As health officials and the general public anticipate the issuance of FDA emergency use authorizations for at least two COVID-19 vaccines in the very near future, how the vaccine will be distributed and allocated in the state of Indiana rests in the hands of the Indiana Department of Health's (IDOH's) Vaccine Allocation Plan Development Advisory Group. This advisory group, one of six multi-agency, cross disciplinary advisory groups brought together to plan and operationalize a vaccination response to COVID-19 in Indiana, will provide the final recommendations on the ethical and equitable allocation of the vaccine once the EUAs are issued. Because there will be a limited vaccine supply initially, the IDOH's COVID-19 Vaccine Allocation Plan (the Plan), issued as an interim draft in October of this year, anticipates a phased approach, with Indiana's critical populations identified as the highest priority for receiving vaccinations during the initial vaccine distribution stages.
To ensure vaccine resources will be utilized in an efficient and equitable manner across the state, IDOH brought together a large, multidisciplinary team of experts to help create the Plan. This group developed a three-phased approach, while readily acknowledging that changes to the phased approach and the populations identified for vaccination in each phase of the Plan, may be subject to change based on any number of factors, including the number of individuals in each group who are willing to receive the vaccine and the number of individuals for whom vaccination is deemed to be inappropriate due to inadequate immune response or complications secondary to the vaccination itself.
Phase 1: Acknowledging that vaccine supplies will be limited, vaccine administration efforts in Phase 1 of the Plan will be focused on reinforcing and supporting the health care infrastructure and protecting vulnerable populations. This means the vaccination of health care personnel with the potential for direct or indirect exposure to patients or infectious materials (regardless of job title) and individuals who are at particular risk of mortality and morbidity associated with COVID-19 infections will have first access to vaccine administration. Vaccination of direct patient care health care providers (such as nurses, physicians and EMS providers) and other patient facing staff (such as environmental services, maintenance and security personnel) in a variety of health care settings (hospitals, long-term care facilities, pharmacies and many others) will be the focus during this phase, along with the immunization of individuals 65 years age or older, those individuals having co-morbid conditions and residents of long-term care facilities.
Phase 2: The priority during this phase of the Plan is administration of the vaccine to those individuals at an elevated risk of transmission of COVID-19 infections due to their working or living circumstances. These populations include workers whose in-person work is essential and which places them in settings where social distancing is not possible and transmission risk is high. This includes fire and police officers, teachers and food service, retail and public transportation workers. People living or working in shelters, group homes, detention centers, jails and similar types of facilities will also be the focus during this phase of the Plan.
Phase 3: Anticipating that the availability of vaccine supplies will increase over time, the final phase of the Plan moves to the vaccination of the general public.
Crucial to the implementation of this phased approach to vaccine distribution is a network of providers with the training and resources to receive, safely store and, of course, administer the vaccine. The IDOH has been recruiting and enrolling providers who can rapidly vaccinate the Phase 1 populations, anticipating that initial distribution efforts will be to large hospitals and health care systems in locations central to the identified populations. In Phases 2 and 3 of the Plan, a larger distribution system is anticipated, and the IDOH will be calling upon a variety of providers to administer the vaccine, including primary care physicians, local health departments and pharmacists. Strike teams and mobile units will also be utilized, allowing vaccination teams to focus on critical populations and/or specific high need areas.
Distribution and administration of the COVID-19 vaccines in an efficient, effective and equitable manner are crucial to the continued battle to reduce and eventually eliminate COVID-19 infections. With a plan in place that addresses many of the multitude of issues associated with such an effort, the IDOH and its public health partners appear to be ready and able to deal with this part of the overall effort to contain the COVID-19 virus.
Originally Published by Ice Miller, December 2020
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