The states are sending orders to Pfizer and Moderna directly. The shipments go to the points of dispensing ("PODS"), such as hospitals. the delivery to these sites is working, but needles in the arm are not keeping up. there is substantial documentation needed in the process, and if a site is not ready, their vaccination rate will be very slow. the site needs to be able to do the following:
- Provide a way to identify and vet qualified people. Most sites are focused on vaccinating their own people, so this is okay.
- They need a way to create appointment schedules for people to accept, or a way to organize the flow.
- they need a way to collect all the relevant data from each person during the appointment scheduling. If they don't do this, they have on site work manually = very slow.
- they need to match drug lot number to people on site. this is very manually intensive if you do not have a system.
- they have to record adverse impacts on site into the VAERS system during a 15 min hold after vaccine.
- they have to create inventory tracking and chain of custody. there is a lot of paperwork here, unless they have a system.
- they need to monitor temps on each lot, and collect history multiple times per hour.
- Nightly inventory needs to be sent to FDA/CDC. if you do this manually of via a CSV file, it is very labor intensive. you really need an HL7 integration to the CDC site (there is a spec, but not many using it)
- There is daily reporting of vaccines to the state Dept of Health. this is a large manual form set, but some states will allow HL7 integration, if you can do it.
- The POD needs a management reporting system to manage this process.
I am directly involved in implementing a system for a hospital, and quite familiar with the issues. Without a system, the process is very slow. There has also been some inconsistent guidance on the priorities of who to vaccinate. That does not help.