ANNAPOLIS, MD—Governor Larry Hogan on Tuesday announced the release of the State of Maryland’s initial draft COVID-19 mass vaccination plan, which was submitted to the Centers for Disease Control and Prevention last week.

“In anticipation of a COVID-19 vaccine, Maryland stands ready to order, distribute, and administer it effectively and rapidly as soon as a vaccine becomes available,” said Governor Hogan. “The State of Maryland’s plan for this historic undertaking will immediately make the vaccine available to Marylanders at highest risk of developing complications from COVID-19 as well as our critical frontline health care workers and essential workers in public safety and education.”

“The Maryland Department of Health has worked collaboratively with our many partners in both the public and private sectors to develop a draft plan that will ensure the swift, safe, and equitable administration of a life-saving COVID-19 vaccine,” said Maryland Department of Health Secretary Robert R. Neall. “We stand ready to take additional action and operationalize this effort as soon as a vaccine becomes available.”

“As we learn more, our plan will continue to evolve—but our focus will always be on the safety and efficacy of the COVID-19 vaccine to prevent the spread of the disease among Marylanders,” said MDH Acting Deputy Secretary of Public Health Dr. Jinlene Chan. “From provider recruitment and enrollment to vaccine storage and reminders about second doses, MDH has taken a very calculated approach to ensure the logistics, operations, and execution of this plan are thorough and efficient.”

Governor Hogan recently toured the headquarters of Novavax, Inc. in Gaithersburg—one of nearly 40 Maryland companies that are working on developing and manufacturing COVID-19 vaccines and therapeutics, improving diagnostic tests, and providing clinical research and technological support to ensure safe and effective health care delivery.

In April, state health officials began multi-agency operational discussions in preparation for a COVID-19 vaccine. That preparation included reviewing lessons learned from previous pandemics and outbreaks—including the 2009 H1N1 influenza pandemic—as well as previous influenza vaccination campaigns.

Phased Plan for Vaccination Distribution

Maryland’s draft COVID-19 vaccination plan focuses on two major phases of vaccine availability and distribution. Phase 1 will focus on priority groups to receive vaccination, and Phase 2 will have wide-scale vaccine availability for the general population. Additionally, vaccine supply is expected to rapidly increase once distribution begins, alleviating the need to limit vaccine administration.

Phase 1: Vaccination of Critical Populations

Initial COVID-19 vaccination efforts will target those at highest risk of developing complications from COVID-19 and those in critical industries:

• Frontline first responders and health care workers evaluating and caring for COVID-19 patients;
• Staff and residents of nursing homes, long-term care facilities, and assisted living facilities; and
• Essential workers, including public safety, education, and staff in congregate living facilities.

Specific vaccination metrics will be utilized to assess Phase 1 vaccination progress and determine where additional effort is needed. These metrics may include:

• Percent of Phase 1 population vaccinated;
• Percent and number of residents and staff at long-term care facilities vaccinated;
• Determination of an equitable distribution of COVID-19 vaccine throughout the state for the Phase 1 population; and
• Percent and number of Phase 1 population pre-registered.

Phase 2: Vaccination of General Public

Determination of the beginning of Phase 2 will be influenced by a number of factors:

• Availability of COVID-19 vaccine;
• Notification by CDC and state authorities that the general public Phase 2 can begin due to sufficient supply; and/or
• Achievement of targeted metrics for vaccination of high priority Phase 1 groups.

Primary Components of Maryland’s Draft COVID-19 Vaccination Plan

Provider Recruitment and Enrollment

MDH is in the process of actively recruiting and enrolling health care providers, local health departments, employee occupational health providers, and pharmacists in Maryland’s Vaccine Program Immunization Information System (ImmuNet) to ensure that there will be sufficient vaccinators to meet local needs. ImmuNet is where providers register to order COVID-19 vaccines, track delivery of vaccines, report doses administered, and determine when second doses are due.

Vaccine Allocation, Ordering, Distribution, and Inventory Management

MDH will require pre-registration of Phase 1 vaccine sites and registration of priority vaccine candidates at each site. Vaccine orders will be placed in ImmuNet, which will then be uploaded to the CDC VTrckS vaccine ordering system for shipping directly to the hospital or work site.

Vaccine Storage and Handling

COVID-19 vaccine products are temperature sensitive and will need to be stored and handled correctly to ensure vaccine viability prior to administration to a patient. The CDC is currently developing storage and handling guidelines for COVID-19 vaccines.

Vaccine Safety Monitoring

With the rapid development and licensing of COVID-19 vaccines, vaccine safety monitoring is a high priority to establish and maintain confidence in the vaccine. CDC and the FDA continuously monitor the safety of vaccines. Three main systems are used to monitor the safety of vaccines: MDH participates in the Vaccine Adverse Event Reporting System (VAERS), Vaccine Safety Datalink (VSD), and Clinical Immunization Safety Assessment Project.

Vaccination Program Metrics

Monitoring of the COVID-19 vaccination program will be critical to the program’s success, and several online dashboards are currently under development. The weekly flu vaccination dashboard and the COVID-19 vaccination response dashboard will use data related to flu and COVID-19 vaccination that are collected from various sources. MDH will also have Maryland-specific dashboards based on information collected in ImmuNet.

Vaccination Second Dose Reminders

For most COVID-19 vaccines, two doses of vaccine will be required separated by >21 or >28 days. Second dose reminders will be provided to patients in several ways. Marylanders may choose to receive reminders through PrepMod, an online resource that will be used to schedule clinics, track equipment needs, and report vaccination activity. Alternatively, patients may be scheduled for second doses from the provider-based systems. Maryland also has a dedicated consumer vaccination portal, Maryland MyIR, which allows registered users to obtain their current vaccination records from ImmuNet, and can also be used to issue reminder messages if two doses are required.

Public Health Campaign

MDH will coordinate with trusted community partners, priority group representatives, and representatives of vulnerable populations, along with a marketing vendor, to execute a public health campaign focused on the safety and efficacy of a vaccine.

The full draft version of the plan can be viewed below.

Click to access 10.19.2020_Maryland_COVID-19_Vaccination_Plan_CDCwm.pdf