COVID-19 Vaccine Distribution:
Are you ready?

With new COVID-19 vaccines being distributed, state health departments, hospitals, and community health centers/FQHCs must be ready to meet the demand.

JSI understands the complexities of new vaccine introduction, supply chain and storage planning, and communication with communities after more than 40 years of global public health, vaccine, and supply chain experience.

Things are moving quickly. Information on what’s available to whom is changing as vaccines are produced and allocations to states shift.

Prioritizing Target Populations


How populations are prioritized and vaccines are distributed is critical. Age, race, and occupation are all risk factors of the disease, and allocation strategies for limited supplies require identifying and quantifying priority populations geographically for appropriate allocation in each phase of distribution. Using data and working with trusted partners at the community level help mitigate further disparities in the vaccine distribution process.

COVID-19 vaccine distribution is happening in three phases, and access is prioritized using the frameworks of Advisory Committee on Immunization Practices and the National Academies Report on Equitable Allocation. Within these frameworks, each state is managing internal distribution strategies to ensure equity. JSI can support this work by bringing data and our understanding of communities.

In addition to extensive knowledge of community mapping, JSI has been instrumental in similar exercises with the H1N1 and HPV vaccines, both of which required identifying target populations and strategies to deliver vaccines to them.

Training


With the introduction of COVID-19 vaccines, there is a significant range of training needs to support planning, storage, and handling, administration at public health planning and provider levels, and distribution, to name a few.

JSI has global experience facilitating training for vaccine introduction as well as changes in characteristics for multiple vaccines. Our training has included both technical skills for vaccine administration and the management of data collection and analysis, communication and demand-generation, supply and cold chain planning and management, and vaccine procurement.

JSI is adapting e-learning modules to support the NH Division of Public Health Services in COVID-19 vaccine distribution. JSI has adapted seven lessons (two modules) of material for staff at points of COVID-19 vaccine distribution and created on-demand lessons in Articulate that live on its TRAIN Learning Management System.

Provider Outreach and Capacity Assessment


Launching a massive vaccine campaign requires engaging established and new vaccine providers who care for high-risk populations but may not be traditional vaccine distribution sites.

JSI has conducted needs assessments and used GIS mapping, provider surveys, and a variety of datasets to analyze provider capacity for Health Professional Shortage Areas for 20 years. In countries where the HPV vaccine has been introduced, JSI has helped assess how to adapt both locations and services to reach 10–13-year-old girls.

JSI has supported point-of-dispensing set up and education for infectious disease vaccination efforts such as H1N1 in New Hampshire.

Systems Planning


State, local, and regional planning, including workshops, tabletop, and full-scale exercises, and documentation are crucial to stakeholder engagement and developing vaccine distribution protocols and systems.

JSI has led vaccine distribution planning activities, which includes mapping cold chain equipment capacity to the required vaccine quantities for priority populations, in multiple countries. We have also optimized storage points and distribution routes to bring efficiencies and cost savings to the distribution system.

JSI has led cold chain planning for vaccine introduction and supply chain design changes in more than 10 countries.

In the U.S., we have worked with states and health care coalitions to strengthen plans for medical countermeasures dispensing.  For more than 15 years we have worked across the state of New Hampshire to strengthen the operational readiness of regional points of dispensing through collaborative planning, training, and implementation of discussion and operations-based exercises. We worked with North Central Wisconsin Healthcare Emergency Readiness Coalition to plan and conduct a virtual exercise on closed points of dispensing to increase readiness to administer medical countermeasures (e.g., vaccines) to staff in the event of a public health emergency. In Massachusetts, we worked with the Metro Regional Preparedness Coalition to design and conduct a series of tabletop exercises that are strengthening municipal plans to receive and store vaccine, and to administer vaccine to critical infrastructure staff including police, EMS, fire, and health care professionals.

We regularly conduct exercises on a range of topics, from Coalition Surge Tests, an infectious disease tabletop exercise, to workshops and functional exercises on low-flow oxygen in alternate care sites, and points of dispensing.

In Massachusetts, we supported the Department of Public Health during the H1N1 pandemic by quickly creating multiple systems to develop solutions to manage its pandemic response. We launched a help desk and helped develop and implement an electronic system to register, prioritize, and monitor thousands of providers including hospitals, community health centers, doctors’ offices, and other prospective H1N1 vaccination sites.

Community Education and Engagement


Effective and timely health communication is crucial as public health and medical communities work to stop the spread of COVID-19. The importance of basic public health measures like social distancing and wearing a mask have become broadly understood through concerted health communication efforts.

Trusted partners are essential to educating communities on vaccine safety, availability, and access points. Trepidation about rapid development of the COVID-19 vaccine and historical concerns about vaccine safety—in particular among communities that have been hardest hit by COVID-19—will require strategic outreach to overcome. We have supported communication through community education in more than a dozen countries, developing key messages and strategies to promote new vaccine uptake.

In the United States, we have helped develop outreach, communications, and media efforts on infectious disease including HIV, H1N1, and most recently COVID-19, for 25 years. For the JSI-led Reproductive Health National Training Center, we developed a suite of COVID-19-related job aids for Title X family planning agencies, including a COVID-19 social media toolkit to help providers communicate with clients in both English and Spanish. For the Massachusetts Healthy Aging Collaborative (for which JSI developed a website), we compiled COVID-19 resources for older adults and publish regular updates to inform individuals and partners, including communities working to become more age- and dementia-friendly.

In New Hampshire, we’ve incorporated COVID-19-related messaging into ongoing youth substance use-prevention campaigns. Since 2010, JSI has provided services to the New Hampshire Immunization Program, including a comprehensive immunization outreach marketing plan to support informed vaccine decisions. The award-winning, multi-media Start the Conversation campaign focuses on routine health care, community immunity, and vaccine safety to increase immunization rates among NH residents.

Supply Chain and Logistics


The distribution of COVID-19 vaccines is complicated by potentially ultra-cold chain storage requirements. Temperature-sensitive vaccine products require specific distribution and storage strategies that use existing infrastructure to maintain efficacy. Staff training and storage capacity assessment are important for effective distribution.

JSI has deep vaccine supply chain expertise. We can update cold chain equipment inventory and assess capacity based on the current use and COVID-19 vaccine requirements. This is closely tied to distribution strategies and target populations, assuming a phased approach as manufacturers build capacity to meet the demand for the vaccine.

With initial vaccine introduction, transportation, security, receipt and handling at the site of transfer, and storage at the site of distribution all are serious challenges. Surge capacity adds another layer of complexity.

JSI has developed supply chain systems in multiple countries, providing analysis to identify the most cost-effective approaches to meet cold chain needs.

JSI has developed supply chain systems in multiple countries, providing analysis to identify the most cost-effective approaches to meet cold chain needs. We have engaged private-sector providers, creating solutions for short-term capacity requirements. This also extends to the ultra-cold chain option. We have developed cost-effective solutions in countries around the globe, for example, using dry ice for an ultra-cold chain during initial surge distribution instead of purchasing equipment.

Monitoring and Evaluation


Tailoring the vaccine-distribution strategy based on available cold chain equipment and quantities of vaccines needed at each re-supply point is critical.

As seen through our system-design work for immunization supply chains, constraints in cold chain and transport can be alleviated through different delivery frequencies and optimizing resupply points. We are adept at looking at the design of the supply chain to adapt various components for optimal use and efficiency.

Ensuring temperature standards is also critical. Cold chain equipment needs regular maintenance and temperature monitoring.

JSI has led the way with remote cold chain equipment temperature monitoring ensuring visibility into the performance of the cold chain, and quick reaction to temperature excursions to prevent risks to the quality of the vaccines.

Currently, JSI is supporting COVID-19 data management in Massachusetts and New Hampshire. We are ensuring coordination efforts for the health departments’ COVID-19 dashboards. We developed standard operating procedures that ensure continuity and enhancement of the data life cycle from data acquisition, analysis, and report preparation through the production of information to the public and other key stakeholders during the COVID-19 emergency.

JSI is ready to help your state as the COVID-19 vaccines are rolled out. Clients trust us to develop flexible solutions to complex public health problems, and we have the global immunization and supply chain experience to help you plan, train, educate, and, achieve your vaccine targets.

Please contact Natalie Truesdell natalie_truesdell@jsi.com to learn how we can help you.

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