December 18, 2020

How Do Physicians Receive the COVID-19 Vaccine?

The SCMA has been sending out information on registering to receive the COVID-19 vaccine for several weeks. With the arrival of the vaccine this week, physicians have had many questions these last few days. Below is a list of the questions we are getting a lot of, along with the answers, in hopes of helping everyone through this process.  

1. 
   Who is receiving the vaccine first? 

• The CDC is determining the vaccine allocations for each state.  Initial allocations in Phase 1a will be limited.
• In making the priority decisions, DHEC is utilizing recommendations from the CDC's Advisory Committee on Immunization Practices (ACIP).
• DHEC is providing the vaccine to facilities with healthcare workers that fall into high-risk settings, which includes physicians.
• Because each healthcare office is different, DHEC developed guidance explaining which healthcare workers will be vaccinated first. The guidance can be read here: Phase 1a Guidance for COVID-19 Vaccine Allocation.
• DHEC has also provided a letter explaining the prioritization within Phase 1a, noting that front line healthcare workers that are most at risk of exposure to COVID-19 will receive the vaccine first.   

2. It looks like only hospitals are receiving the vaccine.  Is this true? 

• Both hospitals and independent practices are in line to receive the vaccine in Phase 1a. Only 56 facilities have received the vaccine to-date.
• Your facility, if it qualifies as a Phase 1a facility, may still receive the vaccine. However, the state has not yet received enough of the vaccine to distribute to all qualified parties within Phase 1a.  
• It will take a while to obtain enough vaccine to distribute to the entire Phase 1a category; therefore, please do not be concerned if it is not at independent facilities yet.

3. How does my office receive the vaccine for our practice - physicians and staff?

• First and foremost, you cannot be in the pool to receive the vaccine if you do not enroll in the vaccine program.  To register you start by reviewing a presentation, and then you may enroll.  This is a federal process that DHEC is rolling out and is required. You can register with DHEC here. 
• Many physicians have said that the registration, which begins with a presentation, seems to be for vaccinating patient populations. It is not. It is to register to obtain the vaccine for your facility. 
• If you read that enrollment needed to be completed by November 23rd, do not worry. You can still register; you will just be added into the pool as DHEC moves forward. 
• If you would like to know what is required to register, you can access the CDC COVID-19 Vaccination Program Provider Agreement to view in advance.  The DHEC presentation defines several of the terms, such as who would qualify as the CMO signatory if you do not have this official title in your facility.  
• There are three official DHEC documents you will need to sign to complete enrollment. 
• If you are interested in receiving the vaccine for your staff but cannot meet the requirements of the enrollment process, such as not having ultra-cold storage or a CMO, physicians and physician offices are directed to reach out to DHEC here: ACC-Immunization@dhec.sc.gov.

4. Are all physicians going to be accepted into the vaccine roll out process for Phase 1a? 

• No. DHEC will reject applications that do not meet the Phase1a Guidance criteria. You should review the Phase 1a Guidance and information linked above in question one to see if your facility is likely to receive the vaccine.
• There is a Phase 1b and a Phase 1c that the CDC's ACIP is still determining regarding other critical need persons, such as those over 65 or with other illnesses that make them higher risk.
• Phase 2 will include broader provider networks, to include most doctor's offices and public health venues. 
• Physicians receive the vaccine before the general public but are tiered within the phases depending on the likelihood of exposure.

5. How will I know when Phase 1b begins or when physicians can receive the vaccine if they do not fall under Phase 1a? 

• DHEC has not provided information on Phase 1b populations as the federal ACIP is expected to provide this by the end of 2020. DHEC will not announce a plan until this information is provided. 
• The SCMA and DHEC will continue to put out information on their websites, social media, and elsewhere to inform physicians about the availability of the vaccine. There is no registration site for updates. 

6. I see on social media all types of physicians receiving the vaccine that are not working on a COVID-19 unit. 

• Once a shipment is provided to a hospital, DHEC recommends that the vaccines be given to the personnel with the highest exposure, co-morbid conditions (which includes being over 65), or due to the need for bench depth. 
• Physicians outside of the COVID-19 wing are eligible for the vaccine that fall into these categories.  
• Physicians in hospital settings treating COVID-19 are more likely to be exposed to COVID-19.  
• Physicians that are not in a hospital but fall into the high-risk categories in Phase 1a may receive the vaccine through their facility if it has completed the registration process. 
• No system is perfect, and certainly there may be a physician that receives the vaccine outside of these parameters. But please try to be understanding as there may be many factors for why a hospital chooses prioritization.

We will continue to work with DHEC and encourage an equitable distribution for all physicians in South Carolina as well as all providers and high risk patients. Please continue to let us know your concerns and questions and we will continue to try and find answers through DHEC. As you know, this is an ever-changing process that can create many logistical challenges, but we want to continue to work on behalf of the physicians in the state.