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New York State releases draft plan for COVID-19 vaccine distribution

On Sunday, Governor Andrew Cuomo announced that the state Department of Health had released its draft COVID-19 Vaccination Administration Program.

It will serve as an ‘initial framework’ for ensuring the safe and effective distribution of a COVID-19 vaccine in New York, the Governor said.

The draft program was developed in consultation with leading clinical and public health experts, and requires collaboration and partnership with local departments of health, community partners and organizations, and the federal government.

Given the many unknowns at this point in the vaccine development process, the draft New York State COVID-19 Vaccination Administration Program is designed to be flexible and account for multiple variables and scenarios regarding vaccine availability, timeline for vaccine approval, delineation of federal and state responsibilities, funding, supply chain needs, and allocation requirements.

“We are coming up with a plan on many presumptions. We don’t know how many doses we’re going to get. We don’t know what vaccine we’re going to get. We don’t know when we’re going to get it. The state will have a statewide vaccination plan. We will do it in concert with the federal government. The federal government is in charge of producing the actual vaccine and distributing the vaccines,” said Governor Cuomo. “States cannot do this on their own. Period. This is a massive undertaking. This is a larger operational undertaking than anything we have done under COVID to date. This is a more complicated undertaking and task. And we need the federal government to be a competent partner with this state and with every state.”

Following the determination that the vaccine is safe and effective, the draft Vaccination Program prioritizes vaccination recipients based on science, clinical expertise, and public health. The plan puts forward the following proposed prioritization matrix to ensure those most at risk and essential workers are priority recipients, with particular attention paid to those living in communities with highest COVID prevalence.

Within each phase, the draft plan puts forward the following proposed additional prioritization phases to be used based on vaccine availability and vaccination rates:

Phase 1
  • Healthcare workers (clinical and non-clinical) in patient care settings (ICU, ED, EMS top priority)
  • Long-term care facility workers who regularly interact with residents
  • Most at-risk long-term care facility patients
Phase 2
  • First responders (fire, police, national guard)
  • Teachers/school staff (in-person instructions), childcare providers
  • Public Health workers
  • Other essential frontline workers that regularly interact with public (pharmacists, grocery store workers, transit employees, etc.) or maintain critical infrastructure
  • Other long-term care facility patients and those living in other congregate settings
  • Individuals in general population deemed particularly high risk due to comorbidities and health conditions
Phase 3
  • Individuals over 65
  • Individuals under 65 with high-risk
Phase 4
  • All other essential workers
Phase 5
  • Healthy adults and children

The draft New York State COVID-19 Vaccination Administration Program was prepared by the NYS Dept. of Health and is subject to change based on future details expected from the federal government. The draft plan outlines:

  • Guiding principles to be adhered to throughout the vaccine process
  • Key assumptions, unknowns, and variables that may impact vaccine planning
  • Measures to ensure vaccine safety and effectiveness, both pre and post administration
  • Expertise to guide vaccine distribution and implementation
  • A vaccine prioritization matrix based on clinical guidance
  • A process for efficient vaccine distribution and delivery
  • Measures to train, register, deploy and support providers to administer the vaccine
  • A data and IT infrastructure to coordinate and monitor all aspects of the vaccine program
  • A public education and community outreach campaign to build trust and inform the public
  • A Vaccine Central Command Center to manage the entire vaccine program
  • A budget and procurement process to obtain necessary supplies and equipment

The draft New York State COVID-19 Vaccination Administration Program responds to the fact that there are still myriad unknowns about the federal government’s vaccine development process and plan, including its timing, allocation, quantities, prioritization, distribution, administration and monitoring post-administration. To date, the federal government has not clearly delineated the roles and responsibilities between the federal and state government, outlined how the vaccine will be funded or reimbursed, and provided other key details that will be required before New York can finalize plans for a vaccine program.