Coronavirus 2019 Disease (COVID-19) VACCINE DISTRIBUTION INFO

Coronavirus 2019 Disease (COVID-19) VACCINE DISTRIBUTION INFO

COVID-19 Vaccine Information

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BCHD’s plan for allocation and prioritization of COVID-19 vaccine follows CDC and MDH vaccine prioritization guidance. This plan is interim and might be updated based on changes in MDH vaccine prioritization guidance, changes in conditions of FDA Emergency Use Authorization, FDA Authorization of new COVID-19 vaccines, changes in vaccine supply, or changes in COVID-19 epidemiology.

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Jump To:

Background
How Do The Vaccines Work?
Differences between the Vaccines
Side Effects
Frequently Asked Questions
Allocation of Vaccine
Priority Groups
Additional Information
 

Background

  • In December 2020, pharmaceutical companies Pfizer and Moderna were granted Emergency Use Authorizations (EUAs) by the Federal Drug Administration (FDA) for COVID-19 vaccines.
  • This means the vaccine has been tested and is considered safe and effective for the general public to take.

How do they work?

  • Both the Pfizer and Moderna vaccines are known as mRNA vaccines. 
  • mRNA vaccines help our body develop immunity against COVID-19. Immunity means that your body will quickly recognize the virus that causes COVID-19 and will protect you from getting sick. 
    • mRNA vaccines do not change your DNA 
    • mRNA vaccines do not cause disease
    • mRNA vaccines are not weakened COVID19 virus
  • The vaccines require 2 separate doses to be fully protected from COVID-19
    • For the Pfizer vaccine, the doses are 21 days apart.
    • For the Moderna vaccine, the doses are 28 days apart.

What are the differences between the Moderna Vaccine and the Pfizer Vaccine?

 A powerpoint slide. Text reads "The COVID-19 Vaccines Summary" Pfizer vaccine, two doses, 21 days apart, approved for 16 year olds and up, 95% efficacy and reduces the risk of severe illness. Moderna Vaccine, 2 doses, 21 days apart, approved for 18 ye

Side Effects of the COVID-19 Vaccines

  • After getting the vaccine, some may experience side effects. These side effects are common to vaccines, are usually mild to moderate, and usually go away 1-2 days after vaccination. People may experience more side effects after Dose #2.
  • Side effects may include: 
    • Pain, redness, or swelling at the injection site
    • Fever
    • Headache
    • Lymph node swelling 
    • Joint pain
    • Fatigue
    • Muscle pain

Frequently Asked Questions About the COVID-19 Vaccines

The Maryland Health Department has created a frequently asked questions website that we encourage residents to visit for additional information. Some of the most frequently asked questions we're received are directly answered below. Check back frequently for updates! 

COVID-19 vaccines will not give you COVID-19 

  • There are several different types of vaccines in development, however, none of the COVID-19 vaccines available or currently in development in the United States use the live virus that causes COVID-19. The goal for each of these vaccines is to teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity.  

People who have been infected with COVID-19 will still benefit from getting the COVID-19 vaccine 

  • At this time, we do not know how long someone is protected from getting sick again after recovering from COVID-19. The immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long. We don’t know exactly how long immunity produced by a vaccination lasts but there is strong evidence to support that immunity due to vaccination lasts longer than natural immunity. The vaccine provides longer and stronger immunity 

Getting vaccinated can help prevent getting sick with COVID-19 

  • While many people with COVID-19 have only a mild illness, others may develop more severe illness or even death. There is no way to know how COVID-19 will affect you, even if you are not at increased risk of severe complications. If you get sick, you also may spread the disease to friends, family, and others around you while you are sick. COVID-19 vaccination helps protect you by creating an antibody response without having to experience sickness. 

Until we’ve reached herd immunity, you still need to wear a mask, avoid large indoor gatherings, and physically distant even after getting the vaccine.  

  • Even though the vaccine is between 94 and 95% effective at reducing severe illness, about 1 in 20 people who receive it will not become immune.  At this time, it is also unclear whether having immunity protects you from carrying the virus and passing it to others. Until a significant portion of the population becomes immune (referred to as “herd immunity”), the precautions must be carefully followed. This will likely take months or even years depending on vaccine uptake. 

Receiving an mRNA vaccine will not alter your DNA 

  • mRNA stands for messenger ribonucleic acid and can most easily be described as instructions for how to make a protein or even just a piece of a protein. mRNA is not able to alter or modify a person’s genetic makeup (DNA). The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA is kept. This means the mRNA does not affect or interact with our DNA in any way. Instead, COVID-19 vaccines that use mRNA work with the body’s natural defenses to safely develop protection (immunity) to disease. 

Key Principles for Allocation in Baltimore City

During the early weeks of Maryland’s vaccination program, vaccine supply is expected to be limited. With a limited supply of vaccines, healthcare workers, first responders, LTCF residents and people at significantly higher risk of severe COVID-19 disease will need to be sub-prioritized. Multiple factors, informed by the National Academies of Science, Engineering and Medicine’s Framework for Equitable Allocation of Vaccine, have been considered for sub-prioritization, such as, but not limited to:  

  • Risk of acquiring infection: People have higher priority if work or live in an environment with a higher risk of transmission due to a circulating virus.
  • Risk of severe morbidity and mortality: People with a high risk of severe outcomes (hospitalization, mechanical ventilation) and death from SARS-COV-2 infection. People who are older or have chronic medical conditions are at higher risk of severe outcomes.
  • Risk of negative societal impact: Inability to maintain services to preserve the functioning of society (i.e. providing health care, emergency response, public safety).
  • Risk of transmitting the virus to others (at work or at home): People have higher priority if there is a higher likelihood of them transmitting the disease to others.  

 

Prioritization Guidelines from the State. A pyramid, with text reading 1A, 1B, 2 and 3.

In the setting of limited vaccine supply, BCHD is utilizing ethical principles as outlined by ACIP to guide sub-prioritization decision making. These ethical principles are: 

  • Maximize benefits and minimize harm: Allocation of vaccine to groups or individuals should maximize the benefits of vaccination – reduction in hospitalization and death and reduction in risk of SARS-COV-2 infection, the virus that causes COVID-19. Preserving the functioning of society and minimizing harm to certain individuals and groups should also be considered. 
  • Promotion of justice: All individuals and groups should have equal opportunity to receive the COVID-19 vaccine, within priority populations during constrained supply and when the vaccine becomes available to the general population. 
  • Mitigation of health inequity: Certain groups have been disproportionately impacted by COVID-19 with an increased risk of infection, hospitalization, and death. Socioeconomic marginalization, age distribution, occupation/employment-type, limited access to healthcare are intersecting determinants of health that have resulted in disparate outcomes in hospitalization and death among older adult, Latino/Hispanic, and African American Baltimore City residents. Prioritization of vaccine allocation for certain groups should aim to reduce health disparities and not widen or create disparities. 

BCHD’s sub-prioritization decision making is grounded in the promotion of transparency. Transparency is essential to building and maintaining community trust. Outreach to priority groups throughout the vaccination program is critical. BCHD is engaging community members, collaborating with City government agencies, local health organizations, and health systems to inform focused outreach to priority groups. BCHD is developing a public-facing COVID-19 vaccination data dashboard to show vaccine administration by age, race/ethnicity, neighborhood, and other demographics, and to help inform outreach to priority groups

Priority Groups and Tiers

The following is the sub-prioritization for allocating the COVID-19 vaccine in Priority Group 1A, Priority Group 1B, and Priority Group 1C. Settings and roles within a priority group have equal priority. Vaccine allocation within Priority Groups is tiered due to initial limited vaccine supply. List order does not imply ranking within a tier. Sub-prioritization was developed in concert with Health Officers from Maryland jurisdictions for near consistent prioritization across the State. Baltimore City Health Department is taking into account specific population factors and priorities to tailor sub-prioritization to meet the needs of Baltimore City.

BCHD Prioritization and Allocation Interim Timeline Graphic

Priority Group 1A

Tier 1

  • Hospital-based healthcare workers
  • Long-Term Care Facilities staff and residents
  • Acute Living Facilities (ALF) staff and residents

Hospital systems are responsible for vaccine administration to hospital-based healthcare workers. The CDC's Pharmacy Partnership is coordinating the distribution and administration of vaccination in congregant living facilities, and both  CVS and Walgreens have partnered with CDC to distribute and administer vaccines to LTCF staff and residents.  

BCHD is responsible for vaccinating first responders and some healthcare workers in this tier. BCHD received 100 doses of Moderna vaccine the week of December 20th and received an additional 2600 doses the week of December 27th. BCHD began vaccinating public health vaccinators, COVID-19 testing staff, and clinical services staff on December 29th. The Health Department is prepared to respond to anaphylaxis/severe allergic reactions after the COVID-19 vaccination and is pre-screening individuals to determine if there are any contraindications or precautions. 

Tier 2
Definition:  Populations with frequent exposure to individuals with known COVID-19 and/or providing services essential to the maintenance of public health and healthcare systems during the COVID-19 pandemic. Includes populations unable to work from home and unable to control social distancing.

  • Public Health vaccinators and those administering COVID-19 vaccine in Phase 1A.
  • Emergency Medical Services/Fire Department
  • COVID-19 testing staff: People providing testing at large community testing centers
  • Lord Baltimore TRI Center staff
  • Convention Center Field Hospital staff
  • Baltimore City Health Department Clinical Services and Syringe program staff
  • Urgent Care Staff
  • Dialysis Center Staff
  • Clinic-based primary care staff (internists, family practice, pediatricians, geriatricians)/Federally Qualified Health Centers
  • Home health staff
  • Correctional facilities/Detention Center health care staff
  • Public Health/Baltimore City Health Department Staff

Tier 3a

Definition: Populations with risk of exposure to individuals with suspected COVID-19 and/or providing services essential to the maintenance of public health and health care systems during the COVID-19 pandemic. Includes populations unable to work from home and unable to control social distancing.

  • Law Enforcement: Police Department
  • Law Enforcement: Correctional facility officers, Sheriff’s Office, Department of Public Works Police
  • Dentists
  • Pharmacists
  • Phlebotomists

Tier 3b

Definition: Populations at risk of exposure to individuals with suspected COVID-19 and/or providing services essential to the maintenance of public health and health care systems during the COVID-19 pandemic. These populations may be able to telework or control social distancing.

  • Community Health Workers
  • Home and Community- based visiting program staff
  • Specialty out-patient clinical staff
  • Outpatient surgery centers
  • Student Health staff at non-hospital affiliated academic institutions
  • Laboratory staff
  • Physical Therapy/Occupational Therapy
  • Chiropractors
  • Optometrists
  • Audiologists
  • Podiatrists
  • Behavioral Health
  • Nutritionists
  • Morticians

Priority Group 1B:

Tier 1
Definition:  It is well established that certain groups are at significantly higher risk for severe COVID-19 illness.  Older adults ≥ 75 years old have a >30 times higher risk of death from COVID-19 compared to persons 35-54 years old.

  •  Adults ≥ age 75 years

Tier 2a
Definition: Other attributes that put people at significantly higher risk for severe COVID-19 illness include living and working in congregate settings, experiencing homelessness, living in an area with a high rate of transmission, and working in an industry with a high rate of transmission.

  • People experiencing homelessness
  • Shelter staff and residents
  • Correctional Facilities/Detention Center inmates and staff
  • Individuals in group home settings (i.e. halfway homes for returning citizens)

Tier 2b

Definition: Front-line essential workers hold critical jobs essential to the functioning of society and have potential occupational exposure to individuals with COVID-19. A subset of frontline essential workers has the highest risk for potential exposure as they are unable to work from home or control social distancing.

  • Public and private transit workers
  • Education sector (Teachers and support staff in schools)
  • Child care workers
  • Food and agricultural workers (Restaurant workers, Food Pantries, Farmers Markets, Farms)
  • Postal service workers
  • Grocery/Convenience store workers

Tier 3

Definition: Front-line essential workers hold critical jobs essential to the functioning of society and have potential occupational exposure to individuals with COVID-19. A subset of frontline essential workers has the highest risk for potential exposure as they are unable to work from home and may be able to control social distancing.

  • Manufacturing workers

Priority Group 1C:

Tier 1

Definition: It is well established that older adults are at significantly higher risk for severe COVID-19 illness. More than 40% of COVID-19 hospitalizations were in adults aged 65 years and older.  

  • Adults 65 – 74 years old

Tier 2

Definition: Populations with high-risk medical conditions have a significantly increased risk of hospitalization and death from COVID-19. Nearly 90% of persons hospitalized for COVID-19 have an underlying medical condition.

  • Adults 16/18* – 64 years old with high-risk medical conditionsHigh-risk medical conditions include:
    • Cancer
    • Chronic Kidney Disease
    • Chronic Obstructive Pulmonary Disease
    • Heart conditions
    • Immunocompromised state
    • Obesity/Severe obesity
    • Pregnancy
    • Sickle Cell Disease
    • Smoking
    • Type 2 Diabetes, Type 1 Diabetes
    • Asthma (moderate-severe)
    • Cerebrovascular disease
    • Cystic fibrosis
    • Hypertension or High Blood pressure
    • Immunocompromised conditions (from blood or bone marrow transplant, immune deficiencies, HIV, prolonged use of corticosteroids or other immunosuppressive medication)
    • Dementia, ALS, other neurologic issues
    • Liver disease
    • Pulmonary disease
    • Thalassemia

*Individuals 16 years and older can receive the Pfizer COVID-19 vaccine under the FDA EUA. Individuals 18 years and older can receive the Moderna COVID-19 vaccine under the FDA EUA.

Tier 3

Definition: Other attributes that put people at significantly higher risk for severe COVID-19 illness include living and working in congregate settings, experiencing homelessness, living in an area with a high rate of transmission, and working in an industry with a high rate of transmission.

  • People experiencing homelessness
  • Shelter staff and residents
  • Correctional Facilities/Detention Center inmates and staff
  • Individuals in group home settings (i.e. halfway homes for returning citizens)
  • Essential workers not previously in Phase 1A or Phase 1B
  • Transportation & logistics
  • Water and wastewater
  • Foodservice industry
  • Shelter & housing (e.g. construction)
  • Finance (e.g. banks)
  • IT & Communications
  • Energy
  • Legal (state’s attorneys, public defenders, judiciary)
  • Media
  • Public Safety (e.g., engineers)
  • Social & Human Services (Aging, DSS, Human Services) – field/in-home services
  • Elected officials

Priority Groups 2 and 3

  •  In the future, individuals who would like to receive the COVID-19 vaccine will be able to pre-register to express their interest. This will help us plan our local vaccination clinics and help us share information about upcoming clinics for those who choose to sign-up.  
  • We are also making plans to account for those who are unable to pre-register and would still like to receive the vaccine.  We know that many people in Baltimore City don’t have the internet at home and may have challenges pre-registering online. 
  • Once plans for Priority Groups 2 and 3 have been finalized, we will update this webpage! 

 

Additional Information

 

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