Orange County COVID-19 Vaccine Taskforce

Thursday, December 3, 2020

Introductions&

Opening Remarks

Dr. Clayton ChauHCA, Director

Welcome New Members

Ellen Ahn, JD, MSWExecutive Director, KCSOC Asian Pacific Islander COVID 19 Task Force

Oliver ChiCity ManagerCity of Huntington Beach

Aaron Kheriaty, MDUCI School of Medicine

David Ramirez, M.D.

Chief Medical Officer

CalOptima

Gloria Alvarado

Executive Director for the Orange County Labor

Federation

Dan Cooper, MDAssociate Vice Chancellor for Clinical and Translational

Research

University of California, Irvine

Cevadne Lee, MPH

Director, Community Outreach & EngagementUCI Cancer Center

Philip Robinson, MD, FIDSAMedical Director of Infection Prevention and Hospital

Epidemiology

Hoag Hospital

Lisa Armony

Senior Director, Community Relations OC interfaith

Network

Director Community Relations Jewish Federation OC

Jason Cord, M.D.President & Board of Directors, Orange County Medical

Association

Chief of Radiology, Kaiser Permanente Orange County

SCPMG Government Relations Lead, Orange County

Ann Light, MD

Medical Director

OC Social Services Agency

Jasjit Singh, MD

CHOC Children’s Hospital

Whitney Ayers

OC Regional Vice President

Hospital Association of Southern California

Lucy Dunn President and CEOOrange County Business Council

Adam Loeser

Fire Chief

City of Brea

Michelle Steele

Chairwoman

OC Board of Supervisors

Isabel Becerra

Chief Executive Officer

OC Coalition of Community Clinics

The Most Rev. Timothy FreyerAuxiliary BishopThe Roman Catholic Diocese of Orange

Helen Macfie, Pharm.D., FABC Chief Transformation Officer

Executive Administrator, Clinically Integrated Network

MemorialCare

Lisa Wright Jenkins

President & CEO

Council on Aging – Southern California

Bernadette Boden-Albala M.P.H., Dr.PhDirector and Founding Dean of the Program in Public Health

University of California, Irvine

Joy Anne Fumera, RN, MSNRegistered Nurse

Lieutenant Dave MainOrange County Sheriff’s Department Security Bureau

Rebecca Yee

Ensign Services

Donna Boston, MPA, CEMDirectorOrange County Sheriff's Department, Emergency Management Division Orange County Operational Area

Jeff Goad, Pharm.D., MPH, FAPhA, FISTM, FCPhA, FCSHPProfessor & Chair Department of Pharmacy Practice, School of PharmacyChapman University

Al Mijares, Ph.D.

County Superintendent of Schools

Matt Zahn, MDMedical Director of the Division of Communicable Disease

Control

OC Health Care Agency

America Bracho, MPH, CDE

Executive Director

Latino Health Access

Laura Gomez

Teacher

Santa Ana Unified School District

Mario A. OrtegaPresident and CEOAbrazar, Inc

Margaret Bredehoft, Dr. PH

Deputy Agency Director, Public Health Services

OC Health Care Agency

Stu GreenbergTustin Police Chief

Representing Orange County Chiefs of Police and

Sheriff’s Assoc.

Jeff Pagano

UCI, OC Veterans & Military Families Collaborative

Clayton Chau, M.D., Ph.D

Director

OC Health Care Agency

Candi Kern

President

Fourth District PTA

Karen Pavic-Zabinski, PhD RN, MSN, MBA, MA, MS

Regional Director Of Ethics

Providence St. Joseph Health Southern California

Agenda

1. Introductions

• Welcome & Opening Remarks

• Session Agenda & Objectives

2. Updates

• Vaccine Status

• HCA COVID Response

• Update on Marketing & Strategies

3. Vaccine Hesitancy Survey Findings (initial analysis)

4. Next Steps & Debrief

Updates & Communication

Our App to Expand HCA Capacity to Achieve Independence from COVID-19

Benefits for Health Providers: App is an end-to-end process to stand up your vaccination clinic and engage your staff with minimal impact on current operations.

• The system talks to CALVAC and the California Department of Public Health electronically via DiEX.

• It automatically bills and files for reimbursements for COVID related testing, vaccine kits, and affiliated

services.

Benefits for Patients: The system will help patients monitor side-effects and prompt them to seek medical attention for any urgent issues.

• It will provide them with after-visit summaries, as well as mobile-based testing records

• “CoVax Passports” that can be shown at restaurants, events, airports, and other businesses as proof of

vaccination.

Benefits for Public Health: The system will help with equitable distribution of vaccines across wide demographics.

• By removing barriers to care, App will help ensure that the vaccines are made available to every single

resident of Orange County, driving the entire population towards herd immunity, leading to the resumption of

normal life.

HCA Vaccine Near-Term Activities

First Shipment:

• Targeted Date of Receipt of Initial Supply: December 15th (Pfizer only for the first allocation)

• 26 Boxes of 975 totaling 25,350 vaccine

• HCA responsible to distributed to all hospitals in OC to vaccinate their high risk healthcare workers in Phase 1A in the first

allocations

• Long-term care facilities will work directly with national retail pharmacies to coordinate roll out of C19 vaccine to its population.

• Subsequent shipments have not been confirmed but expected to be received weekly

Facts:

• For Pfizer Requires Ultra-low Freezer (-80 to -100 degrees F); special handling is required for transport and storage

• Need to be administered within 5 days - requiring an administration rate of an average 200 patients per day (once thawed)

• Both MCE and Non-MCE Hospitals - no LTCF

Distribution Rules – for first shipment:

• HCA to assess provider readiness to determine allocation, including freezer/storage, readiness to deliver ‘shots in arms’

• Distribution will be in full boxes of 975

• Hospital needs to attest to having a plan to administer all vaccines within 5 days (unless the facility has the proper freezer)

Task Force to provide feedback on allocation approach in this session!

Proposed HCA Approach for Phase 1a/Allocation #1 (“Preposition”)

25,350 Doses: distributing 26 boxes of Pfizer vaccines (975 per box; boxes kept whole)

1st Criteria: what the hospital says they need and can deliver, per requirements

2nd Criteria: COVID patient volume (weighting towards hospitals who are seeing more COVID admissions)

3rd Criteria: a ceiling on the amount a given hospital may receive based on their proportional size

HCA will promote hospital’s sharing of ‘extra’ vaccine from this preposition allocation with key community partners (e.g. small hospitals, community clinics)

We expect to receive our next allocation in several weeks (a much larger volume); distribution targets will include non-hospital health care providers

Update on Marketing & Communication Strategies

1. Press Release – early next week

• County of Orange Prepares for First Allocation of COVID-19 Vaccine

2. CovidVaccineFacts.com Website – Initial Content

• Introduction

• FAQs

• Myth busters & OpEd – Herd Immunity

• Vaccine News & Information – Diocese press release, BBC effective vaccines, etc. (maybe 6 recent)

• CDC – Key Vaccine links – Facts, Benefits, 10 Things Health Professionals Need to Know

• TESTING link to testing page.

3. Advertising:

• Paid search terms – all things vaccine

• Digital Display Ads – promote covidvaccinefacts.com – Spanish, Vietnamese, Chinese, Korean

• Some streaming radio – in multiple languages

4. Media Monitoring – More details next meeting

Update on Communication Strategies: FAQs

1. How do COVID-19 vaccines work?

2. When will a COVID-19 vaccine be available?

3. What is herd immunity?

4. Why should I get a COVID-19 vaccine?

5. How do I know the COVID-19 vaccine will be safe?

6. What is Operation Warp Speed?

7. How can we be sure a COVID-19 vaccine is safe since vaccine development and production are being expedited?

8. Who will get the vaccines first and how is that decided?

9. The first vaccines are seeking Emergency Use Authorization. What does that mean?

10. Do vaccines only protect the person who is vaccinated or do they also protect others?

11. When people start getting the vaccine, can I stop social distancing and face covering?

Update on Communication Strategies: Myths: The Truth and the Facts

• Messenger RNA (mRNA) is not an untested vaccine methodology

• mRNA vaccines cannot change your DNA

• Microchips are not injected along with the vaccine

• Racial/ethnic groups or the elderly are not being singled out as “guinea pigs” to get the first vaccine

Advisory Committee on Immunization Practices (ACIP – Special Advisory Group to the CDC) &

California Department of Public Health

Guidance provided during Week of November 30th

Sequence for Approval and Distribution of First Vaccine Doses: California

1. Phase 3 trial data submitted to FDA by Developer (Pfizer and Modernadone)

2. FDA Vaccines & Related Biological Products Advisory Committee (VRBPAC) votes to recommend. Pfizer: 12/10; Moderna 12/17

3. FDA authorizes use of vaccine under Emergency Use Authorization

4. ACIP meeting to vote to recommend prioritization scheme (for Phase 1a, done 12/1)

5. CDC allocates to states based on population

6. Western states’ Safety Monitoring Workgroup convenes

7. Vaccination begins (~12/15/20)

California’s Initial Allocation (Pfizer vaccine only)

327,000 doses of Pfizer vaccine

ACIP Allocation Proposal

ACIP Allocation Proposal: Phase 1a

ACIP: Health Care Personnel: Sub-prioritization Considerations

Where sub-prioritization of health care personnel is needed, consider:

– Individuals with direct patient contact and unable to telework:• Personnel who provide services to patients or patients' family members

• Personnel who handle infectious materials

• Can include inpatient or outpatient settings

– Personnel working in residential care or long-term care facilities

– Personnel without known infection in prior 90 days• Reinfection appears uncommon during the initial 90 days after symptom onset of

preceding infection

• Serologic testing not recommended prior to vaccination

ACIP: Pfizer and Moderna Side Effects Data - HealthCare Workers

Phase 1 & II have had several months of post vaccination follow up

ACIP: Side Effects of Moderna and Pfizer Vaccines in Older Adults, Group Settings

Long Term Care

Long-Term Care Facility Residents will Receive Vaccine via Federal Pharmacy Partners

California Allocation Considerations

California Recommendations: Phase 1 Subprioritization

California Recommendations: Phase 1 Subprioritization

California Recommendations: Phase 1 Subprioritization

California Recommendations: Phase 1 Subprioritization—Type of Facility

California Recommendations: Phase 1 Subprioritization– Tier 1

To date, 1,084 Orange County care settings have enrolled in the CDC-Federal LTCF Pharmacy program

with CVS and Walgreens.

California Recommendations: Phase 1 Subprioritization—Tier 2

California Recommendations: Phase 1 Subprioritization—Tier 3

California Recommendations: Phase 1 Subprioritization—Location of Facility

California Recommendations: Phase 1 Subprioritization—Worker Atri

California Recommendations: Phase 1 Subprioritization—Vaccine Hesitancy

Vaccine Hesitancy SurveySummary of Findings

Update: Current Volume on Survey Results by Language

As of November 30, 2020 = 26,324 23

Arabic

Farsi 28

Khmer 85

Chinese 286

Korean 154

Vietnamese 236

Spanish 700

English 24,812

Face-to-face surveys

1,232

Demographicsof the Responses

Race/Ethnicity

Other Non-Hispanic

White Hispanic Non-Hispanic

Black Asian Total Age 18-34 Years 355 1,767 2,011 63 1,096 5,292

35-54 Years 709 6,618 3,567 121 2,187 13,202 55-74 Years 275 4,347 866 76 924 6,488 75 and older 17 552 60 4 119 752

Total 1,356 13,284 6,504 264 4,326 25,734 Gender Other 51 39 29 2 11 132

Female 928 9,662 5,042 183 2,872 18,687 Male 381 3,553 1,434 77 1,426 6,871

Total 1,360 13,254 6,505 262 4,309 25,690 Occupation Other 199 1,132 670 27 359 2,387

Healthcare worker 140 1,303 586 27 792 2,848 First responder 55 449 194 15 78 791 Retail/Food Services 56 360 287 11 172 886 Education 320 3,832 1,366 55 656 6,229 Student 113 435 443 23 453 1,467 Construction/Maintenance/Landscape 17 163 127 5 40 352 Office/Professional/Technical 345 3,247 1,963 79 1,152 6,786 Housekeeping/Cleaning/Janitorial 5 18 107 2 12 144 Homemaker 51 747 507 5 246 1,556 Retired 46 1,417 116 9 285 1,873 Disabled/Unemployed 16 174 121 5 68 384

Total 1,363 13,277 6,487 263 4,313 25,703 Highest level

of education Less than high school 20 37 448 4 97 606 High school diploma 63 395 827 10 275 1,570 Community College/some college 334 2,719 1,997 65 630 5,745 College degree (4-year) 442 4,152 1,676 78 1,622 7,970 Graduate degree 494 5,970 1,516 108 1,695 9,783

Total 1,353 13,273 6,464 265 4,319 25,674 Primary

language Other 65 120 31 2 324 542 English 1,258 13,036 4,871 257 2,978 22,400 Spanish 20 50 1,609 2 5 1,686 Vietnamese 1 1 1 - 575 578 Farsi 15 77 1 2 5 100 Chinese 1 1 1 - 337 340 Cambodian/Khmer 2 1 2 1 101 107

Total 1,362 13,286 6,516 264 4,325 25,753

Final Results will be presented in a report to be made available to the public.

We will use these findings to shape our targeted communications – working with task force members!

Early Conclusions: Overall Sample

Overall sample:

• Overall, percent who plan to be vaccinated is low (<60%)

• Overall, safety of the vaccine is the main concern

• Asians most likely to get vaccinated, followed by Whites then Hispanics and Blacks

• Males more likely to get vaccinated than females (so true likelihood of vaccination is higher than indicated for men)

• Protecting others is strong reason to vaccinate for younger people , 18-34

• Within ethnic groups (excluding Blacks), older Hispanics less likely to vaccinate, more concerned about safety, less concerned about seriousness of COVID-19, but are concerned about protecting others

• Age not a strong factor among Whites and Asians

Conclusions: Healthcare Workers

Among Healthcare workers

• Low likelihood of getting vaccinated (<60%) same or lower than general population

• Safety is main concern

• Protecting others is a strong factor for everyone

• White and Asian workers more likely to be vaccinated than Hispanic workers

• Safety a greater issue for Hispanic workers, concern for protecting others somewhat lower than for Whites or Asians

• Older healthcare workers less concerned about safety and more concerned about protecting others

• Male healthcare workers more likely to vaccinate than female

Next Meeting

Preview the Vaccine app and brainstorm how to deploy it

Advance the communication readiness for Phase 1a and county-wide messaging

Explore equity concerns related to COVID to inform communication strategies (Advance OC demonstration – Social Progress Index & OC COVID-19 data)

Thank you!

Standing Schedule: 1st and 3rd Thursdays, 4:00-5:30Next meeting: Thursday, December 17th