Onboarding
How do I become a vaccinator in Pima County?
Providers have been crucial in the fight against COVID-19. We want to be prepared and engage our future partners now, so we are ready when more vaccines are available for distribution in Arizona. Currently, vaccine inventory is very limited; not all onboarded providers will receive vaccine immediately.
Here is how to get started.
How do I get assistance with the ADHS onboarding process?
ADHS has created a tool for
Pandemic Vaccine Provider Onboarding. If you need additional assistance with completing the onboarding process, please email
ASIISHelpDesk@azdhs.gov.
How do I check the status of my onboarding?
The approval process following your submission of the completed ADHS onboarding tool takes time to complete - possibly more than a week. If you have questions about your approval status, please email
ASIISHelpDesk@azdhs.gov.
What kind of refrigeration do I need to become a vaccinator?
The storage requirements for each of the vaccine presentations currently available are below. Please note that digital data logger reports will need to be sent to ADHS VFC at least every two weeks. If purchasing new cold storage unites, 5 days of temperature monitoring is needed before you are able to receive vaccine for storage in those units.
Pfizer
- Ultra-Cold Freezer: Vaccine may be stored in an ultra-cold freezer between -80°C and -60°C (-112°F and -76°F).
- Before mixing, vaccine may be stored in a freezer between -25°C and -15°C (-13°F to 5°F) for up to 2 weeks. The total time vials are stored at these temperatures should be tracked and should not exceed 2 weeks. Use CDC’s beyond-use date labels to track how long the vaccine has been in the freezer.
- Store vaccine vials upright in the tray and protect from light.
- Vials stored in the freezer can be transferred to the refrigerator for an additional 120 hours (5 days). Once thawed, they cannot be refrozen.
- Vials stored in the freezer can be returned one time to ultra-cold temperature storage. Once returned, the 2-week time frame is suspended.
- Refrigerator: Before mixing, the vaccine may be stored in the refrigerator between 2°C and 8°C (36°F and 46°F) for up to 120 hours (5 days).
Moderna
- Freezer: Vaccine may be stored in a freezer between -25°C and -15°C (-13°F and 5°F).
- Refrigerator: Vaccine vials may be stored in the refrigerator between 2°C and 8°C (36°F and 46°F) for up to 30 days before vials are punctured.
Johnson & Johnson
- Store Johnson & Johnson COVID-19 Vaccine in the refrigerator between 2°C and 8°C (36°F and 46°F) for up to the expiration or beyond use date (BUD).
- After the vial is first punctured, the vaccine vial may be held:
For up to 2 hours at room temperature; discard any vaccine not used within 2 hours
—–OR—-
For up to 6 hours refrigerated between 2°C and 8°C; discard any vaccine not used within 6 hours.
- You should not add these time limits together (i.e., you may not hold the vaccine at room temperature for 2 hours and then hold refrigerated for another 6 hours).
- If you do not reach the 2-hour time limit at room temperature, you may transfer the punctured vial to a refrigerated storage unit between 2°C and 8°C for the remaining time, up to 2 hours. For example, a vial held at room temperature for 1 hour after first puncture can be stored in the refrigerator (between 2°C and 8°C) for no more than 1 hour before using or discarding. If the 2-hour time limit at room temperature has been met, it must be discarded and cannot be transferred to the refrigerator.
What is a digital data logger and what kind can I use? Where can I get one?
In the most basic sense, a "data logger" is any computer-based device that can be used to store statistics and information, which could include plug-in boards, serial communications, or wireless transmitters to a mobile device. But those configurations are already superseded. Most instrument manufacturers today define a “digital data logger” or DDL as a stand-alone device that can read various types of electrical signals and store the data in internal memory for later download and analysis independent of a computer.
In the most recent
Vaccine Storage and Handling Toolkit, The Centers for Disease Control and Prevention (CDC) now specifically recommends the use of digital data loggers with the following features:
- Detachable probe that best reflects vaccine temperatures (e.g., a probe buffered with glycol, glass beads, sand, or Teflon)
- Alarm for out-of-range temperatures
- Low-battery indicator
- Current, minimum, and maximum temperature display
- Recommended uncertainty of +/-0 .5° C (+/-1° F)
- Logging interval that can be programmed by the user to measure and record temperatures at least every 30 minutes
Digital Data Logger resources
Once I have completed ADHS onboarding, when will I receive the vaccine?
After completion and approval of the onboarding survey, vaccine may arrive as soon as the following week depending on the timing of approval and allocation for that week. Vaccine orders, based on local allocation by the county, are typically submitted by ADHS on Friday and arrive to your facility on Monday of the following week along with ancillary kits. Vaccine and ancillary kits are shipped separately.
Storage and Handling
How will vaccine arrive to my facility?
Vaccine will be shipped directly to the address you provide in the ADHS onboarding survey.
Vaccine has arrived. What do I do next?
First,
you must receive vaccine orders in ASIIS.
Moderna
Moderna vaccine will arrive frozen between -25°C and -15°C (-13°F and 5°F).
- Examine the shipment for signs of damage.
- Open the box and remove TagAlert Temperature Monitor from box (placed in the inner box next to vaccine).
- Check the TagAlert temperature monitoring device by pressing the blue “start and stop” button.
- IF...
- Left arrow points to a green checkmark: The vaccine is ready to use. Store the vaccine at proper temperatures immediately.
- Right arrow points to a red X: The numbers 1 and/or 2 will appear in the display. Store the vaccine at proper temperatures and label DO NOT USE!
- Call the phone number indicated in the instructions or your jurisdiction's immunization program IMMEDIATELY!
Expiration Date for Moderna
To determine the expiration date, scan the QR code located on the vial or carton. The QR code will bring up a website; then choose the lookup option, enter the lot number, and the expiration date will be displayed.
An alternate option is accessing the
website directly.
Pfizer Vaccine
Pfizer provides a checklist for delivery.
Johnson & Johnson
This vaccine is shipped thawed at refrigerator temperatures. Store Janssen COVID-19 Vaccine in the refrigerator between 2°C and 8°C (36°F and 46°F) for up to the expiration or beyond use date (BUD).
The expiration date is NOT printed on the vaccine vial or carton. To determine the expiration date:
- Scan the QR code on the outer carton, or
- Call 1-800-565-4008, or
- Visit vaxcheck.jnj
Ancillary Supply Kits
Ancillary supply kits will be provided for administering the vaccine and include enough supplies to administer the allocated doses of vaccine. These kits are delivered separately from the vaccine.
Administration supplies include needles, syringes, sterile alcohol prep pads, vaccination record cards (shot cards), and some PPE.
Unpack the kit and check contents for correct supplies and quantities.
What are the storage and handling recommendations?
What if my cold storage unit goes outside of the recommended temperatures?
"Heat, cold, or light exposure can damage vaccines, resulting in reduced potency. Once potency is lost, it cannot be restored." - Centers for Disease Control and Prevention
If the vaccine is subject to a temperature excursion - that is, any temperature outside of the recommended temperature storage ranges for
any amount of time - it must be reported to ADHS VFC using
the incident reporting form and submission instructions.
What kind of information do I need to give to vaccine recipients?
For each COVID-19 vaccine authorized under an Emergency Use Authorization (EUA), the Food and Drug Administration (FDA) requires that vaccine recipients or their caregivers are provided with certain vaccine-specific EUA information to help make an informed decision about vaccination. This is accomplished by providing a an EUA Fact Sheet for Recipients and Caregivers. The Fact Sheet is similar in purpose and content to vaccine information statements (VISs) for licensed vaccines but differs in that the EUA Fact Sheet is specific to each authorized COVID-19 vaccine, is developed by the manufacturer of the vaccine, and is authorized by the FDA.
There is no VIS for COVID-19 vaccines authorized under an EUA. Instead, the FDA-issued EUA Fact Sheet for Recipients and Caregivers for each COVID-19 vaccine must be used.
To help facilitate documentation of having provided the EUA Fact Sheet in electronic medical records/immunization information systems, CDC is leveraging the existing
VIS Code Set infrastructure, barcoding, and URLs to provide the information needed for various systems, analogous to electronic system and workflow documentation of VISs.
FDA Fact Sheets must be made available for vaccine recipients.
We also recommend handing out information about the
VSAFE program.
My staff doesn't routinely give immunizations. What training resources can we use?
There are several online training resources for staff to complete for education on COVID-19 vaccines, storage and handling, inventory management and immunization best practices.
Prioritization and Distribution
Who can I administer vaccines to?
Pima County has developed a comprehensive plan for making the COVID-19 vaccine available throughout the community. Following guidance from both the CDC and Arizona Department of Health Services, PCHD, in collaboration with local hospitals and community partners, is committed to the equitable and efficient distribution of the vaccine. Because the initial vaccine supply is limited, the plan has been prioritized to first vaccinate critical workforces, which includes healthcare and nursing home workers and other groups vulnerable to severe COVID-19 illness.
PCHD has consulted with its ethics committee for direction and recommendations to ensure that the plan reflects community sentiment and concerns.
PCHD will adhere to the following guiding principles for ethical vaccine allocation:
- Administer an effective COVID-19 vaccine to all Pima County residents to reduce the spread of COVID-19 and related illnesses, hospitalizations, and deaths.
- Execute the safe and timely delivery of the vaccine.
- Provide equitable access to all who live, work, or are educated in Pima County while targeting high risk and vulnerable populations based on evidence.
- Seek broad and meaningful community engagement so that communication strategies are responsive, data informed and trusted • Provide clear, transparent and data driven information to the public about vaccine risks, benefits, safety, allocation, targeting, and availability.
Please check
Vaccine Distribution page for updates.
When I receive a vaccine, should I give it all as first doses or should I hold half of my inventory to ensure I have booster doses?
At this time, we ask that initial allocations be used as first doses. Second doses will be provided as inventory allows when the prescribed time frame has elapsed.
If I receive vaccine, am I guaranteed to receive second doses?
All efforts will be made to ensure second doses are allocated in a timely manner but due to the constrained nature of the inventory, we cannot guarantee the availability of booster doses.
What if I cannot use all the vaccine I received?
If you have full vials that you are unable to administer, please email the Pima County Health Department vaccine team at
HEOCVaccine@pima.gov.
All efforts should be made to ensure eligible patients are available for vaccination however, if you are unable to identify an eligible patient and have doses remaining in a vial, it is acceptable to use remaining doses on any clinically appropriate patient to avoid wastage.
VAERS Information
The Vaccine Adverse Event Reporting System (VAERS) is a national early warning system to detect possible safety problems in vaccines used in the United States.
VAERS accepts and analyzes reports of adverse events (AEs) after a person has received a vaccination. Anyone can report an adverse event to VAERS. Healthcare professionals are required to report certain adverse events and vaccine manufacturers are required to report all adverse events that come to their attention.
Healthcare professionals are encouraged to report any clinically significant event following a vaccination in VAERS, even if they are not sure if vaccination caused the event.
Healthcare providers are required to report to VAERS the following adverse events after COVID-19 vaccination, under Emergency Use Authorization (EUA), and other adverse events if later revised by CDC:
Vaccine administration errors, whether or not associated with an adverse event (AE)
Serious AEs regardless of causality. Serious AEs per FDA are defined as:
- Death
- A life-threatening AE
- Inpatient hospitalization or prolongation of existing hospitalization
- A persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions
- A congenital anomaly/birth defect
- An important medical event that based on appropriate medical judgement may jeopardize the individual and may require medical or surgical intervention to prevent one of the outcomes listed above.
- Cases of Multisystem Inflammatory Syndrome
- Cases of COVID-19 that result in hospitalization or death
Also report any additional select AEs and/or any revised safety reporting requirements per FDA’s conditions of authorized use of vaccine(s) throughout the duration of any COVID-19 Vaccine being authorized under an EUA.
Managing Vaccine Hesitancy
With COVID-19 vaccine, Healthcare Providers still remain the most trusted advisor and influencer of patient decisions. The capacity and confidence of providers, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address patient questions.
Overall, providers need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between providers, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations.
Resources