Buncombe County’s COVID Vaccination Plan

December 16, 2020


Buncombe County’s COVID Vaccination Plan

Tentatively, local health departments, including Buncombe County Public Health, should be receiving their first allocations of COVID-19 vaccine next week. At this time, we do not know the specifics about which vaccine (as Moderna’s vaccine EUA is to be reviewed later this week by the FDA) or how many doses will be received.

  • In fact, we heard today on a call with NCDHHS that the federal government isn’t planning on notifying NCDHHS of the allocation amount until this Friday. Then the state has to split that allocation up between hospitals, health departments and pharmacies that are administering vaccine to LTCF staff and residents. We are all hoping we get information before then, but no guarantees.
  • We also heard on today’s call that enrollment for providers beyond hospital, health departments, FQHCs/CHCs, and correctional facility healthcare provider won’t begin until January 2021.


In Phase 1a, local health departments in NC have been tasked with vaccinating a wide variety of non-hospital-affiliated healthcare workers who are at high risk for COVID-19 exposure based on their work duties or who are vital to the initial COVID vaccine response. This list includes healthcare first responders (EMTs, paramedics); staff in outpatient primary care, urgent care and specialty care clinics; healthcare trainees (medical students, nursing students, pharmacy students, etc.); laboratory staff involved with COVID-19 testing; home health workers; funeral home staff/morticians; dentists and dental hygienists; and pharmacists.

  • Hospitals/health systems are receiving their own vaccine supply to administer to their inpatient staff and hospital-affiliated staff. If you haven’t heard from your hospital system yet, we encourage you to reach out to see if you are included in their vaccine plan.

Additionally, health departments are to assist LTCFs (e.g., assisted living facilities, family care homes, group homes, intermediate care facilities for individuals with intellectual disabilities) with vaccination of their staff and residents if the facilities are not participating in the federal government’s Pharmacy Partnership for Long-term Care (LTC) Program.


Because of the large size of this population and the limited number of doses BCHHS is expected to initially receive, we have had to prioritize subpopulations within Phase 1a. Here is what we have proposed:

  • Our initial shipment(s) of vaccine will be focused on our local healthcare first responders (EMTs, paramedics) and the staff of our COVID-19 testing and vaccination sites.
  • As we receive additional weekly allocations of vaccine and make it through these subpopulations, we will then begin administering COVID vaccine to healthcare workers who are not affiliated with any of the local hospital systems.
    • Within this subpopulation, we will continue to prioritize those healthcare workers who are at higher risk for COVID-19 exposure or who will be involved in getting others vaccinated. So, for example, we want to make sure that our local urgent care and primary care clinic staff who are evaluating sick patients and testing for COVID-19 and who will be administering vaccine get vaccinated before staff in a specialty care clinic where evaluation and testing for COVID-19 do not occur and where vaccine will not be administered. Under the circumstances, it is impossible for us to please everyone, so 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. Our goal is to ensure that vaccine administration is safe, efficient and equitable in all our populations.


If you are a non-hospital-affiliated healthcare worker in Buncombe County, 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.
    1. Only 1 spreadsheet per clinic/agency, please, so coordinate with everyone in your clinic on this effort.
    2. All columns must 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/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 (once available in your clinic).
        • 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:


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


Image removed by sender.

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 CVS 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. 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.

As more details become available, I will push them out to you. We expect there to be bumps and hiccups along the way (as there has been with most everything this pandemic), and we thank you for your patience and understanding as we enter this new phase in COVID-19 pandemic response.