Department of Health Issues COVID-19 Vaccine Order to Help Expedite Vaccine Administration, Improve Accessibility for Seniors

Harrisburg, PA - Acting Secretary of Health Alison Beam today issued an order directing vaccine providers’ administration of COVID-19 vaccines to ensure that Pennsylvanians are vaccinated as quickly and efficiently as possible. Governor Tom Wolf signed a concurrent order.

“I understand how frustrating the current vaccine process can seem and we have heard from many Pennsylvanians that are struggling to schedule an appointment,” Acting Secretary Beam said. “As there is very limited COVID-19 vaccine supply compared to demand, every possible effort must be made so that the vaccine received in the commonwealth is effectively administered. To achieve this goal, I am issuing an order outlining appropriate steps and recognized best practices to ensure vaccine providers are effectively meeting the goal of vaccinating Pennsylvanians and creating a healthy Pennsylvania for all.”

The updated requirements for vaccine providers include:

• At a minimum, vaccine providers must administer 80 percent of their first doses of vaccine received within seven days of receipt of those doses.
• Vaccine providers must follow all requirements and recommendations in the COVID-19 Interim Vaccination Plan.
• Vaccine providers must adhere to the current phase of Pennsylvania’s vaccine rollout, as defined by the department.
• Vaccine providers giving a two-dose vaccine shall provide the COVID-19 vaccine reminder card with a date for a return appointment for the second dose of vaccine.
• Vaccine providers giving a two-dose vaccine must make every appropriate effort to ensure available appointments for second doses, including, but not limited to, designating appointment times for second doses or scheduling second doses at the time of first dose administration, or both.
• Vaccine providers must have both an online and a phone-based registration system for direct appointment scheduling. Information on these systems must be made available to the department so it can be posted online.
• Vaccine providers must report the following:
  • Vaccinations and the information required by the Order Requiring Reporting of Data Related to Each Administration of an Immunization for COVID-19, dated December 15, 2020, on each vaccine administered, including race and ethnicity of the recipient, whether or not the recipient is connected to the vaccine provider.
  • Within 24 hours of receipt of inventory or administration of a vaccine, vaccine providers shall report:
    • Receipt of shipments of COVID-19 immunization inventory;
    • Reduction in inventory levels as vaccines are administered; and
    • Reconciliation of inventory levels.

Vaccine providers may have their allocation of first doses reduced, or temporarily suspended, for failure to comply with guidance from the federal government and state law, including failure to comply with the Order. Allocations of first doses reduced or temporarily suspended may be restored once a vaccine provider provides assurance of future compliance of the Order to the department.

If a vaccine provider doesn’t administer 80 percent of its first doses within seven days of receiving those doses, the provider will still be able to receive second doses, as second doses are secure. The department may grant a vaccine provider additional time to meet the 80 percent administration metric if the vaccine provider informs the department of inclement weather or infrastructure failures outside of the provider’s control, which impacted the vaccine administration.

The Order requires that every provider have a phone number for direct appointment scheduling. We know that not every individual has access to the Internet, and others may find it challenging to go online to find providers in their area or navigate online appointment portals.

We also know that vaccine demographic reporting has thus far been incomplete. The Order makes clear that providers must follow the racial and ethnic data reporting requirements.

This Order is effective at 12:01 a.m. on February 12, 2021 and shall take effect as follows:

• The online and phone-based registration system requirements shall take effect 12:01 a.m. on February 19, 2021;
• The allocation enforcement shall take effect 12:01 a.m. on February 22, 2021; and
• The remainder of this Order shall take effect immediately.

This Order rescinds and replaces the Order of the Secretary of the Pennsylvania Department of Health Requiring Health Systems, Hospitals, Federally Qualified Health Centers and Pharmacies to Vaccinate Certain Health Care Personnel, dated December 30, 2020.

The department may reduce or temporarily suspend a Vaccine provider’s allocation of first doses for failure to comply with guidance from the federal government and state law, including failure to comply with this Order. It is important to note the Order is not intended to stop second doses from being allocated to providers at the prescribed interval.

Allocations of first doses reduced, or temporarily suspended, under this Order may be restored once a vaccine provider provides assurance of future compliance of this Order to the department.

The only exclusions to the Order are vaccine providers whose provider agreement is with the Philadelphia Department of Public Health and facilities owned or operated by the federal government, including facilities operated by the federal Department of Veterans Affairs.

Frequently asked questions on the Order can be found here.

While vaccine supply from the federal government remains very limited, the Department of Health is working to ensure the vaccine is provided in a way that is ethical, equitable and efficient.

QUESTIONS/ANSWERS

How is the Department narrowing the number of providers?  Beam - We worked diligently over the past several weeks.  We’ve been inclusive and have 1700 providers who enrolled to stand with us.  Providers who reach communities, like hospitals, health systems, county muni health departments, pharmacists and FQHCs.  We have focused allocation on those types of providers.  Previously there were many other provider types including primary care physician offices, who worked to fulfill our initial mission, but now that those staff have been vaccinated, we will focus on the other four.

 

Have weather conditions slowed down distribution.  Update?  Beam - It’s been a challenge, impacts scheduling mechanisms, flexibility and nimbleness of our system has played out.  We’ve had 1-2 day delays, but still getting into arms relatively timely.

 

Providers prefer to use their own scheduling systems, and the Chester County system crashed in ten minutes – who are the providers who say yes? Beam - Where there are providers who invested in their own technology and EHR systems, to avoid duplicative systems and to use their technology we’re okay with that.  We want a culture of continuous improvement.

 

If the goal is to push out more vaccine, why not give them even more?  Beam - We’ve been in discussion with them. First the county allocation, then partnerships with counties, hospital systems, and infrastructure that already exists.  This will allow further alignment and higher throughput, which this crisis demands.

 

You’ve had 1700 providers but under new course today, what will that number be?  Beam - This week we narrowed that list to around 200-300 providers who will be able to avail themselves of the vaccine going forward.

 

Are providers expected to schedule…just have a person available to talk to and schedule whoever asks for an appointment?  Beam – This is not just an online system – we want phone lines staffed by real live individuals who can schedule an appointment for you.  That should happen simultaneously.

 

How do you respond to calls to get teachers vaccinated?  Beam - One of the stakeholder groups we’ve been talking with are the school related groups, leadership and educators to hear their concerns.  We understand that desire but at this stage, the federal government has them in phase 1B, value front line in their own right, and at this stage we are still conforming to federal guidelines.

 

The pharmacies and providers in the community have said a central system would be better, but it seems you would squeeze out the smaller ones who are different from hospital and health systems – and who had their own scheduling system, some of which invested in theses systems to give them some autonomy.  But this alternative is for those who need a scheduling system.  When will you be at that 200-300 figure?  Beam - This is a plan, progressively coming into effect.  It took effect at 12:01 a.m. today.  Next week we will demand data reporting, and looking at phone and online scheduling capabilities in place, following that we’ll be able to have allocations in terms of the order.  They have to place orders in line with our expectations.

 

How will you know if there’s compliance or not?  One pharmacy was vaccinating educators – didn’t know who WAS in 1A.  How do you see your compliance system working out? Beam – our order sets expectations, and they will deliver by complying with those expectations.  Local hospitals have only vaccinating their own, and turning away others in 1A for those working remotely?  How will this address this?  Beam – We will move forward with them and be scheduling for all of 1A. That is our focus for next week.

 

Is the Commonwealth’s goal to still open to public by summer? Why should we think that’s realistic, aside from new rules which enforce what should already have been doing?  Beam – The major factor is supply from federal partners. We are3 putting their numbers into our forecasting.

 

Follow up – Plans being progressive in reducing number of providers to 200-300, why not do this immediately?  How long will it take? – Beam – the data reporting starts now, plan is reaffirmed now, and that data will inform our contingencies.  Allow their next week’s orders to reflect what they can use and put into arms, with enforcement next week.

 

PA seems to be far behind other states.  Ohio teachers getting vax, other state’s fairgrounds, etc and not working.  Is there an explanation for this?  Beam - We are concerned likewise.  We need to do better and we will do better.  Plan for communicating how our strategy and pivoting on providers who can deliver.  Down the line, we will be building out towards convenience.