BCHHS Public Health Provider Alert: COVID-19 Vaccine Update

December 30, 2020


Today, Buncombe County Public Health started week #2 of vaccination of Phase 1a healthcare workers. I wanted to provide an update on NCDHHS guidance about the phases, as well as provide additional details about Buncombe County’s COVID-19 vaccine registration and scheduling process.

Phase 1a of COVID-19 Vaccine Administration

  • If you missed the 12/22/2020 NC AHEC “Office Hours with DHHS to Discuss the COVID-19 Vaccine Distribution Plan” with State Health Director, Dr. Betsey Tilson, a link to the slides can be found here (slides also attached).
  • During that call, Dr. Tilson clarified that, due to the current surge in COVID-19 cases and rise in hospitalizations and deaths across NC and the limited supply of COVID-19 vaccine initially available, the goal of Phase 1a vaccination is to stabilize the healthcare workforce that is critical to caring for patients with COVID-19 and to protect North Carolinians who are at the highest risk of being hospitalized or dying from COVID-19 (i.e., LTCF residents).
    • This means the healthcare workers who are to be vaccinated in Phase 1a are those who are:
      • evaluating people in-person for COVID-19,
      • testing for COVID-19,
      • managing COVID-19 illness,
      • working directly in areas where patients with COVID-19 are cared for (e.g., staff responsible for cleaning, food service and maintenance in those areas),
      • performing procedures at high risk of aerosolization on patients with known COVID-19 (e.g., intubation, suctioning, CPR), or
      • handling the bodies of decedents with COVID-19.
    • Outpatient providers who have an increased risk of exposure beyond that of a typical general outpatient setting should be included in Phase 1a. See attached “NCDHHS Deeper Dive Phase 1a” handout for more details.
    • While it is acknowledged by NCDHHS and BCHHS Public Health that other healthcare providers may be at risk of exposure due to the nature of their work, unless they provide COVID-related care, they do not fall into Phase 1a.
      • Where other healthcare providers fall among the subsequent phases is still to be determined, as NCDHHS currently is reviewing the CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations that were published 12/22/2020 on who to vaccinate next as vaccine supplies increase. Once NCDHHS releases their revised vaccine rollout plan, we will pass that information on to you.
  • In terms of moving from one phase of vaccine administration into the next, the state wants all counties and hospital systems to move together in lockstep through the phases. NCDHHS will announce this phase transition on their website, through communication to providers and potentially through a public listserve. We will notify you via these email communications. How quickly NC moves through the prioritized phases for vaccination depends on the available vaccine supply and how quickly health departments and hospitals can administer the vaccine to everyone in the current phase. At this time, NCDHHS is informed of the state’s weekly vaccine allocation with no more than a week’s notice, which makes it difficult to estimate when we can move into the next phase.


Buncombe County’s COVID-19 Vaccine Registration and Appointment Scheduling Process

This week we have started to administer vaccine to Phase 1a providers beyond medical first responders and our COVID testing and vaccination site staff.

  • In an attempt to keep things more orderly for us and to make sure we don’t overlook getting providers scheduled for their appointments in the appropriate phase, we have decided to upload spreadsheets to CVMS only for those clinics/agencies whose staff meet current phase criteria and who we are ready to get scheduled for vaccination.
  • Last week, to get this process started, we uploaded spreadsheets to CVMS and shared the vaccine appointment scheduling link with those clinics/agencies who, based on data available to us through the state’s COVID-19 reporting system, have conducted the most COVID-19 tests and/or diagnosed the most cases of COVID-19 in the county since the start of the pandemic.
  • We will continue to roll out CVMS enrollment and scheduling emails this week to all other providers who meet the state’s Phase 1a criteria. We plan to have 250 vaccine appointments open on each of 4 days next week and at least that many in subsequent weeks.
  • Rest assured that if you received an auto-reply from the covidvax@buncombecounty.org email after submitting your spreadsheet, we received your spreadsheet and are reviewing your email to determine if your staff meet inclusion in Phase 1a. If they do not meet Phase 1a criteria, we will hold onto your spreadsheet for now. We would like to reach out to those clinics who submit spreadsheets but don’t qualify for Phase 1a, but have not yet had capacity to do so. I’m working on this.


CVMS Issues

  • One of the glitches in CVMS is that it sometimes assigns Phase 1a staff into different phases after they complete their online enrollment.
    • There is not a question on the enrollment questionnaire asking whether you are a healthcare worker providing COVID care. However, there is a question asking if you are a frontline essential worker. We recommend that you answer “yes” to this question as this may help with phase assignment.
    • We have submitted this issue to the state, but our guidance for now is that, if you received an email from CVMS asking you to enroll and your clinic received a link from us to get scheduled for a vaccine appointment, you are Phase 1a, so go ahead and make your appointment even if CVMS says you are in a different phase, and we’ll fix the issue when you show up.


Recipient Bulk Upload spreadsheet tips

  • Please be sure to include thorough & correct information on all your Phase 1a staff on the spreadsheet you submit to us.
    • Our staff have had to spend a significant amount of time uploading subsequent spreadsheets with 1 or 2 staff who were overlooked by a clinic or who had incorrect email addresses, and that distracts us from completing additional important tasks.
  • If your clinic/agency has identified additional staff who weren’t included on the initial spreadsheet that was submitted to us or if there was an error in an email address on a submitted spreadsheet, please submit a new version of the attached spreadsheet, including only information about these specific staff, per the same process outlined below.
  • Please submit the spreadsheet to us in the same format (.xlsx) as the original.


For those of you who haven’t yet submitted your spreadsheet or need to submit a new one, here are the instructions again.

If you are a healthcare worker in Buncombe County WHO MEETS PHASE 1A CRITERIA and will not be getting vaccinated through a hospital, please complete the following steps to let us know who in your clinic/agency is interested in getting vaccinated by Buncombe County Public Health:

  1. Complete the attached spreadsheet (“Recipient Bulk Upload File”) for your clinic/agency, listing everyone on your staff who is interested in getting the vaccine AND MEETS PHASE 1A CRITERIA.
    1. Only 1 spreadsheet per clinic/agency, please, so coordinate with everyone in your clinic on this effort.
    2. All columns must be filled out for each individual.
      1. For RISK (column D):
        • Enter “High” if the employee is responsible for one or more of the following:  caring for COVID-19 patient; cleaning in areas with COVID-19 patients; performing tasks with high risks of aerosolization (intubation, bronchoscopy, suctioning, invasive dental procedures, invasive specimen collection, CPR) on patients with known COVID-19; handling decedents with COVID-19, or administering COVID vaccine.
        • Enter “Low” if the employee does not meet any of the above criteria.
      2. For TYPE (column E):
        • Enter “Employee” if the person works for the organization.
        • Enter “Individual” if the person is a resident of the organization (e.g., resident of an assisted living facility)
    3. These individuals need to be healthcare workers in your clinic/agency, but do not have to live in Buncombe County, or even NC.


  1. Send the email with completed spreadsheet attached to COVIDvax@buncombecounty.org.
    1. In the body of the email, include the following information:
      1. Name of your clinic
      2. The following information for the best point of contact and alternate point of contact (so a total of 2 points of contact) for your clinic. These are the individuals we will contact to get or provide further information for your clinic/agency.
        • Names
        • Phone numbers
        • Email addresses


  1. After our staff upload your clinic’s spreadsheet into the COVID Vaccine Management System (CVMS), CVMS will send each individual on the spreadsheet an email that looks like this:


From: Vaccine Management System <nccvms@dhhs.nc.gov>
Sent: (date)
To: (your email)
Subject: Thank you for Signing up!


Image removed by sender. https://ncdhhsimmunization.my.salesforce.com/servlet/servlet.ImageServer?id=015t0000000gXly&oid=00Dt0000000XlDt

Dear (your name),

Thank you for signing up for our COVID-19 vaccination program. Your registration is not yet complete. To continue your enrollment process, please click here to reset your password. Once you have reset your password, please complete the health questionnaire.


Username:  (your discrete username)


Thank you,

NC Department of Health and Human Services
Division of Public Health
Immunization Branch

  2. Each individual must click on the link in their email from CVMS to reset their password and complete the enrollment process for them to receive the vaccine. Basically, this involves answering a brief online questionnaire.
  3. After they submit their answers, the system will tell them if they are approved or not approved to get the vaccine in the current phase. (Again, if they received an email from CVMS asking them to enroll and a link from us to get scheduled for a vaccine appointment, they are Phase 1a, so tell them to go ahead and make their appointment even if CVMS says they are in a different phase, and we’ll fix the issue when they show up at the vaccine clinic.)


  1. The primary and back-up points of contact will be sent instructions from Buncombe County Public Health staff on how to get their Phase 1a staff scheduled for the actual vaccine appointment.


As more details become available, I will continue to share them with you. As Dr. Tilson has said, this is the biggest, most complicated mass vaccination effort ever, at the fastest pace ever. We ask for your patience, understanding and cooperation. You are each important to us and we want you all to get vaccinated when it is your turn based on the state’s prioritization framework. Our goal is to ensure that vaccine administration is safe, efficient and equitable in all our populations.


Stay safe, and thank you for the care you provide to our communities,


Jennifer Mullendore, MD, MSPH


Health & Human Services,

Medical Director

p. (828) 250-6308  c. 828-989-6145

40 Coxe Ave. - Asheville, NC 28801


Respect. Honesty. Integrity. Collaboration. Equity.