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Reporting LAHAN Alerts

COVID-19 Vaccine

Prioritization & Allocation


Background

Vaccine eligibility will be determined by phases of prioritization developed by the Centers for Disease Control and Prevention (CDC) through the Advisory Committee of Immunization Practices (ACIP) as well as guidance developed by the California Department of Public Health (CDPH) until sufficient supply of COVID-19 vaccine becomes available. Local planning is used to further refine these categories and assist in implementation based on the current status and trends in transmission in LA County.

LA County Vaccine Allocation Phases and Tiers
Phase 1A Priority Populations
  • Healthcare workers: Persons at high and moderate risk of exposure to SARS CoV-2 through their work in any role in direct health care or long-term care settings. This population includes persons at direct risk of exposure in their non-clinical roles, such as, but not limited to, environmental services, patient transport, or language interpretation.
  • Long-term care facility residents: Residents of skilled nursing facilities, assisted living facilities, and similar long-term care settings for older or medically vulnerable people.
Phase 1A

All groups in Phase 1A are now being offered vaccine.

Vaccination began in mid-December. It is estimated that everyone in Phase 1A will have been offered at least one dose of vaccine by late January/early February*.

Note: Vaccination is only available to the healthcare workers listed in Phase 1A who have the potential for direct or indirect exposure to patients or infectious materials. (Low risk healthcare workers such as administrative support staff WITHOUT routine in-person patient contact, will be offered vaccination in Phase 1B Tier2).


  • Green circles show groups that have been, or are being, offered vaccine
  • Red squares show groups that are waiting to be offered vaccine
Tier 1 Healthcare Workers
How to get vaccinated
  • Healthcare workers and residents of skilled nursing facilities (SNFs)
  • Healthcare workers and residents of other long-term care facilities (facilities that provide medical and personal care to adults, such as assisted living facilities and similar settings for older or medically vulnerable individuals, and special needs group living facilities)
  • Healthcare workers in:
    • Acute care hospitals
    • Acute psychiatric hospitals
    • Correctional facility hospitals
    • Dialysis centers
    • Emergency medical services, including EMTs and Paramedics
    • Infusion/oncology centers
    • Residential and inpatient substance use disorder (SUD) treatment facilities
    • Residential and inpatient mental health facilities
Tier 2
  • Healthcare Workers in:
    • Department of Children and Family Services (DCFS) contracted Short-Term Residential Therapeutic Programs (STRTP) and Transitional Shelter Care Program Facilities (TSCF)
    • Department of Mental Health
    • Home healthcare organizations and home health agencies (in-home supportive service personnel)
    • Intermediate care facilities (for persons who need non-continuous nursing supervision and supportive care)
    • Outpatient substance use disorder (SUD) treatment, mental health facilities, and crisis stabilization units
    • Public Health field staff who have face to face contact with patients/public (e.g. during testing, contact tracing, outbreak investigations)
    • Primary care clinics, including Federally Qualified Health Centers (FQHCs), rural health centers, and correctional facility clinics
    • Urgent care clinics
    • Office of Diversion and Re-entry (ODR)
    • Medical shelters
    • Sheltered and Unsheltered settings who are providing direct clinical care for people experiencing homelessness
    • Field-based community health workers, including promotoras (including those involved with testing, contact tracing, or supportive services to persons with suspected or confirmed COVID-19)
    • Regional Centers
    • Outreach workers who have face-to-face contact with people experiencing homelessness
Tier 3
  • Healthcare Workers in:
    • Acupuncturists
    • Chiropractors
    • COVID-19 Testing
    • Death Care (mortuaries)
    • Dental and Other Oral Health Clinics
    • Laboratories
    • Occupational Health
    • Optometry Clinics
    • Pharmacies (if not working in settings at higher tiers)
    • Physical Therapists/Occupational Therapists (if not working in settings at higher tiers)
    • School and University Health Centers
    • Specialty Clinics
    • Speech Therapists
    • Surgery Centers
Phase 1B

Vaccine is not yet available to persons listed in Phase 1B, except for persons age 65 and older.

Persons age 65 and over
How to get vaccinated

Persons age 65 and over are now eligible for vaccination. For the rest of Phase 1B, it is estimated that vaccination will begin in early February and that everyone in this phase should have been offered at least one dose of vaccine by late March*.

The following prioritization is from the California COVID-19 Vaccine Plan

1B Tier 1

  • Persons 65 years and older
  • Those at risk of exposure at work in the following sectors:
    • Education and Childcare
    • Emergency services
    • Food and agriculture

1B Tier 2

  • Those at risk of exposure at work in the following sectors:
    • Transportation and logistics
    • Industrial, commercial, residential, and sheltering facilities and services
    • Critical manufacturing
  • Congregate settings with outbreak risk:
    • Incarcerated
    • Homeless
Phase 1C

Vaccine is not yet available to persons listed in Phase 1C.

It is estimated that vaccination will begin for those in Phase 1C in March and that everyone in this phase should have been offered at least one dose of vaccine by late April/early May*.

The following prioritization is from the California COVID-19 Vaccine Plan

  • Persons 50-64 years old
  • People 16-49 years of age and have an underlying health condition or disability which increases their risk of severe COVID-19
  • Those at risk of exposure at work in the following sectors:
    • Water and wastewater
    • Defense
    • Energy
    • Chemical and hazardous materials
    • Communications and IT
    • Financial services
    • Government operations / community-based essential functions
Phase 2 (PROPOSED)

Vaccine is not yet available to persons listed in Phase 2.

It is estimated that vaccination will begin for those in Phase 2 by mid-May or early June*.

  • Persons 16-49 years old without high-risk medical conditions

*Note: These timings are estimates and may change according to factors such as vaccine supply and the state prioritization requirements. The phases and tiers will overlap.

Healthcare Worker Risk Stratification
  • Highest-risk employee: front-line clinical staff who care for patients in high risk settings or for patients with unknown COVID-19 status (e.g. ED, ICU, urgent care, respiratory therapists, anesthesiologists, etc.)
  • High-risk employee: front-line clinical staff who provide direct patient care and support staff with risk of exposure to bodily fluids or aerosols (includes physicians, NPs, LVNs, MAs and employees in environmental services)
  • Moderate-risk employee: staff who have indirect or limited in-person patient contact (e.g. food services, medical records, front desk staff)
  • Low-risk employee: administrative support staff without routine in-person patient contact.
Administration of COVID-19 Vaccine to Healthcare Workers and Long Term Care Facility Residents

The current LA County Phase 1A administration of COVID-19 vaccine plan is as follows:

  • Acute care hospitals are overseeing the administration of vaccination to HCWs employed within their system.
  • Skilled Nursing Facility healthcare workers and residents are being vaccinated onsite by the facility staff, Public Health, community, or healthcare partners.
  • Healthcare workers and residents of other long-term care facilities (Community Care Facilities) will be vaccinated onsite thorough a federal pharmacy program.
  • All other healthcare workers will be vaccinated in community clinics and special vaccination sites by LAC DPH in collaboration with county, city, community, and healthcare partners. Visit the LAC DPH Healthcare Worker Vaccination webpage for more information on how to access vaccination.
Allocation Goals and Principles

The following are goals and principles guiding the vaccine allocation strategy based on CDC, ACIP, and CDPH recommendations:

Goals:

  • Decrease death and serious disease
  • Preserve functioning of necessary healthcare services and the larger society
  • Reduce the additional burden the disease is having on people already facing healthcare and income disparities

Principles:

  • Maximize benefits and minimize harms — Respect and care for people using the best available data to promote public health and minimize death and severe illness.
  • Mitigate health inequities — Reduce health disparities in the burden of COVID-19 disease and death, and make sure everyone has the opportunity to be as healthy as possible.
  • Promote justice — Treat affected groups, populations, and communities fairly. Remove unfair, unjust, and avoidable barriers to COVID-19 vaccination.
  • Promote transparency — Make a decision that is clear, understandable, and open for review. Allow and seek public participation in the creation and review of the decision processes.

In addition to these guiding values, additional operational considerations are necessary:

  • Efficient targeting —criteria to improve implementation feasibility.
  • Maximum coverage —criteria that maximizes actual recipients among intended recipients.
  • Minimum leakage —criteria that minimizes unintended recipients among actual recipients.












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Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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