December 24, 2020

Updates to Physician Questions on Receiving the Vaccine

Physicians have many questions on how to obtain the COVID-19 vaccine for themselves and staff. The SCMA is continuing to work with DHEC to obtain answers.  Below is a new series of questions and answers on the COVID-19 vaccine.  (The 12/19/2020 Alert on how to register your site to receive the vaccine is below, after these questions and answers, in case you missed it.)

1. Why did hospitals receive the COVID-19 vaccine first?  

• Per federal requirements, DHEC had to submit a statewide vaccine plan to the federal government prior to the FDA approval of any vaccines.  DHEC submitted its plan on October 16,2020 based on the guidance at that time.
• At the time of DHEC's submission, the CDC's Advisory Committee on Immunization Practices (ACIP) recommended that Phase 1a of the vaccine delivery be given priority to front line healthcare workers treating COVID patients and Long Term Care residents. 
• The federal government required states to place an order for the number of vaccinations in the first round, designate sites that could handle quick distribution, and preposition the sites to receive the first delivery of the vaccine.  
• On December 1, 2020, after DHEC was required to submit information, the ACIP broadened its guidance to include all healthcare workers in Phase 1a. DHEC was unable to increase its request or change its site plan for the initial vaccines provided to South Carolina. 
• Not even all hospitals received vaccines with the first shipment, only selected sites that were prepositioned and trained on CDC guidelines for distribution. 

2. Hospitals are reaching out to primary care doctors and providing the vaccine.  Why?

• Because the ACIP guidance has broadened, DHEC has encouraged and asked hospitals to reach out and vaccinate as many physicians as it can within the broader Phase 1a description. 
• There are still challenges in getting the vaccine to non-hospital sites due to limitations with storage and pre-set doses requiring facilities to accept large quantities of the vaccine. Hospitals can help distribute the vaccine quickly to all health care workers. 

3. Staff at hospitals are receiving the vaccine, not just physicians. Why?

• DHEC has encouraged hospitals to vaccinate physicians, other healthcare providers, and administrative staff that are crucial to running a hospital. A hospital may vaccinate staff members and is not required to only vaccinate physicians. 

4. Will independent physician facilities obtain the vaccine? 

• Yes. DHEC has registered and accepted 611 sites to receive the vaccine, which includes many independent practices.
• Currently only Pfizer COVID-19 vaccines are being distributed, meaning a facility must be able to accept and store 975 vials of the vaccine at sub-zero temperatures.  DHEC cannot change these requirements set forth by the CDC.  In other words, it cannot provide the vaccine in smaller doses.
• The Moderna vaccine, which will be available soon, will be provided in smaller quantities and does not need sub-zero temperatures.  However, the initial Moderna vaccines will be used to vaccinate long term care facility residents and staff. 
• As the Moderna vaccine production increases, a site may qualify later to receive the Moderna vaccine at its site. 

5. DHEC accepted my practice's registration to receive the vaccine.  What is next? 

• Receiving an acceptance email from DHEC is the first step in the registration process.  Next, your site must be activated.  Sites are being activated as vaccine supplies increase.
• Prior to activation, DHEC will email your accepted practice through the listed coordinator and coordinate the proper training as required by the CDC.  
• As more vaccine becomes available, the federal government will provide DHEC an ordering cadence.  This means that soon DHEC will know South Carolina's weekly allocation and can begin placing orders and activating additional sites more regularly. Right now DHEC does not know exactly how much vaccine will be provided and on what distribution dates.  
• Sites may prepare for activation in advance. Then, when DHEC reaches out to activate your practice, you will have completed the training and can be activated more quickly. To prepare in advance, click here and scroll to the bottom of the page where there are additional resources. The training modules for the CDC record keeping and the VAMS system are located there.

6. My practice was rejected when it tried to register to receive the vaccine.  Or, my practice cannot meet the criteria set forth in the registration required by DHEC. What should my practice do to receive the vaccine? 

• DHEC is working to provide the vaccine for everyone, but there are limited supplies.
• Also, the CDC will not allow vaccine to be sent to sites that do not meet all of the CDC requirements, which currently require subzero storage and accepting 975 vials of vaccine. 
• DHEC has already asked that hospitals work to get the vaccine out to physicians in the community.  DHEC is working on this and other distribution mechanisms for practices that cannot meet CDC requirements.
• Various locations that are accepted sites around the state will be made access points, and your practice and staff will be able to receive the vaccine through that access point. 
• As these locations are decided, DHEC and the SCMA will be providing additional information to physicians and their staff on how to get vaccinated at these access points.

7. We are not a vaccination site, but we see plenty of patients with COVID.  Can I just go to the hospital and ask for the vaccine? Who do I ask? 

• DHEC has already asked that hospitals work to get the vaccine out to physicians in the community.  DHEC is working on this and other distribution mechanisms for practices that cannot meet CDC requirements.
• Various locations that are accepted sites around the state will be made access points, and your practice and staff will be able to receive the vaccine through that access point. 
• As these locations are decided, DHEC and the SCMA will be providing additional information to physicians and their staff on how to get vaccinated at these access points.

8. Why are hospitals distributing the vaccine to everybody, not just high-risk physicians? 

• The SCMA has brought this concern to the forefront for DHEC.  Please let the SCMA know if you see issues with the distribution from the hospitals and we will continue to take your concerns to DHEC and the South Carolina Hospital Association (SCHA).
• However, note that with the broader ACIP guidance, hospital decisions still may be within the guidelines as their are multiple criteria for these decisions.  
• Also, hospitals have been encouraged to reach out to provide the vaccine to physicians it can connect or partner with. 
• Last, remember that this was the first vaccine delivery and that DHEC is coordinating additional distributions as the vaccine allotment increases. DHEC is diligently working to expand the distribution of the vaccine to healthcare workers.