At the end of what AppHealthCare Health Director Jennifer Greene calls a long year, some are starting to see the light at the end of the tunnel as local agencies receive word of incoming shipments of the COVID-19 vaccine.

The Food and Drug Administration granted Emergency Use Authorization for the Moderna COVID-19 vaccination at its hearing on Thursday, Dec. 17. This meant that Moderna could immediately begin shipping nearly 6 million doses of the vaccine across the U.S. According to N.C. Department of Health and Human Services Secretary Dr. Mandy Cohen, North Carolina was expected to receive 175,000 doses of the Moderna vaccine this week to be supplied to more rural areas due to the vaccine’s ability to remain stable at refrigerated conditions for longer periods of time.

AppHealthCare stated on Dec. 18 that it had been notified that the agency will likely receive the first shipment of COVID-19 vaccine early the following week. This came true on Dec. 22 when the agency receive its first allotment of the Moderna vaccine for each of the counties it serves — 100 doses for Alleghany, 300 doses for Ashe and 600 doses for Watauga.

Greene said AppHealthCare staff were excited to receive the Moderna vaccine allotment as it begins the next part of the journey to protect the community.

The COVID-19 vaccine will be rolling out in phases and will be given to those who are most at risk first. The first doses of vaccine will go to frontline health care workers who are at higher risk of COVID-19 exposure and those who are working and living in long term care facilities and group homes. Supplies will be limited at first but will increase throughout 2021.

“We are working closely with local and state partners as we prepare to offer the vaccine to those who are eligible in this first phase,” Greene said in a statement. “Even though we are hopeful about the vaccine, we must continue to practice prevention measures like the three Ws and wear a face covering, wash your hands and wait 6 feet from others. These prevention measures will help slow the spread and protect local hospital capacity.”

AppHealthCare plans to partner with hospitals across the district, and will be following the N.C. DHHS guidelines as staff determine who is eligible for the vaccine in each phase. Local hospitals were likely to also be receiving vaccine supply within the same week, and AppHealthCare stated the the hospital’s supply would likely be used to vaccinate hospital staff who qualify in the first phase of rollout.

Appalachian Regional Healthcare System was notified on Dec. 15 by the North Carolina Department of Health and Human Services that it would receive 800 doses of the Moderna COVID-19 vaccine, as part of NCDHHS’s Dec. 21 weekly allocation.

“We were told yesterday that our first allocation of vaccines will ship to us next week,” ARHS President and CEO Chuck Mantooth said in a statement. “So it appears that Christmas will come early. Our organization has been anxiously awaiting this news for several weeks. This is overwhelmingly good news.”

Distribution of the COVID-19 vaccination is part of the federal government’s Operation Warp Speed initiative, according to ARHS. At the direction of the U.S. government and the Centers for Disease Control, the state of North Carolina and NCDHHS has been working on a COVID-19 Vaccination Plan.

This first 800 dose allocation for ARHS is Phase 1a of the State’s 4 phase Vaccination Plan, which calls for vaccinating front line healthcare workers first. The hospital had not received its allocation as of Dec. 22.

ARHS stated that staff have been preparing to receive these vaccinations for months. However, until recently, ARHS was not sure if it would receive the Pfizer or Moderna vaccinations. Because both vaccines have unique storage and dosing requirements ARHS needed to plan for both.

“We began thinking about how to operationalize it,” Mantooth said. “From shipping and logistics, to how and where we would store it. We ordered an ultra-low temperature freezer. We began evaluating the roles of our workers to ensure that those on the front lines would receive it first. We planned how and where our vaccine clinics would occur. We want to make it as easy as possible for our employees to get the vaccine.”

ARHS has more than 1,400 employees but also works with hundreds of contractors and non-employed providers in caring for the community. To ensure that front line workers receive the vaccine quickly, ARHS stratified employees, contractors and non-employed providers into high and low risk categories and pre-loaded those high risk employees into the state’s COVID-19 Vaccine Management System database.

“The 800 doses we get this week will not be enough,” Mantooth said. “So even within the high risk group, we placed priority on personnel who lay hands on patients. The risk of being exposed to the virus is greater for them, so they will receive the vaccine first.”

ARHS employees in the high-risk category who wish to receive the vaccination in Phase 1a will receive an email from CVMS to confirm their registration and a separate communication from ARHS to register for a timeslot to receive the vaccination.

“At this point, COVID-19 vaccinations are not mandatory for our employees,” Mantooth said. “However, we are doing all we can to educate them, so they’ll be able to make an informed decision. Of course, our hope is that they will see the vaccine as our best option for fighting the virus.”

AppHealthCare stated that it is initially prioritizing long term care facility staff and residents and health care providers who qualify for Phase 1a since they are at highest risk. There are a number of long term care facilities who have already signed up and registered with a national partnership with CVS and Walgreens Pharmacy; those organizations will be vaccinated through that program. AppHealthCare will be responsible for vaccinating those long term care facilities who were not able to sign up with the national program.

AppHealthCare stated prior to getting its shipment that it was communicating directly with those who are eligible for Phase 1a vaccine, and was planning to begin the process of offering a vaccine to the identified group when the shipment arrived. Greene said on Dec. 22 that AppHealthCare was starting to schedule appointments for vaccinations for the following day.

AppHealthCare plans to partner with hospitals across the district, and will be following the N.C. DHHS guidelines as staff determine who is eligible for the vaccine in each phase. AppHealthCare is working to add information on its website for people who will qualify for Phase 1b.

Below is a summary of the four phases of North Carolina’s vaccination plan:

Phase 1a

  • Health care workers at high risk for exposure to COVID-19 — doctors, nurses and all who interact and care for patients with COVID-19, including those who clean areas used by patients, and those giving vaccines to these workers.
  • Long-term care staff and residents — people in skilled nursing facilities and in adult, family and group homes.

Phase 1b

  • Adults with two or more chronic conditions that put them at risk of severe illness as defined by the CDC, including conditions like cancer, COPD, serious heart conditions, sickle cell disease and Type 2 diabetes, among others.
  • Adults at high risk of exposure including essential frontline workers (police, food processing, teachers), health care workers, and those living in prisons, homeless shelters, migrant and fishery housing with two or more chronic conditions.
  • Those working in prisons, jails and homeless shelters (no chronic conditions requirement).

Phase 2

  • Essential frontline workers, health care workers, and those living in prisons, homeless shelters or migrant and fishery housing.
  • Adults 65 or older.
  • Adults under 65 with one chronic condition that puts them at risk of severe illness as defined by the CDC.

Phase 3

  • College and university students.
  • K-12 students when there is an approved vaccine for children.
  • Those employed in jobs that are critical to society and at lower risk of exposure.

Phase 4

  • Everyone who wants a safe and effective COVID-19 vaccination.

Visit covid19.ncdhhs.gov/vaccines for more information about the vaccine including the COVID-19 vaccination plan and frequently asked questions. For more information related to COVID-19, including local data, visit AppHealthCare’s website at www.apphealthcare.com/covid-19-information.

AppHealthCare’s COVID-19 call center is available to take COVID-19 related calls each day at (828) 795-1970; questions can also be emailed to preparedness@apphealth.com.

AppHealthCare is available and on-call 24/7 to respond to public health emergencies. To reach the agency, call Watauga (828) 264-4995, Ashe (336) 246-9449, Alleghany (336) 372-5641 anytime and follow the prompts. For more information, visit www.AppHealthCare.com and follow the agency on Facebook or Twitter.

Kayla Lasure contributed reporting to this story.

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