Orange County COVID-19 Vaccine Taskforce
Thursday, December 17th, 2020
Introductions&
Reflections
Dr. Clayton ChauHCA, Director
Task Force Group – Welcome New Members
Ellen Ahn, JD, MSWExecutive Director, KCSOC Asian Pacific Islander COVID 19 Task Force
Oliver ChiCity ManagerCity of Huntington Beach
Stu GreenbergTustin Police Chief
Representing Orange County Chiefs of Police and
Sheriff’s Assoc.
Jeff Pagano
UCI, OC Veterans & Military Families Collaborative
Gloria Alvarado
Executive Director for the Orange County Labor
Federation
Dan Cooper, MDAssociate Vice Chancellor for Clinical and Translational
Research
University of California, Irvine
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
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
Aaron Kheriaty, MDUCI School of Medicine
Philip Robinson, MD, FIDSAMedical Director of Infection Prevention and Hospital
Epidemiology
Hoag Hospital
Whitney Ayers
OC Regional Vice President
Hospital Association of Southern California
Lucy Dunn President and CEOOrange County Business Council
Cevadne Lee, MPH
Director, Community Outreach & EngagementUCI Cancer Center
Jasjit Singh, MD
CHOC Children’s Hospital
Isabel Becerra
Chief Executive Officer
OC Coalition of Community Clinics
Emily Fonda, M.D.
Interim Chief Medical Officer
CalOptima
Anne Light, MD
Medical Director
OC Social Services Agency
Michelle Steel
Chairwoman
OC Board of Supervisors
Bernadette Boden-Albala M.P.H., Dr.PhDirector and Founding Dean of the Program in Public Health
University of California, Irvine
Megan FrancisExecutive Director, Orange County Dental Society
Adam Loeser
Fire Chief
City of Brea
Lisa Wright Jenkins
President & CEO
Council on Aging – Southern California
Donna Boston, MPA, CEMDirectorOrange County Sheriff's Department, Emergency Management Division Orange County Operational Area
The Most Rev. Timothy Freyer
Auxiliary Bishop
The Roman Catholic Diocese of Orange
Helen Macfie, Pharm.D., FABC Chief Transformation Officer
Executive Administrator, Clinically Integrated Network
MemorialCare
Rebecca Yee
Ensign Services
America Bracho, MPH, CDE
Executive Director
Latino Health Access
Joy Anne Fumera, RN, MSNRegistered Nurse
Lieutenant Dave MainOrange County Sheriff’s Department Security Bureau
Matt Zahn, MDMedical Director of the Division of Communicable Disease
Control
OC Health Care Agency
Margaret Bredehoft, Dr. PH
Deputy Agency Director, Public Health Services
OC Health Care Agency
Jeff Goad, Pharm.D., MPH, FAPhA, FISTM, FCPhA, FCSHPProfessor & Chair Department of Pharmacy Practice, School of Pharmacy, Chapman University
Al Mijares, Ph.D.
County Superintendent of Schools
Clayton Chau, M.D., Ph.D
Director
OC Health Care Agency
Laura Gomez
Teacher
Santa Ana Unified School District
Mario A. OrtegaPresident and CEOAbrazar, Inc
Agenda
1. Introductions• Welcome & Reflection
• Session Agenda & Objectives
2. Updates• Vaccine Status
• Communication Activities
3. Vaccine Hesitancy Survey – Report & Actionable Findings• Report Actionable Findings
4. Othena• Introducing’s HCA’s Technology Partner – CompositeApps
• Demonstration of Othena
• Brainstorm Approaches to Dissemination and Adoption
5. Next Steps & Wrap-Up
Updates & Communication
What is OCA’s plan for delivering vaccine to Orange County?
Allocation Algorithm
Data driven decision making tool • to meet goals of fair distribution of limited supply
of vaccine
To hospitals with capacity
Prioritizing
Highest Risk Staff
Areas with higher COVID burden
Census data• 184,053 Hospital workers
General Acute Care Hospital: 44%
Skilled Nursing/Elderly Facility: 16%
Acute Psychiatric hospital: 5%
Other: 35%
Doses to be distributed with first vaccine shipment
• 25,350 doses
Data Driven Decision Making for First Allocation
Total highest/high risk staff and
hospital readiness/capacit
y
COVID Burden in surrounding area
of hospital
Calculation
Allocation distributed by
box of 975 doses
Total Highest/High Risk staff and Hospital Readiness & Capacity• Hospital Self Reported Survey Oct 2020 with re-
verification of information by HCA closer to allocation decision
• Readiness/capacity to deliver ultralow temp freezer requiring storage of initial COVID vaccine
COVID Burden in Surrounding Community of each Hospital
Calculation- Approximate # needed to vaccinate similar % of highest/high risk staff- Rounding up or down to meet allocation of 1 box (975 doses) per hospital-
(Round up if high COVID burden, round down if low COVID burden)- Further HCA staff review and adjustments when data did not reflect
experience of burden
Final Allocation Recommendation- Distribution recommendation in boxes of 975 doses- HCA to assist with storing for smaller hospital facilities/groups
Pfizer first
shipment
Allocations
Health System Allocation Boxes
Vaccination Doses
AHMC Healthcare Inc. 24 23,400
CHOC Children’s
Hoag
Kaiser Permanente
KPC Health
MemorialCare Health System
Prime Healthcare Services
Providence
Tenet Healthcare Corp
UC Health
*Encompass Health-working with one of the one of the hospitals listed above to vaccinate highest risk staff
HCA
Stored for distribution College Hospital Costa Mesa, Kindred, HCA corrections, EMS
1 975
Reserved for other high risk Phase 1a, Tier 1 not in hospital settings
1 975
Total 26 25,350
Pfizer vaccines makes it’s way to the OCDecember 16th, 2020
Data-driven Option for Continued Phased Distribution
Continue to offer Vaccinations to highest risk of Phase 1a Tier 1
Progressively move to Tier 2 and 3 of phase 1a as more vaccine becomes available
Utilize technology to assist with • Personal calculation which phase/tier might belong in – dependent on work
environment/role, living environment, exposure, personal attributes that might
increase risk
• Virtual Queue and notification once vaccination becomes available
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/CDPH-Allocation-Guidelines-for-COVID-19-Vaccine-During-Phase-1A-Recommendations.aspx
HCA- 1st Pfizer shipment received Dec 16 and redistributed • Hospitals- approx. 24K doses distributed to
hospitals (60% of total identified highest risk staff of hospitals)
• HCA- Approx 1K doses reserved for other high risk Tier 1 candidates (EMT/Paramedics, other)
CDC pharmacy partnership
Hospitals currently administering vaccines to their highest risk staff this
week
CVS/Walgreens Anticipated to start delivering vaccine to LTCF week of Dec
21-25
Guidance – We are in Phase 1a, Tier 1 Activity/EntityWhere is vaccine being
administered?
Dialysis centers being contacted at this time
Anticipate more clinics will be approved over next few
weeks to administer vaccine, however clinics outside of
hospitals who can administer vaccine will be asked to
administer to set populations within highest risk Phase 1a, Tier 1 first. As more vaccines become available, vaccines can be offered to Phase 1a
Tier 2/Tier 3 candidates
Smaller clinic sites being determine to assist with administering vaccines to
highest risk
Tier 1
Acute care, psychiatric and correctional facility
hospitals
Skilled nursing facilities, assisted living facilities, and
similar settings for older or medically vulnerable
individuals
Also, in concordance with ACIP, residents in these
settings
Paramedics, EMTs and others providing emergency
medical services
Dialysis centers
Tier 2
Intermediate care facilities for persons who need non-
continuous nursing supervision and supportive care
Home health care and in-home supportive services
Community health workers, including promotoras
Public health field staff
Primary Care clinics, including Federally Qualified
Health Centers, Rural Health Centers, correctional
facility clinics, and urgent care clinics
Tier 3
Other settings and health care workers, including
Specialty clinics
Laboratory workers
Dental and other oral health clinics
Pharmacy staff not working in settings at higher tiers
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/CDPH-Allocation-Guidelines-for-COVID-19-Vaccine-During-Phase-1A-Recommendations.aspx
Week 1Dec 16
Week 2Dec 20-26
Week 3Dec 27-Jan 2
Week 4Jan 3-9
Week 5Jan 10-16
Pfizer #1 (dose 1) 25,350
Pfizer #2(dose 1)
Pfizer #1 (dose 2)
Pfizer #3 Pfizer #2(dose 2)
Moderna #1(dose 1)
Moderna #1(dose 2)
Moderna #2 (dose 1)
Phase 1a Tier 3Specialty clinics, laboratory workers, dental and other oral health clinics, pharmacy staff not working in settings at higher tiers
LTCF + SNF (CDC & Pharmacy Partnership)
Phase 1a Tier 2Intermediate care, home health, in-home support service, community health, workers, public health field staff, primary care clinics, FQHC, correctional facility clinic, urgent care clinic
Phase 1a - Tier 1: Hospital/EMT/Paramedic/LTCF/Dialysis
Week 6Jan 17-23
Week 7Jan 24-31
Week 8-10Feb 1-28
Week 12-16March 1-30
Phase 1bUnderlying medical conditions placing at high risk for severe CovidOlder adults in congregate/overcrowded settings
Estimated timeline for vaccine availability for Phase 1
OC Census data 2020:184,000 Healthcare workers in OC
Phased Distribution Plans for OC – Phase 1 (Dec 2020-Mar 2021) Note: These estimates are subject to changes; they are dependent on vaccine availability, local capacity, re-classification of a group in relation to COVID prevalence and risk- Table reflects CDPH current guidance as of 12.5.2020
CDPH Phase 1a Link
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/CDPH-Allocation-Guidelines-for-COVID-19-Vaccine-During-Phase-1A-Recommendations.aspx
Phased Distribution Plans for OCPhased Distribution non-HealthCare population 2021
Update on Communication Strategies
1. Communication with Providers
• Weekly updates
• Targeted FAQs
• Resources / links
• Forums / webinars
2. Communication with General Public
• CDPH Toolkit (released 12/15) -
https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-
Toolkits/Communications-Toolkit.aspx
• CDC Toolkit - COVID-19 Vaccination Communication Toolkit for Health Systems
and Clinics | CDC
• Website with FAQs, announcements, links and newsfeeds (Spanish &
Vietnamese sites coming)
• Town Halls
3. Targeted Communications
• Address issues identified in the survey, including understanding the cause of the
hesitancy
• Developed with each strategic partners
• Adapting materials and activities for specific community groups
https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Communications-Toolkit.aspxhttps://www.cdc.gov/vaccines/covid-19/health-systems-communication-toolkit.html
The OCHCA Vaccine Hesitancy Survey Results
Casey Dorman, Ph.D.Orange County Healthcare Agency
Composition of Sample (n = 26,324)
• Convenience sample send by email to 25,000 by Taskforce members and
1300 responses collected face-to-face or telephone from central OC
community clinics
• Gender: 73% female
• Age: 51% 35-54
2.9% 75+
• Ethnicity: 51.6% are Non-Hispanic White
25.3% are Hispanic
1.0% are Non-Hispanic Black
• Education: 70% had 4- year college degree or higher
• Language: 87% English was primary language
Occupations of Respondents
Group Number %
Healthcare worker 2,902 11.1
First responder 810 3.1
Retail/Food Services 894 3.4
Education 6,350 24.3
Student 1,474 5.6
Construction/Maintenance/Landscape 358 1.4
Office/Professional/Technical 6,897 26.4
Housekeeping/Cleaning/Janitorial 145 0.6
All Responders Agreement with Positive Vaccination Questions (margin of error
Willingness to be Vaccinated by Personal Attributes
0%
10%
20%
30%
40%
50%
60%
70%
80%
% Willing to be Vaccinated
Vaccine - Yes
Who was Most Willing to be Vaccinated?
Willingness to be vaccinated for COVID-19 varied by city, age, gender, race/ethnicity, level of education, and occupation.
With some exceptions, willingness to be vaccinated increased with • Age
• Education level
• Males were more willing than females,
• Asian and non-Hispanic Whites race/ethnicity
• Primary language other than English or Spanish
• Residence in Anaheim, Brea, La Habra, Santa Ana, or San Clemente
Which Occupations were Most and Least Willing to be Vaccinated
Among occupations, those most willing to be vaccinated included: • Retirees
• Students
• Disabled/unemployed
Those least willing to be vaccinated included • First responder
• Construction/maintenance/landscaping workers
• Homemakers
Willingness to be Vaccinated by Occupation
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
% Willling to be Vaccinated
How Well do the Five Concerns Predict Willingness to be Vaccinated?
Overall Sample: • A combination of five concerns predicts Willingness, accounting for 58% of the variability in
Willingness scores. • All concerns made a significant contribution to Willingness.
In order of strength of prediction when all the concerns were taken into account, the strongest predictors of willingness to vaccinate were:
Consistent across all groups1. Confidence in vaccine safety2. Valuing protecting others through vaccination3. Viewing COVID-19 as serious enough to warrant vaccination
Inconsistent but a significant concern in some groups4. Whether everyday stresses interfered with getting vaccinated5. Whether one weighed the benefits and risks before making a decision (negatively related to
willingness)
Who Needs to be Focus of Vaccine Acceptance Messaging?
All groups need to be encouraged to get vaccinated
Special Focus on:• Gender: Women
• Age: 35-54 year olds
• Race/Ethnicity: Hispanics and non-Hispanic Blacks
• Education: Those with a high school diploma and some college
• Occupation:
First responders
Construction/maintenance/landscaping workers
Homemakers
• Residents of Anaheim, Brea, La Habra, Santa Ana, and San Clemente
What Concerns need to be Addressed and For Whom?
1. Vaccine Safety needs to be addressed with everyone.
2. Protecting others and understanding the seriousness COVID-19 also needs to be addressed with everyone.
3. Understanding the seriousness of COVID-19 needs to be a target for messaging with non-Hispanic Whites, those with a 4-year college degree, first responders, and construction/maintenance/landscaping workers.
4. Reducing the difficulty of getting vaccinated is particularly important for non-Hispanic Whites, those with college degrees, students and retired people.
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!
Feedback & Questions
Thoughts on Opportunities for Your Constituencies?
Thank you!
Standing Schedule: 1st and 3rd Thursdays, 4:00-5:30Next meeting: Thursday, January 7th