Allocation Framework COVID-19 vaccination efforts continue across the state. The scarce supply makes it even more critical for people to understand how vaccine is being allocated. Phase 1A Health Care Personnel This first phase (Phase 1a) focuses on health care personnel, specifically defined by the national Advisory Committee on Immunization Practices (ACIP) and the State Disaster Medical Advisory Committee (SDMAC). The SDMAC definition of Phase 1a "health care personnel" is individuals who: Provide direct patient service (compensated and uncompensated) or engage in healthcare services that place them into contact with patients who are able to transmit SARS-CoV-2, and/or infectious material containing SARS-CoV-2 virus. How is DHS incorporating SDMACs recommendations when allotting to vaccinating entities? DHS incorporates SDMAC's recommendations into its allocation formula, which governs distribution of vaccine throughout the state. The following information details the logic applied. Recommendation 1. Fill partial vaccine orders, where applicable. To inform allocation decisions, we input several factors into an allocation algorithm. One factor is the number of vaccine doses requested by each organization. The allocation algorithm prioritizes filling at least some of every order for all entities, rather than filling some orders completely and others not at all. Recommendation 2. Vaccine should be administered in the shortest possible time after receipt by the vaccinating entity. The bulk of the responsibility to meet this recommendation falls to vaccinators. In the weekly Allocation Survey, vaccinators indicate their current vaccine inventory and request doses only according to what they will use the following week for phase 1a health care providers. We will provide guidance about the transition to later phases as the demand for vaccine for phase 1a providers decreases. Vaccinators are required to maintain their inventory daily and doses administered in the Wisconsin Immunization Registry (WIR). DHS reviews this information from the Allocation Survey prior to fulfilling an order. Recommendation 3. Give greater priority to vaccinating entities who will administer vaccine in communities characterized by higher levels of social vulnerability. DHS is in the process of enhancing its algorithm to consider geographic-level Social Vulnerability Index (SVI) data. This will allow DHS to give greater allocation priority to vaccinating entities in communities characterized by higher levels of social vulnerability. Recommendation 4. Give greater priority to vaccinating entities who will vaccinate unaffiliated healthcare providers such as emergency medical responders. When vaccinators request vaccine for the upcoming week, they provide a breakdown of how many of those vaccines will be for internal use and how many will be for outside entities such as unaffiliated healthcare providers. Entities vaccinating unaffiliated healthcare providers receive an increased allocation. Entities able to vaccinate unaffiliated phase 1a providers are strongly encouraged to do so and to coordinate messaging and outreach to unaffiliated providers in phase 1a with local health departments. How has DHS allocated current supply? DHS has been able to fill most providers' weekly allocation requests. Health care entities have had primary responsibility for vaccination in the early phases, as they were most equipped to handle administration of initial vaccine shipments within logistical and clinical guidelines. As allocations from the federal government change and/or the number of eligible providers in Wisconsin increase, the allocation algorithm is updated accordingly. Does SDMAC provide vaccinating entities guidance on prioritizing health care personnel during Phase 1A? Yes, the SDMAC has identified 11 prioritization criteria, in no particular order, that vaccinating entities may include in their vaccination plans, and the recommendations also include demographic and health status information that may be taken into consideration. What is the vaccine ordering and delivery process? - The federal government informs DHS how much vaccine Wisconsin will be allocated on a week-by-week basis.
- DHS issues an Allocation Survey on Monday evenings to enrolled vaccinators who can vaccinate Phase 1a recipients.
- Enrolled vaccinators indicate how many initial doses they can safely store and administer the following week by returning the allocation survey by Tuesday evening.
- DHS generates the recommended number of vaccine doses for each vaccinating entity using an allocation algorithm, which factors in recommendations from the ACIP and the SDMAC noted above; the state's federal vaccine allocation for the upcoming week; and information from the Allocation Survey from vaccinators.
- DHS reviews the results and places orders with the federal government on behalf of providers, usually Thursday or Friday.
- Vaccinators receive an email informing them about the type of vaccine and number of doses they will be receiving, usually between Friday and Sunday.
- Early the following week, vaccine is shipped to vaccinating entities from McKesson (the Distributor), directly from Pfizer, or from a Wisconsin-based hub.
- Once received, vaccinators are responsible for ensuring vaccine viability. Proper vaccine security, storage, handling, and administration are key to ensuring patients receive a viable vaccine.
When can we move on to Phase 1B? The State of Wisconsin is committed to a unified, state-wide approach to COVID-19 vaccinations. At this time, when demand is high and vaccine supply is limited, we are carefully following the guidance of the Wisconsin State Disaster Medical Advisory Committee (SDMAC) and facilitating vaccinations only to residents of long-term care facilities and health care personnel. There are many individuals within Phase 1A who have not yet had their chance to be vaccinated. As a state, we will progress to Phase 1B only when a critical mass of those included in the first phase have been vaccinated. Vaccination efforts rest on three equally important pillars: adequate demand, adequate delivery system, and adequate supply. While some counties, cities, or hospitals have made good progress vaccinating their Phase 1A recipients because their demand and delivery system has been strong – as a state, we do not yet have adequate supply to move on to the next phase. | 
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