-21 and you are satisfied with the amount allocated, you should email covidvac@dhhs.nc.gov to accept your allocation and agree that you will exhaust supply by 1-25-21 not later than NOON on Friday, 1-15-21.

                                          i.    Use the subject ACCEPT ALLOCATION

    1. If you cannot exhaust your on-hand supply by 1-25-21 you should email covidvac@dhhs.nc.gov and decline your allocation not later than NOON on Friday, 1-15-21.

                                          i.    Use the subject DECLINE ALLOCATION

    1. If your supply will be exhausted before 1-25-21 and you would like to be considered for more, you should email Zach Stepp (zach.stepp-EY@dhhs.nc.gov) and provide the following not later than NOON on Friday, 1-15-21:

·         How many additional first doses you can accept and administer before 1-25-21.

·         How you will use your on-hand, allocation and additional supply down to 0 first doses by 1-25-21.

·         If you have already submitted a request for more, you may forward that request to Zach Stepp.

 

Please remember, it is the responsibility of all vaccine providers to ensure equitable access to vaccines. This will mean taking intentional actions to reach and engage historically marginalized communities. The state will continue to look to providers leading the way in exhausting their vaccine supply each week. Requests for more will be reviewed and granted as vaccine supply allows. 

 

 

Though we had hoped to be able to keep locations receiving one product or the other, some sites will receive a different product this week. 

 

The allocation table will likely be released to the media as we have already received may requests.

 

Here are some additional notes on the week of 1/18 allocation plan:

  • We expect vaccine to arrive 1/19-20/21.
  • Pfizer vaccine must be shipped in units of 975. Moderna vaccine must be shipped in units of 100. 
  • For Pfizer vaccine, once product ships, sites will receive a confirmation email from Pfizer and UPS and then a shipment notification email from Pfizer and UPS with tracking details and an estimated time of arrival. If you do not receive the shipment tracking emails and your site has a Vaccine For Children (VFC) program, please contact your VFC program shipping contact to see if they received the emails.   The current expectation is that ancillary kits will arrive the same day and dry ice recharges (unless opt out) the next day. 
  • Providers will begin to receive notices of Moderna vaccine shipment from McKesson directly. 
  • Both Pfizer and Moderna products may have additional doses in the vial and it is acceptable to use all FULL doses in the vials. Please do not account for additional doses in your inventory in advance. 

 

Thanks-Amanda

 

 

 

Amanda Fuller Moore, PharmD

Pharmacist

Division of Public Health

NC Department of Health and Human Services

 

Help protect your family and neighbors from COVID-19.

Know the 3 Ws. Wear. Wait. Wash.

#StayStrongNC and get the latest at nc.gov/covid19.

 

 



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