When will the vaccine be available?
Although DHEC does not have specifics about when a vaccine will be available in South Carolina, the CDC has shared that the US may have 20-40 million doses of coronavirus vaccine available in late November 2020. A date is uncertain. Vaccine availability will depend on the results of the vaccine clinical trials and associated FDA approval. We're monitoring progress with COVID-19 vaccine trials from the federal government, including reports by the FDA.
Who can get the vaccine?
When the vaccine first becomes available, the number of doses will be limited in South Carolina like all states. These limited doses will be allocated to vaccine providers enrolled in South Carolina according to federal guidance to be administered to those at highest risk for spreading the virus, contracting the virus or those at the highest risk of death. These groups include:
- front-line medical personnel, including those individuals who provide care for our senior populations in nursing homes
- residents of nursing homes
- critical infrastructure employees, as defined by federal guidelines
As additional vaccines are approved vaccination access will be expanded to the general public when sufficient doses are available. COVID-19 vaccine supply is expected to increase substantially in 2021.
What is the South Carolina Vaccine Advisory Committee?
The purpose of Vaccine Advisory Committee is to inform a diverse array of stakeholders about what to anticipate regarding COVID-19 vaccinations, to facilitate community input, and to plan for equitable allocation of COVID-19 vaccines. The Committee membership represents health care and vaccine providers, health care delivery systems, health care coverage, population groups at increased risk for COVID-19, and policy and planning decision-makers. In addition to prioritizing vaccine for those at highest risk, the committee will discuss ways to promote community awareness and engagement, and assist in developing vaccine communication strategies to assure credible, compelling and culturally sensitive messaging for various populations and address those who might be hesitant about vaccines.
Will the COVID-19 vaccine be mandatory for health care providers?
Similar to influenza vaccine requirements, decisions regarding COVID-19 vaccine in health care settings will be determined by individual facilities. It DHEC highly recommends vaccination for all health care workers caring for persons with COVID-19 or those at high risk for severe disease (e.g., those working in long term care facilities).
Will more than one dose of COVID-19 vaccine be recommended per patient?
At this time, it's anticipated that COVID-19 vaccines will require two doses separated by 21 or 28 days. The second dose of any COVID-19 vaccine must be completed with the same vaccine brand as the first dose.
What are the side effects of the vaccine?
Any vaccine or medication can cause side effects. These are typically minor, such as a sore arm or low-grade fever, and go away within a few days. As with all vaccines, COVID-19 vaccines will not be approved until clinical trials have taken place that show they are both safe and effective. Safety is the top priority of any vaccine. Early results from the first COVID-19 vaccines tested in people show they worked as intended with no serious side effects.
Will people who have already had COVID-19 be able to get the vaccine?
We do not yet know whether the vaccine will be recommended for people who have had COVID-19 already. Phase 3 studies currently underway include individuals who had previously tested positive, with or without symptoms, and safety and efficacy data will help inform decisions about whether vaccination is appropriate for them.
Are COVID-19 vaccines safe?
Several vaccine candidates are in various stages of testing in humans to ensure they are both safe and effective. DHEC will communicate findings from the FDA approval process that will follow the same protocol as for all other vaccines. The FDA is committed to science and the critical evaluation of all new vaccines for their safety and efficacy in an unbiased way before their approval for use.
We will know more once the clinical trials conclude. It’s typical for vaccine candidates not to reach the final stages of testing, so likewise, we do not expect 100% of all COVID-19 vaccines under development to become available.
How can a safe vaccine be made so quickly?
Vaccine development typically takes many years. However, scientists had already begun research for coronavirus vaccines during previous outbreaks caused by related coronaviruses such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). That earlier research provided a head start for rapid development of vaccines to protect against infection with the novel coronavirus SARS-CoV2, the virus that causes COVID-19.
We have already heard concerns from clients and patients about the safety of a new vaccine. How do we address this?
The CDC and DHEC will be addressing vaccine confidence throughout the COVID-19 vaccination campaign. CDC is in the process of developing communication resources to address concerns about COVID-19 vaccines. Additional information will be shared when the resources are available.
Allocation & Distribution
The CDC has shared that we may have 20-40 million doses of coronavirus vaccine available in late November 2020. This date is uncertain. Vaccine availability will depend on the results of the vaccine clinical trials. We are working with the federal government and local partners within South Carolina to plan for the distribution of COVID-19 vaccine when one becomes available.
Which vaccine will be available first?
At this time, jurisdictions are planning for Vaccine A (Pfizer/BioNTech), which is an ultra-cold vaccine (stored at -90°C to -60°C) that must be ordered in minimum quantities of 1,000 doses. This vaccine poses a number of complex logistical challenges. DHEC is diligently working through a number of planning scenarios to plan for as many of these challenges as possible.
Is DHEC planning for COVID-19 vaccine distribution?
Yes. The Centers for Disease Control and Prevention (CDC) will determine the timing and amount of vaccine allocated to different jurisdictions across the United States. DHEC will determine the further distribution within the state in a phased approach. It is likely that initial vaccine availability will be quite limited, and not everyone who wants vaccine will be able to receive it in this first phase.
DHEC has collaborated with the S.C. Emergency Management Division; S.C. Hospital Association; National Guard; S.C. Law Enforcement Division; Department of Labor, Licensing and Regulation; and other public and private sector partners to develop South Carolina’s Vaccine Plan. This plan is available online at scdhec.gov/covid19vaccine. In addition, DHEC is convening a series of meetings with the South Carolina Vaccine Advisory Committee to assist with creating a framework for most effective, equitable, and ethical allocation of vaccine.
How will vaccine distribution work?
The CDC will primarily manage the distribution of any coronavirus vaccine. The current plan is to distribute the vaccine through two mechanisms:
- Use of a centralized distributor (e.g. McKesson). This mechanism is similar to how our state currently distributes vaccine through South Carolina’s Vaccines for Children (VFC) program.
- Direct shipments from the vaccine manufacturer (e.g. Pfizer) to enrolled providers.
As part of this planning effort, the federal government and the state are considering many factors such as prioritization of high-risk groups, vaccine supply and distribution, logistics, and clinical guidance. Because the current top three vaccine candidates all require different temperatures, properly transporting and storing the vaccine at the right temperature is a large concern and big part of the planning. Vaccine distribution will adjust over time as the number of available doses increases, moving from limited to broader populations in a phased approach.
Administration & Supplies
Can any pharmacy or clinic offer the COVID-19 vaccine?
To receive and administer the coronavirus vaccine and supplies, providers must enroll in a federal vaccine distribution program, coordinated through the state immunization program (unless they are part of a national chain that registered directly with the CDC). The federal government will procure and distribute the vaccine and ancillary supplies at no cost to enrolled providers.
Walgreens and CVS Pharmacies have enrolled directly into the COVID-19 Vaccination program with CDC to receive federal vaccine allocations to vaccinate residents and workers in long term care facilities.
How much will it cost to get vaccinated?
The federal government will cover the cost of the vaccine. It is possible that health care providers may charge an office visit fee, or a fee to administer the vaccine. Health insurance most likely will cover these fees. DHEC will work with other state agencies to understand and address insurance-related barriers, and how to make the vaccine accessible at no cost to people without health insurance.
Will more than one dose of COVID-19 vaccine be needed?
It is anticipated the first available COVID-19 vaccines will require two doses separated by intervals of 21 or 28 days depending on the vaccine product. The different vaccine products will NOT be interchangeable. The series of two doses must be completed with the same vaccine product. Second dose reminders for patients will be necessary.
How will the COVID-19 vaccines be administered?
At this time, the initial doses of COVID-19 vaccines are expected to be administered by intramuscular (IM) injection. Depending on the brand of vaccine, reconstitution of the vaccine may be required. Additional information and guidance will be made available as it is received.
Will there be a required observation period after vaccination?
ACIP currently recommends providers should consider observing patients for 15 minutes after receipt of a vaccine. For vaccine administered in drive-by venues, adequate parking must be ensured so that persons receiving vaccine have a place to wait post-vaccination.
Is the COVID-19 vaccine a live vaccine?
There are currently multiple vaccine candidates in various stages of clinical trials. The first two vaccines anticipated to be available are not live vaccines and are known as “inactivated” vaccines. As more vaccine products become available, additional guidance will be provided.
Is there guidance for administering vaccines in a setting other than a doctor’s office (e.g., pharmacies; temporary, off-site, or satellite clinics; and large-scale influenza clinics)?
Yes. Guidance has been developed for giving vaccines at pharmacies, temporary, off-site, or satellite clinics, and large-scale influenza clinics. Other approaches to vaccination during the COVID-19 pandemic may include drive-through immunization services at fixed sites, curbside clinics, mobile outreach units, and home visits. Please collaborate these plans with Local Public Health. The general principles outlined for healthcare facilities should also be applied to alternative vaccination sites, with additional precautions for physical distancing that are particularly relevant for large-scale clinics, such as:
- Providing specific appointment times or other strategies to manage patient flow and avoid crowding.
- Ensuring sufficient staff and resources to help move patients through the clinic as quickly as possible.
- Limiting the overall number of patients at any given time, particularly for populations at higher risk for severe illness from COVID-19.
Storage & Handling
What are the storage and handling requirements for the COVID-19 vaccines?
The anticipated first available COVID-19 vaccines have varying storage and handling requirements, ranging from refrigerated (2-8° C) to frozen (-20° C) to ultra-cold ( -90° C to -60°C). The manufacturers are conducting ongoing stability testing. Additional guidance will be provided as it is received. An addendum to the CDC Vaccine Storage and Handling Toolkit specifically addressing COVID-19 vaccines is currently being developed in addition to other training materials.
Vaccine Tracking & Other Records
How will DHEC track vaccine distribution and administration?
South Carolina also has a comprehensive state immunization information system (IIS), known as SIMON (Statewide Immunization Online Network) that provides a secure system to track vaccines, access vaccine records, order vaccines, and manage vaccine inventory. One of our planning areas is to ensure that the system can meet the demands of a COVID-19 vaccine program, and ensure the registry connects with any federal systems.
COVID-19 & Influenza
What is the recommendation for receiving influenza vaccine this fall/winter with the current COVID-19 pandemic?
It is likely flu viruses and the virus causing COVID-19 will both be circulating. The CDC recommends everyone ≥6 months receive a yearly flu vaccine. During the COVID-19 pandemic, reducing the overall burden of respiratory illnesses is especially important to protect vulnerable populations at risk for severe illness, the healthcare system, and other critical infrastructure systems. Healthcare providers should use every opportunity to administer influenza vaccines to all eligible persons.
Can other vaccines, including influenza vaccines, be administered at the same time as the COVID-19 vaccines?
The General Best Practice Guidelines for Immunizations from the Advisory Committee on Immunization Practices (ACIP) state, with a few exceptions, any inactivated vaccine may be administered either simultaneously or at any time before or after a different inactivated vaccine or live vaccine. Two or more injectable or nasally administered live vaccines not administered on the same day should be separated by at least 4 weeks (≥ 28 days). More information regarding the administration of COVID-19 vaccine with other routinely recommended vaccines will be forthcoming.
Should influenza vaccines be given to someone with suspected or confirmed COVID-19?
No. Vaccination should be deferred (postponed) for people with suspected or confirmed COVID-19, regardless of whether they have symptoms, until they have met the criteria to discontinue their isolation. While mild illness is not a contraindication to receive flu vaccination, vaccination visits for these people should be postponed in order to avoid exposing healthcare personnel and other patients to the virus causing COVID-19. When scheduling or confirming appointments for vaccination, patients should be instructed to notify the provider’s office or clinic in advance if they currently have or develop any symptoms of COVID-19. Additionally, a prior infection with suspected or confirmed COVID-19 or flu does not protect someone from future flu infections. The best way to prevent seasonal flu is to get vaccinated every year.
Are there any contraindications with providing COVID-19 vaccine while someone is being treated with antivirals for influenza?
DHEC does not have any information on contraindications currently. Information will be shared as COVID-19 vaccines complete clinical trials and are either approved by the FDA or are distributed under an Emergency Use Authorization (EUA).
Is there guidance for safely administering vaccines during the COVID-19 pandemic?
CDC has released Interim Guidance for Immunization Services During the COVID-19 Pandemic. This guidance is intended to help immunization providers in a variety of clinical and alternative settings with the safe administration of vaccines during the COVID-19 pandemic. This guidance will be continually reassessed and updated based on the evolving epidemiology of COVID-19 in the United States.
Interim guidance: immunization services during the COVID-19 pandemic: Vaccination and COVID-19 Vaccination Guidance During a Pandemic Protective Measures for Vaccinating During Pandemic
Are there specific infection control procedures to follow when administering vaccines during a pandemic?
It’s important to apply infection prevention strategies to all patient encounters including physical distancing, respiratory and hand hygiene, surface decontamination, and source control. The CDC has developed General Practices for Safe Delivery of Vaccination Services and the Immunization Action Coalition has developed Protective Measures for Vaccinating During Pandemic.
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