BCHHS Public Health Provider Alert: Update on Rollout of COVID-19 Vaccine for Healthcare Workers

December 18, 2020







·         If you were not able to join the 12/15 NCDHHS COVID-19 vaccine call for clinicians, the presentation and recording can be found here.

·         On that call, the State Health Director/CMO, Dr. Betsey Tilson, provided further clarity about where various healthcare workers (HCW) fall among the state’s vaccine prioritization phases (see slide 23 on the attached 12/15 presentation for overview of the phases). She stressed that there will not be enough vaccine available initially to cover all HCW, so Phase 1a is to be focused on those HCW at highest risk of exposure to COVID-19.


o   Phase 1a:  HCW who are at high risk for COVID-19 exposure (risk of exposure above and beyond that of other healthcare workers) based on their work duties or HCW who are vital to the initial COVID vaccine response.

§  These are HCW who are responsible for:

·         Caring for COVID-19 patients

·         Cleaning areas where COVID-19 patients are admitted

·         Performing procedures with high risk of aerosolization (e.g. intubation, bronchoscopy, suctioning, invasive dental procedures, invasive specimen collection, CPR)

·         Handling the bodies of decedents with COVID-19

·         Administering the COVID-19 vaccine in initial closed or targeted vaccination clinics

§  Based upon this guidance, the non-hospital-affiliated outpatient providers Buncombe County Public Health considers to fall within Phase 1a include:

·         Medical first responders (EMTs and paramedics)

·         Staff working at the county’s COVID-19 testing sites

·         Staff working at the county’s COVID-19 vaccination sites

·         Urgent care and primary care clinic staff who are actively involved in assessing/testing/caring for patients with suspected/confirmed COVID-19

·         Laboratory staff who handle COVID-19 specimens

·         Medical examiners and funeral home staff/morticians handling the bodies of decedents with COVID-19

·         Hospice and home care providers of patients with COVID-19

·         LTCF staff (e.g., staff at skilled nursing facilities, adult care homes, family care homes, and group homes; staff directly working with individuals with intellectual and developmental disabilities who receive home and community-based services)


o   Phase 1b:  Healthcare workers with 2 or more chronic conditions identified by the CDC as increasing the risk of severe illness from the virus that causes COVID-19 [cancer; chronic kidney disease; COPD; heart conditions, like heart failure, coronary artery disease, or cardiomyopathy; a weakened immune system from solid organ transplant; obesity or severe obesity (body-mass index of 30 or higher); pregnancy; sickle cell disease; smoking; or Type 2 diabetes]


o   Phase 2:  All other healthcare workers


·         Buncombe County Public Health’s initial shipment of vaccine next week will be focused on our local EMTs and paramedics and the staff of our COVID-19 testing and vaccination sites.

·         In the coming weeks, we will then begin administering COVID vaccine to other Phase 1a healthcare workers who will not be getting vaccinated by any of the local hospital systems.


NCDHHS and Buncombe County Public Health are aware that there will be HCWs (and others) who do not agree with their placement in the prioritization phases. Please understand that because of insufficient supply of vaccine, we initially need to focus the vaccine we have on those most at risk. We ask for your patience, understanding and cooperation as we work with new vaccines and a new vaccine management system in the middle of pandemic response. 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 that was developed with the input of the NC Institute of Medicine Vaccine Advisory Committee. Our goal is to ensure that vaccine administration is safe, efficient and equitable in all our populations.


·         If you are a HCW in Buncombe County WHO MEETS PHASE 1A CRITERIA and will not be getting vaccinated through a hospital, please complete the steps at the end of this email to let us know who in your clinic/agency is interested in getting vaccinated by Buncombe County Public Health.

o   If you have already sent us your spreadsheet, you do not need to send another one at this time.




·         Per NCDHHS, enrollment for primary care and urgent care providers is expected to begin in early January 2021 (see slide 29 on attached 12/15 presentation).



·         Today, the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended that the Moderna COVID-19 vaccine be authorized for emergency use. The expectation is that the FDA will grant the EUA this week and then the ACIP will make their recommendations for vaccine use over the weekend, so that the Moderna vaccine will start being distributed early next week.



·         NCDHHS’ Friday Office Hours for Providers


12:30- 1:30 pm

Join the Zoom meeting room on your computer, or dial-in at (646) 558-8656 using webinar ID 705-979-628.

As part of the State’s continuing efforts to ensure providers have the information they need, Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and Dr. Zack Moore, State Epidemiologist, will provide brief updates on the State’s COVID-19 response and will respond to questions.


·         What Clinicians Need to Know About the Pfizer-BioNTech and Moderna COVID-19 Vaccines


2:00  – 3:00 pm

This CDC COCA Call will give clinicians an overview of the Pfizer-BioNTech and Moderna COVID-19 vaccines. Clinicians will learn about vaccine characteristics and administration, vaccinating special populations, and contraindications. They will also get answers to a number of clinical questions CDC has received about these new vaccines.


·         Office Hours with DHHS to Discuss the COVID-19 Vaccine Distribution Plan


6:00 – 7:00 pm

Join the Zoom meeting room on your computer, or dial-in at (646) 558-8656 using webinar ID 131 899 801.

Please join Dr. Betsey Tilson, State Health Director and CMO, and other DHHS leaders for an update on North Carolina’s COVID-19 vaccine distribution plan and for a Question & Answer session about that plan.



·         See attached overview document from NC AHEC.



If you are a HCW 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 for your clinic/agency, listing everyone on your staff who is interested in getting the vaccine AND MEETS PHASE 1A CRITERIA.

a.       Only 1 spreadsheet per clinic/agency, please, so coordinate with everyone in your clinic on this effort.

b.      All columns must be filled out for each individual.

                                                              i.      For RISK (column D):

·         Enter “High” if the employee is responsible for one or more of the following:  caring/cleaning in areas with COVID-19 patients; performing tasks with high risks of aerosolization (intubation, bronchoscopy, suctioning, invasive dental procedures, invasive specimen collection, CPR); handling decedents with COVID-19, or administering COVID vaccine.

·         Enter “Low” if the employee does not meet any of the above criteria.

                                                             ii.      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)

c.       These individuals need to be healthcare workers in your clinic/agency, but do not have to live in Buncombe County, or even NC.


2.       Send the email with completed spreadsheet attached to COVIDvax@buncombecounty.org.

a.       In the body of the email, include the following information:

                                                              i.      Name of your clinic

                                                             ii.      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


3.       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!



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




b.       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.

c.       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. If not approved, the system will tell them in what phase they should receive the vaccine.


4.       Then wait for further instruction from Buncombe County Public Health on how to get scheduled for the actual vaccine appointment.

    1. While waiting, we recommend creating a staggered schedule in which different staff get vaccinated different weeks. As people have reported temporary reactions like sore arms, fevers and tiredness 24-48 hours after receiving the vaccine, the CDC has said that it is a “consideration” to stagger delivery of vaccine to healthcare workers in a facility so that all the workers in a single unit or discipline aren’t getting vaccinated at the same time and then impacting service delivery if post-vaccination signs/symptoms keep them out of work. We are leaving this decision on staggered vaccination scheduling up to each individual clinic/agency and will not be requiring it in any way.