As COVID-19 vaccines become available and distributed, public health professionals are laying the groundwork across the country for how best to distribute the vaccines.  An FDA panel formally recommended that the FDA authorize Pfizer’s COVID-19 vaccine on December 10, and vaccine shipments to states have already begun.  How will each state roll out its plan for vaccine distribution and administration?  Who will have access to the vaccine first?

The CDC has its own COVID-19 Vaccination Program Interim Playbook, prepared on October 29, requiring states to submit their plans for vaccine distribution and administration, including phased approaches to target critical or at-risk populations first.

All the plans outlined below are considered drafts and subject to change.

Jump Ahead to Your State:

Alabama

The Alabama Department of Public Health (ADPH) announced their COVID-19 vaccine distribution and administration plan on November 6.  The plan includes a three-phased approach.  In Phase 1, limited doses of a vaccine will be available.  They will be targeted at the highest risk and highest risk of exposure, including first responders and healthcare workers who care for those with critical needs.  In Phase 2, large numbers of doses will be available, and supply is likely to meet demand.  Critical populations not vaccinated in Phase w will be targeted with educational efforts.  In Phase 3, all unvaccinated groups will be targeted, assuming a sufficient supply and special attention will be directed to populations or communities with low vaccine coverage.

More information can be found on the ADPH website.

Alaska

Alaska’s Department of Health and Social Services released their COVID-19 vaccination plan on October 16.  Alaska’s three-phased approach to vaccine distribution includes Phase 1, where Alaska has formed an Allocation Committee to identify critical populations.  COVID-19 vaccine administration in Phase 1 will occur through closed POD settings, allowing the maximum number of people to receive vaccinations while maintaining social distancing.  Further, the pharmacy team within the Alaska COVID-19 Vaccination Task Force has spoken with the Alaska Pharmacy Association on pharmacists’ possibility of assisting with vaccinating long-term care facilities, staff, and residents.  In Phase 2, Alaska plans to administer COVID-19 vaccinations through commercial and private sector partners (i.e., pharmacies, doctors’ offices, clinics) and public health sites (mobile clinics, federal qualified health centers, public health clinics, temporary or off-site clinics).  In Phase 3, the state will monitor vaccine uptake and coverage in critical populations and enhance their strategies to reach populations with low vaccine uptake or coverage and partner with commercial and private entities to ensure vaccines and vaccination services are widely available.  The state will also monitor refrigerated vaccine products’ supply and transfers to minimize waste of any vaccines in Phase 3.

More information can be found on the ADHSS website.

Arizona

The Arizona Department of Health Services announced its draft COVID-19 vaccine plan on October 20, highlighting Arizona’s local allocator model.  The allocator model designates county health departments and tribal health partners as the local authorities responsible for approving vaccine allocations to providers within each jurisdiction.  Arizona also plans to use a three-phase approach to vaccine administration.  In Phase 1, with potentially limited doses available, vaccines will be limited to organizations that can quickly vaccinate large numbers of people without the need for extended cold storage or repackaging and redistributing.  In Phase 2, with many doses available and supply likely to meet demand, Arizona will use GIS mapping to identify areas that have been disproportionately impacted by COVID-19, including socially vulnerable populations and underserved areas.  In Phase 3, with slowing demand leading to a likely sufficient supply, ADHS will work with local partners to enhance messaging to reinvigorate vaccination efforts.  GIS data, including SVI, will be considered.  ADHS may conduct added public outreach during Phase 3 to understand slowing vaccine uptake trends in specific populations.

More information can be found on the ADHS website.

Arkansas

The Arkansas Department of Health released their draft COVID-19 vaccination plan, which includes a phased approach to vaccine distribution and administration.  Arkansas’ Phase 1 features two sections.  Phase 1-A will see personnel in critical functional roles to receive initial COVID-19 vaccines to maintain Arkansas-wide operational capacity.  This includes health care personnel likely to be exposed to patients with COVID-19, health care workers providing testing or vaccinations for COVID-19, first-responders and emergency preparedness workers, and essential government leaders.  Phase 1-B vaccinations will include people at increased risk for severe illness from COVID-19, including those with underlying medical conditions, those over 65 years old, and essential workers at increased risk (i.e., employees at daycares, state correctional facilities, K-12 schools, law enforcement, meatpacking plants, and other government employees).  In Phase 2, the vaccine supply will increase and allow for vaccination for a larger population, including targeting broad provider networks and health care settings (i.e., pharmacies, medical facilities including physician offices, health clinics, dental clinics, etc.), utility, transportation, and grocery store employees, university employees, and residents of long-term care facilities and other congregate living facilities.  In Phase 3, ADH will monitor vaccine uptake and coverage in critical populations and target hard to reach populations. 

More information can be found on the ADH website.

California

California’s Department of Public Health released its initial COVID-19 vaccination plan on October 16.  In Phase 1, California is creating a scalable foundation to rapidly expand capacity as vaccines become available and will focus initial vaccination efforts on critical populations in separate sub-phases.  In Phase 1-A, vaccines will be available to health care personnel treating patients with COVID-10 or likely to be exposed to COVID-19.  Phase 1-B targets people at increased risk for severe illness or death from COVID-19 and other essential workers.  In Phase 2, the Department plans to ensure vaccine access to all members of Phase 1 critical populations not yet vaccinated and expand communication efforts to broad vaccine access to other essential workers and groups at increased risk to contract COVID-19. 

More information can be found on the CDPH website.

Colorado

Colorado’s COVID-19 vaccination plan will focus its Phase 1 approach on initial critical populations, including health care workers, first responders, and long-term care facility residents.  Additional vaccine providers not activated under the first phase will be activated in Phase 2, with consideration given to ensure a broad network of providers, emphasizing equitable access for all.  In Phase 2, routine vaccination programs, run by public and private partners, will include a COVID-19 vaccine.  Additional vaccination providers may be enrolled in Phase 3 as the state focuses on equitable access to vaccines for all Colorado residents.

More information can be found on the Colorado State website.

Connecticut

The Connecticut Department of Public Health released its draft Mass Vaccination Plan on October 15.  In Phase 1, initial doses of a vaccine will be distributed in a limited fashion.  DPH will prioritize populations that must be vaccinated during the early phases of the initiative, and planning efforts must take underserved populations who may have difficulty assessing vaccination services into consideration.  In Phase 2, the state will ensure high uptake in specific populations, especially populations at higher risk for severe outcomes from COVID-19.  In Phase 3, DPH will maintain a broad network of providers to ensure all who want a vaccine have access to one.

More information can be found on the Connecticut State website.

Delaware

Delaware’s COVID-19 vaccination plan includes three phases.  In Phases 1 and 2, Delaware intends to consider and adopt priority groups, as recommended by the CDC and other experts.  Delaware established Closed Point of Dispensing (POD) Agreements with hospitals and emergency medical service agencies to activate and operate vaccination sites for critical workforce members.  In Phase 3, the public at large will be served at the Point of Dispensing Annex open PODs. 

More information can be found on the Delaware State website.

District of Columbia

The nation’s capital has its COVID-19 vaccination plan.  In Phase 1, DC Health will continue its COVID-19 mitigation and containment strategies.  Critical populations will serve as priority groups for vaccinations.  Allocation will be based on several factors, including input from the District’s Scientific Advisory Committee, the estimated number of doses allocated and timing of availability, populations served by vaccination providers and geographic location, and settings where people representing the critical workforce are employed and have been disproportionately affected by COVID-19.  The DC COVID-19 Vaccine Planning Group will focus on planning for vaccine availability, procurement, and supply management in Phase 2 when supply is likely to meet demand.  Data dashboards will focus on areas of greatest need, which can be communicated to the public.  Mass clinics can be activated if there are gaps or pockets of need.  In Phase 3, providers registered will have their locations published to inform residents of where they can get vaccinated. 

More information can be found on the District’s website.

Florida

Phase 1 in Florida’s COVID-19 vaccination plan has the state focusing on providing a vaccine in a prioritized manner.  In Phase 1, the COVID-19 vaccine will be administered in Hospital Closed PODs, long-term care staff and resident PODs, and first responder and critical infrastructure closed PODs.  Pediatricians, primary care providers, and pharmacies will receive doses as the vaccine becomes more available in Phase 2.  Public Mass Vaccination Clinics will be opened by CHDs in Phase 2 as well.  When a vaccine is more widely available, and demand slows down, the state will provide the vaccine through routine health care delivery systems, such as commercial pharmacies.  Vaccine clinics will remain open in Phase 3.

More information can be found on the Florida Department of Health website.

Georgia

Instead of a three-phased approach, Georgia’s COVID-19 vaccination plan includes a four-phased approach.  Phase 1 populations include health care personnel likely to be exposed to or treat people with COVID-19, first responders, people at increased risk for severe illness from COVID-19, including individuals with underlying medical conditions and those over the age of 65, and other essential workers.  The state’s plan notes this list is not all-inclusive and will be updated as needed.  Phase 1 is further broken down into three sub-phases.  Phase 2 will focus on vaccines for Phase 1 populations not yet vaccine, including non-clinical public health, hospital, and long-term care facilities and their household members, critical populations, and other populations for whom a vaccine has been recommended.  Phase 3 efforts will be targeted to the general population.  The DPH will begin to phase out mass vaccination clinics and outreach where the services are no longer required.  Georgia’s Phase 4 will focus on recovery and mitigation.

More information can be found on the Georgia Department of Public Health’s website.

Hawaii

Hawaii’s Phase 1 of the Department of Health’s COVID-19 vaccine plan will focus efforts on critical populations, including workers in high-risk settings, people at increased risk for severe illness, people living in group settings, and people with limited access to vaccination services.  Phase 1 will further focus on maximizing vaccine acceptance while minimizing waste and inefficiency.  HDOH will work with stakeholders to identify subset groups within the initial populations to focus on who will first receive vaccine doses.   Phase 2 (which has four allocation stages) will target the Phase 1 populations who are not yet vaccinated and other critical population groups.  This includes Allocation Stage 2, which will focus on K-12 teachers and school staff, critical risk workers in high-risk settings, people with comorbid and underlying conditions, people in homeless shelters or group homes, people and staff in prisons, jails, detention centers, etc., and adults over the age of 65 not included in Allocation Stage 1.  Allocation Stage 3 includes young adults, children up to 17 years old, and workers in industries and occupations essential to society’s functioning and at increased risk of exposure.  Allocation Stage 4 will focus on everyone else in Hawaii.  A COVID-19 vaccine will be widely available in Phase 3 and integrated into routine vaccination programs run by public and private partners. 

More information can be found on the Hawaii Department of Health’s website.

Idaho

Critical populations included in Phase 1 of Idaho’s COVID-19 vaccination plan include health care personnel likely to be exposed to those with COVID-19 or treat patients, people, at increased risk for severe illness, including those with underlying medical conditions and above the age of 65, and other essential workers.  Vaccination services will be provided in closed point-of-dispensing (POD) settings to allow the maximum number of people to be vaccinated while maintaining social distancing and other infection control procedures.  Phase 2 of Idaho’s plan focuses on increasing access to vaccination for a larger population, including providing equitable access for all critical populations and ensure high uptake in specific populations, especially in groups at higher risk for COVID-19.  Vaccines will be administered, in Phase 2, through commercial and private sector partners (i.e., pharmacies, doctors’ offices, clinics) and public health sites (mobile clinics, federally qualified health centers, public health clinics, temporary/off-site clinics, etc.).  Phase 3 will monitor vaccine uptake and coverage in critical populations and enhance strategies to reach populations with low vaccine uptake or coverage.

More information can be found on Idaho’s State website.

Illinois

Phase 1 of the Illinois Department of Public Health’s Mass Vaccination Planning Guide is broken into two sub-phases.  Phase 1-A focuses on both paid and unpaid health care workers and first responders, in that order.  Phase 1-B focuses on other essential workers and people considered at higher risks of severe COVID-19 illness, including people over 65.  Phase 2 focuses on critical populations defined by the CDC and ACIP and can then transition to the general population.  Phase 3 will focus on the entire general population.

More information can be found on the Illinois Department of Public Health’s website.

Indiana

The Indiana Department of Health’s COVID-19 vaccine plan includes three phases, the first of which is broken down into sub-phases. Phase 1-A’s goal is to reinforce and support healthcare infrastructure and treatment of disease and focuses on all paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.  Phase 1-A also focuses on healthcare settings, including hospitals, long-term care facilities, outpatient facilities, home health care settings, pharmacies, dialysis centers, emergency medical services, frontline public health interventions, and COVID-19 diagnostic and immunization teams.  Phase 1-B focuses on individuals at high risk of morbidity and mortality associated with COVID-19 based on the latest evidence-based criteria.  Phase 2’s objective is to mitigate the spread and focuses on individuals at elevated risk of transmission of COVID-19 due to working or living circumstances.  Including persons living in prisons, group homes or shelters, and individuals whose in-person work is essential, required, and puts them in situations where social distancing is not possible and transmission risk high.  The objective of Phase 3 is to provide vaccination to the public.

More information can be found on the Indiana state website.

Iowa

Iowa’s Department of Public Health (IDPH) prepared a COVID-19 vaccine strategy in mid-October and released an updated version on December 4.  In Phase 1, Iowa will focus on critical workforce individuals who provide health care and have direct or indirect exposure to patients in hospitals and long-term care facilities, non-healthcare workers in agriculture and food processing, and people at high-risk for COVID-18 illness and long-term care facility residents and staff.  Phase 2 will move focus to the general population and will include identifying POD locations.  Vaccination clinics in Phase 2 will include appointment clinics, direct collaboration with pharmacies, corrections, drive through settings as used for annual influenza vaccines, home visits, mass clinics, and community clinics (i.e., homeless shelters, non-profit agencies, free clinics, assisted living facilities, nursing homes, residential care facilities, group homes, community centers, and schools).  Phase 3 will see IDPH focusing on equitable vaccination access, COVID-19 vaccine uptake, and coverage will be monitored in critical populations, and strategies will be enhanced to reach populations with low vaccination uptake or coverage.  At this point, IDPH will partner with commercial and private entities to make sure vaccination services are widely available.

More information can be found on the Iowa Department of Public Health’s website.

Kansas

Kansas’ COVID-19 vaccination plan includes three phases.  Phase 1A will target vaccines for health care personnel (paid and unpaid) who are likely to be exposed to or treat people with COVID-19 or infectious materials and cannot work from home.  Phase 1B will include people with increased risk for severe illness from COVID-19, including those with underlying medical conditions, people over the age of 65, other essential workers, and long-term care residents.  Kansas intends on participating in the Pharmacy Partnership for long-term care program coordinated by the CDC.  Participating providers in the program will provide on-site vaccine clinics for residents of long-term care facilities and any remaining staff at such facilities not vaccinated in Phase 1-A.  Kansas will focus in Phase 2 on enrolling traditional and non-traditional partners to participate in the COVID-19 vaccine program.  With vaccine supply likely to increase in Phase 2, the focus will move to other critical populations and the general population.  Under Phase 3, a COVID vaccine will be widely available for all populations.  The continued focus will be on ensuring that critical populations have been vaccinated and that areas with low vaccine coverage are identified.

More information can be found on the Kansas Department of Health and Environment website.

Kentucky

Kentucky’s COVID-19 vaccination plan’s Phase 1 will focus on critical populations, such as health care personnel and first responders likely to be exposed to or treat people with COVID-19, essential workers in high public contact jobs (i.e., social service support workers, grocery workers, transportation workers, etc.), and people at increased risk for severe illness from COVID-19, including individuals with underlying medical conditions and those over the age of 65.  Phase 2 will focus on providing equitable access to COVID-19 vaccination for target groups and critical populations.  The state anticipates that during Phase 2, vaccine supply will be enough to meet the demand for both critical populations and the public.  Phase 3 will focus on ensuring equitable vaccination access for the entire population of Kentucky.

More information can be found on the Kentucky Department of Public Health website.

Louisiana

Louisiana’s COVID-19 vaccine plan notes the Louisiana Allocation Tool uses a four-phased response but is adaptable to the three phases described by the CDC’s guidance.  In Phase 1, Louisiana is likely to focus on health care and congregate care setting facilities, and distribution of vaccines to sites within priority groups may be based on geographic positivity rate or hospitalization rate to protect those most at-risk.  Assuming the initial supply of vaccine is inadequate to cover all state hospitals, the vaccine will be distributed to various hospitals based on their COVID-19 hospital census.  Phase 1 has two sub-phases.  Phase 1a focuses on individuals unable to avoid exposure to the virus (health care workers, nursing home residents, staff, etc.).  Phase 1b will focus on people with comorbid and underlying conditions.  In Phase 2, a vaccine will continue to priority groups but will now be available through hospitals, private physicians, and pharmacies.  Under Phase 3, a vaccine will be delivered through a process that ensures vaccines’ availability to all individuals, whatever their social and economic resources, employment, immigration, or insurance status.

More information can be found on the Louisiana Department of Health website.

Maine

Phase 1a in Maine’s COVID-19 vaccination plan targets high-risk workers in health care facilities and first responders.  In Phase 1a, the state will partner with the Maine Hospital Association, Maine Medical Association, health systems, emergency medical services, public health nursing, and tribal health centers.  The Maine Hospital Association Maine Medical Association, and health systems will assist in communicating to hospitals throughout the state to ensure vaccination efforts are in place for the priority population.  Emergency medical services, public health nursing, and tribal health centers will help vaccinate the priority population.  Phase 1b targets people with comorbid and underlying conditions that put them at higher risk of severe illness from COVID-19 and older adults living in congregate or overcrowded settings.  Additional partners in Phase 1b include the Maine Primary Care Association, Bangor and Portland City Health Departments, the Maine Health Care Association, nursing home and long-term care facilities, pharmacies, and the DHHS Office of Aging and Disability Services. 

Phase 2 of Maine’s plan targets critical risk workers (i.e., workers who are both in industries essential to the functioning of society and who are at substantially high risk of exposure to COVID-19), people with comorbid and underlying conditions that put them at moderately high risk, all adults not included in Phase 1, teachers and school staff, and people and staff in prisons, jails, detention centers, and similar facilities.  Maine’s Phase 3 targets children, young adults, and workers in industries considered essential to society’s functioning and at increased risk of COVID-19 exposure who were not included in the first two phases.  In this phase, the Department of Education and Maine Chapter of the American Academy of Pediatrics will promote students’ vaccination efforts and recruit school nurses to offer vaccination clinics.  Post-secondary education partners will further promote vaccination efforts for students living on and off-campus.  Maine also included a Phase 4 in their plan, which targets everyone else in Maine who did not receive a COVID-19 vaccine in the previous three phases.

More information can be found on the Maine Department of Health and Human Services website.

Maryland

Maryland’s Phase 1 of its COVID-19 vaccination plan targets high-risk health care workers, first responders, older adults in congregate or overcrowded settings, those in the judiciary, people and staff in prisons, jails, detention centers, and staff, and people with comorbid and underlying conditions which put them at significantly higher risk.  Maryland will require preregistration of Phase 1 vaccine sites and registration of priority vaccine candidates at each site.

The beginning of Maryland’s Phase 2 will be influenced by factors such as the availability of a vaccine, notification by the CDC and state authorities that the general public can begin receiving vaccines and that there is a sufficient supply of vaccines, and achievement of targeted metrics for vaccination of high priority Phase 1 groups.  When a vaccine becomes more widely available for the general public in Phase 3, the state will use earned/paid/social media communication to target the public to seek vaccination through MarylandVax.org or their doctor or local pharmacy.

More information can be found on the Maryland Department of Health website.

Massachusetts

Phase 1a of Massachusetts’ COVID-19 vaccination plan will target paid and unpaid individuals working in health care settings that can be exposed directly or indirectly to patients or infectious materials and cannot work from home.  Phase 1b will focus on other essential workers and people at risk for severe COVID-19 illness, including those over 65 and those with underlying medical conditions.

Phase 2 of Massachusetts’ vaccination plan will target the broader population and broaden its vaccine provider network.  Phase 3 will further target the general population.  The state will target areas of low vaccine uptake.  It will partner and collaborate with local communities to identify obstacles and barriers to vaccination and develop appropriate strategies to address those obstacles and barriers.

More information can be found on the Massachusetts state website.

Michigan

Phase 1 in Michigan’s COVID-19 vaccination plan will focus on getting the initial allocations of a vaccine to the hospitals and health systems to use for health care workers.  This includes paid and unpaid persons serving in health care centers, directly or indirectly exposed to patients with COVID-19 or infectious materials.  Phase 1 will also include those at elevated risk of severe complications for COVID-19 illness based on age, including those over 65.

Phase 2 of Michigan’s plan focuses on other essential personnel, including grocery and food distribution workers, health care workers not vaccinated in Phase 1, high-risk populations, and other critical populations.  Local health jurisdictions will allocate vaccines in Phase 2.  Phase 3 will see all enrollment, distribution, and communication efforts expanded to include the general population.

More information can be found on the Michigan Department of Health & Human Services website.

Minnesota

Minnesota’s COVID-19 vaccination plan will focus its Phase 1 efforts on priority populations, as defined by the National Advisory Committee on Immunization Practices (ACIP).  These initial activities will be targeted through local and regional public health plans to specific settings (i.e., not open to the public).  Vaccines will be administered in Phase 2 through clinics, pharmacies, and public health sites.  The public will be allowed to start getting vaccinated in Phase 2.  Phase 3 in Minnesota will see a more widely available vaccine, and the state will adopt a systematic distribution strategy.

More information can be found on the Minnesota Department of Health website.

Mississippi

Mississippi’s Phase 1 of its COVID-19 vaccination plan is broken into two sub-phases.  Phase 1a will focus on health care workers, pharmacists, first responders, and the National Guard.  Phase 1b will focus on long-term care facilities and health facilities.  Phase 2 will shift its attention to people with comorbid conditions over the age of 18, homeless individuals, those in prisons and jails, adults over the age of 65, and the critical workforce (i.e., education, public health, dentists/dental hygienists, funeral home directors, crematory operators, postal workers, transportation workers, grocery store employees, and butchers and meatpackers.  Phase 3 vaccination efforts will be targeted to the public, who can get vaccinated at doctors’ offices, clinics, and pharmacies.  The state will use TV, news, radio, and social media to target the general population in Phase 3.

More information can be found on the Mississippi State Department of Health’s website.

Missouri

Phase 1 of Missouri’s COVID-19 vaccination plan includes two sub-phases.  Phase 1a will target unpaid and paid health care workers, and long-term care facility staff as the state collaborates with health care systems, pharmacies, and community partners.  Phase 1b will see Missouri shift its attention to critical infrastructure workers and those at higher risk for COVID-19 illness as identified by the CDC.  Vaccination efforts will occur in PODs where possible in this phase.

In Phase 1b, Missouri plans to participate in the CDC’s Pharmacy Partnership for Long-term Care Program to provide on-site vaccination clinics for residents of long-term care facilities and staff not vaccinated in Phase 1a.  Missouri’s Phase 2 will focus on populations at increased risk of getting COVID-19.  In this phase, populations considered include racial and ethnic minority groups, housing-insecure individuals, people living and working in congregate settings, and other groups and other communities at higher risk of severe outcomes from COVID-19.  Phase 3 of Missouri’s plan will focus on continuing vaccination efforts to those from the previous two phases who did not get vaccinated and every citizen, at no cost.  Phase 3 aims to have federally qualified health centers, rural health clinics, private providers, and pharmacies take on most vaccination efforts for adults.

More information can be found on the Missouri state website.

Montana

Montana’s Phase 1 of its COVID-19 vaccination plan will focus its efforts on the critical workforce to maximize the limited supply of vaccines available to ensure essential response personnel and those at the highest risk of life-threatening infection receive the first dose within the first two months of the initial distribution of a vaccine.

Phase 2, expected to occur about three to six months after vaccination efforts begin, will focus efforts on continuing to target those in the critical workforce not vaccinated in Phase 1.  Phase 2 will also focus on providing second dosing for Phase 1 recipients and expand vaccine availability to other prioritized groups.  After about six months, Phase 3 will begin.  At this point, vaccines should be widely available, and distribution should be routine.  COVID-19 vaccinations may be part of routine immunizations with influenza.

More information can be found on the Montana Department of Public Health and Human Services website.

Nebraska

Nebraska’s COVID-19 vaccination plan was updated on December 7.  The state’s Phase 1 is broken down into three sub-phases to provide greater separation between target populations.  Phase 1 providers are the only ones allowed to order and receive vaccines in Phase 1.  Phase 2 will expand the provider network to vaccinate a larger portion of the population. Phase 3 will focus on direct access to vaccines through the more traditional network of vaccination. 

More information can be found on the Nebraska Department of Health and Human Services website.

Nevada

In Phase 1 of Nevada’s COVID-19 vaccination plan, efforts will focus on reaching health care personnel, those at increased risk for severe COVID-19 illness, those over 65 years of age, and other essential workers critical to keeping the state’s infrastructure operating.  The provider network will be expanded in Phase 2 and moving towards focusing on the general population.  Nevada’s Phase 3 will focus on monitoring vaccine uptake and coverage to allow the state to reassess its strategies to make sure that populations or communities with low coverage receive vaccinations. 

More information can be found on Nevada’s state website.

New Hampshire

New Hampshire’s COVID-19 vaccination plan includes a four-phased approach, with the first phase broken down into two sub-phases.  Phase 1a, the “Jumpstart Phase,” will target high-risk health workers and first responders.  Phase 1b will target those with comorbid and underlying conditions that put them at significantly higher risk and older adults living in congregate or overcrowded settings. 

Phase 2 of the state’s plan expands to include K-12 teachers and school staff and child care workers, critical workers in high-risk settings, those with comorbid and underlying conditions that put them at moderately higher risk, those in homeless shelters or group homes for individuals with disabilities, people and staff in prisons, jails, detention centers, and similar facilities, and all older adults not included in Phase 1.

Phase 3 will turn the state’s focus to young adults, children, and workers in industries and occupations essential to society’s functioning and are at increased risk of exposure that were not included in the first two phases.  Phase 4 will further target everyone else in the general population that did not have previous access to a vaccine.

More information can be found on the New Hampshire Department of Health and Human Services website.

New Jersey

New Jersey’s first phase of its COVID-19 vaccination plan is broken down into sub-phases.  Phase 1a will focus on health care workers, which the state estimates will require one million doses of a two-dose vaccine.  Phase 1b will focus on essential workers and those considered at higher risk.  New Jersey’s Phase 2 will continue dispensing sites from Phase 1 (hospitals, regional/LINCS Agency PODS, etc.) and expand to include pharmacies and work with large agencies to provide on-site employee vaccinations through closed PODs.  The Garden State plans to follow the CDC framework for the broad outline of Phase 3.  In Phase 3, vaccines will be available to the general population.  The state will assess reasons for any slow demand and produce a plan to overcome these barriers.

More information can be found on the New Jersey Department of Health’s website.

New Mexico

New Mexico’s COVID-19 vaccination plan provides for sub-phases within the first phase.  New Mexico’s Department of Health (NMDOH) sent out surveys statewide to hospitals, community health centers, and other providers to identify the number of employees with high, moderate, or low or no exposure to COVID-19 patients and hazardous materials.  The surveys will help to determine who is included in each phase.  Assuming supplies are limited, NMDOH will recommend that vaccines be initially offered to vaccinator entities’ workforces.  This includes those in the health care setting, such as those exposed or potentially exposed to patients with COVID-19, those in intensive care units, or those in emergency departments.  Phase 1a will also target those at risk of serious disease or death if they contract COVID-19, such as those over 65.  Phase 1b will expand to first responders and other health care providers not included in Phase 1a.  This includes EMS and fire paramedics, the staff at free-standing emergency departments, urgent care staff, and personnel who conduct COVID-19 testing.  Phase 1b will also include residents of long-term care facilities and individuals who work in congregate care settings (i.e., nursing homes, assisted living facilities, COVID-19 shelters, developmental disability providers in group home settings, the staff at youth, domestic violence, and homeless shelters, and correctional and juvenile justice health care providers and staff.

In Phase 2, NMDOH will identify additional vaccination sites and anticipates widespread participation of health care providers and pharmacies.  NMDOH will conduct targeted outreach in Phase 2 by coordinating with public schools, childcare providers, higher education institutions, and those in the hospitality industry.  Phase 3 will focus on serving the entire population.  NMDOH will coordinate planning for long-term storage and shelf life of a COVID-19 vaccine.

More information can be found on the New Mexico Department of Health website.

New York

New York’s COVID-19 vaccination plan includes a five-phased approach.  Phase 1 will target health care workers (clinical and non-clinical) in inpatient care settings.  The top priority will be on those in ICUs, EDs, and EMS.  Also targeted in Phase 1 are workers in long-term care facilities and the most at-risk long-term care facility patients.  Phase 2 of New York’s plan will target first responders (fire, police, national guard, etc.), teachers and school staff, childcare providers, public health workers, individuals in the general population at high risk due to comorbidities and health conditions, essential frontline workers that regularly interact with the public (pharmacists, grocery store workers, transit employees, etc.) or maintain critical infrastructure, and other long-term care facility patients and those who live in congregate settings.

Phase 3 will see New York targeting individuals over 65 years of age and those under 65 with high-risk comorbidities and health conditions.  All other essential workers will be targeted in Phase 4, and all healthy adults and children will be targeted in Phase 5.

More information can be found on the New York Department of Health website.

North Carolina

North Carolina’s COVID-19 vaccination plan includes a four-phased approach.  Phase 0, the planning phase, is already underway and helped identify priority populations and designed a process to identify and enroll providers who can reach the priority populations.  Phase 1, the implementation phase, will target populations, including critical health care workers at high risk of exposure, essential workers (i.e., emergency management, fire, etc.), and long-term care staff and residents.  These vaccines are likely to be administered in closed settings for employees or residents.  The state is also working to prioritize populations with a high risk of morbidity and mortality of COVID-19, including those in settings or occupations with increased risk of exposure, those living in congregate settings, workers in high-density settings, and frontline workers.  Vaccinations for these groups are likely to be administered through vaccination clinics administered by local health departments for critical populations or through arrangements for on-site vaccination clinics.

The second phase, the adjustment phase, will see higher supply and high demand.  This phase will see the state transition from providers’ allocation to providers ordering for themselves based on local population demand and needs.  The last phase, the transition phase, will see enough vaccine availability so that anyone in the state can receive a vaccine who wants one.

More information can be found on the North Carolina Department of Health and Human Services website.

North Dakota

North Dakota’s first phase in its COVID-19 vaccination plan will see large, urban areas holding mass clinics for outreach to eligible groups, such as health care workers and essential workers.  Further, vaccines will be supplied to health systems and long-term care facilities.  If vaccines can be redistributed or transferred, then smaller clinics can be held near high-risk populations (i.e., rural health care workers, elderly housing, areas with urban American Indian populations, etc.).  Individuals can pre-register for vaccinations with PrepMod, the state’s mass vaccination system.

In Phase 2, vaccine distribution to large urban areas will include ancillary health care workers, infrastructure workers, and other high-risk population members.  Further, those in group homes, corrections, and other congregate settings will be targeted in Phase 2.  The emphasis in Phase 3 will be on private health care providers and pharmacies to vaccinate the entire general population.

More information can be found on the North Dakota Department of Health website.

Ohio

Ohio’s COVID-19 vaccination plan includes a four-phased approach, with the first phase broken into two sub-phases.  Phase 1A will target high-risk healthcare workers and first responders.  Phase 1B will target older adults living in congregate or overcrowded settings and those at significantly higher risk due to comorbidities or underlying conditions.

Ohio’s second phase will target critical risk workers essential to the functioning of society and at high risk of exposure, teachers and school staff, those of all ages with comorbidities and underlying conditions, older adults not included in Phase 1, those in homeless shelters, those in group homes for individuals with physical or mental disabilities or in recovery, and people and staff in prisons, jails, and detention centers.

Ohio’s Phase 3 will target young adults, children, and workers in industries and occupations essential to society’s functioning and at increased risk of exposure who were not included in the first two phases.  The last phase will target all other Ohio residents who did not have access to the vaccine in the first three phases.

More information can be found on the Ohio Department of Health website.

Oklahoma

In Phase 1 of Oklahoma’s COVID-19 vaccination plan, the state will provide vaccination services in closed point-of-dispensing (POD) settings to allow the maximum number of people to be vaccinated while maintaining social distancing.  The first phase will also see closed PODs being conducted by private and public providers (including tribes).  During the second and third phase, mass immunization clinics will enable quick administration and greater public access.  The state anticipates priority populations to include people from racial and ethnic minority groups, tribal communities, those with underlying medical conditions or disabilities, and people who are not insured.

More information can be found on the Oklahoma Department of Health website.

Oregon

Phase 1 of Oregon’s COVID-19 vaccination plan includes two sub-phases.  Phase 1-A will focus on paid and unpaid people in health care settings who can potentially be exposed directly or indirectly to patients or infectious materials and cannot work from home.  Phase 1-B will focus on other essential workers and people at higher risk of severe COVID-19 illness, including those aged 65 and older.  In Phase 1, vaccines will be administered in closed settings best suited for reaching these initial critical populations.

Phase 2 will expand beyond the initial populations to include other critical populations and the general population.  A broader provider network and settings will be used in Phase 2, including health care settings (i.e., doctors’ offices and clinics), commercial sector settings (i.e., retail pharmacies), and public health venues (i.e., public health clinics, mobile clinics, community settings, etc.).  Phase 3 vaccine administration will expand to additional private partner sites.  It will focus on direct access to vaccination by the public-at-large.

More information can be found on the Oregon state website.

Pennsylvania

The first phase of Pennsylvania’s COVID-19 vaccination plan is broken down into two sub-phases.  Phase 1A will target health care personnel, first responders, critical workers, and individuals with high-risk conditions.  When more vaccine doses become available, Phase 1B will focus on additional health care providers, people at higher risk, and critical workers.  Phase 2 will see a larger number of doses available and focus on those with barriers to access to care, those contributing to the maintenance of core societal functions, and those at elevated risk due to working or living conditions.  Phase 3 will shift to the general population and focus on populations not identified in the first two phases.

More information can be found on the Pennsylvania Department of Health website.

Rhode Island

Rhode Island’s COVID-19 vaccination plan features three phases, the first of which is broken into two sub-phases.  High-risk health care workers and first responders will be the focus of vaccination efforts in Phase 1A.  As more vaccine becomes available, Phase 1B will focus on those with significant comorbid conditions and older adults in congregate or overcrowded settings and make sure those in Phase 1A receive their second dose in the event of a two-dose vaccine series.  According to the vaccination plan, additional work could be done to identify and prioritize subgroups within these critical population groups depending on how limited the state’s vaccine allotment is during the first phase.

Rhode Island’s Phase 2 will focus on K-12 teachers, school staff, childcare providers, critical workers in high-risk settings, moderate comorbid conditions, homeless shelters or group homes and staff, incarcerated or detained people and facility staff, and all other adults.  Phase 3 will prioritize young adults, children, and workers in industries critical to society’s functioning.

More information can be found on the Rhode Island Department of Health website.

South Carolina

South Carolina’s COVID-19 vaccine plan is a three-phased approach, with the first phase broken down into two sub-phases.  Phase 1-A will include paid and unpaid persons serving in health care settings who can potentially be exposed, directly or indirectly, to patients or infectious materials and cannot work from home.  Phase 1-B will focus on other essential workers and those at higher risk of severe COVID-19 illness, including those over 65.  Phase 2 will ensure access to vaccination for Phase 1 targeted groups who were not yet vaccinated and expand efforts to the general population by utilizing an expanded provider network.  Phase 3 will see vaccine access for the entire population and focus on equitable vaccination access while reassessing the state’s strategy to increase vaccine uptake in communities with low coverage.

More information can be found on the South Carolina Department of Health and Environmental Control website.

South Dakota

South Dakota’s COVID-19 vaccination plan begins with Phase 1, targeting health care personnel and ACIP recommended target populations.  The state will partner with health care systems, tribal partners, and organizations serving at-risk individuals.  Communication about the vaccination process will be conducted via paid traditional and digital media and earned media.  Vaccination clinics will be held in closed PODs to target specific populations.  Further, South Dakota Tribes may elect to receive a direct allocation of the COVID-19 vaccine from the federal government or coordinate with the state to receive the vaccine.  Phase 2 will focus on at-risk groups, and Phase 3 will ensure that the entire population has access to the vaccine.

More information can be found on the South Dakota Department of Health website.

Tennessee

Tennessee’s COVID-19 vaccination plan is broken into four phases. The first phase, unlike other states, features three sub-phases.  Phase 1a1 will focus on hospital staff with direct exposure to patients or infectious materials, home care staff, COVID-19 mass testing site staff, student health providers, first responders with direct public exposure, and staff and residents long-term care facilities.  Phase 1a2 will focus on primary care providers and staff, outpatient specialty providers and staff working with acute patients, pharmacists and staff, patient transport, outpatient therapists, urgent center providers, staff, environmental services, oral health providers, and behavioral health providers.  Phase 1b will focus on adults with two or more high-risk conditions, with the priority being those aged over 65.  High-risk conditions include cancer, chronic renal disease, COPD, pulmonary fibrosis, cystic fibrosis, moderate to severe asthma, solid organ transplant, obesity, heart failure, CAD, cardiomyopathies, hypertension, sickle cell, thalassemia, diabetes, cerebrovascular disease, immunocompromised (HIV, chronic steroids, immunomodulators, blood or bone marrow transplant), dementia, and liver disease.

Tennessee’s Phase 2 will turn the state’s attention to critical infrastructure workers, K-12 teachers, school staff, and childcare workers, all ages with comorbid or underlying conditions with moderate risk, healthy individuals over the age of 65, congregate care residents and staff, and corrections residents and staff.  Phase 3 will focus on young adults, children, and workers in industries/entities essential to society’s functioning and a higher risk of exposure (i.e., universities, entertainment, goods-producing industries, etc.).  Phase 4 will turn the state’s focus on anyone else, not already vaccinated in the general population.

More information can be found on the Tennessee Department of Health website.

Texas

Texas’ COVID-19 vaccination plan features a four-phased approach.  Phase 1 will concentrate on vulnerable and frontline populations considering those who live in remote, rural areas and may have difficulty accessing vaccination services.  During Phase 2, Texas will administer the vaccine through commercial and private sector partners (i.e., pharmacies, doctors’ offices, clinics), public health sites (mobile clinics, FQHCs, RHCs, public health clinics, temporary/off-site clinics).  Phase 2 will expand beyond the initial population groups from Phase 1 with an emphasis on equitable access.  The state will move to Phase 3 when a broad vaccine administration network becomes available and integrated into routine vaccination programs run by public and private partners.  The fourth phase in Texas’ plan notes that a vaccine will be at a decreased need but may include boosters or annual vaccines.  The state will further monitor areas with low vaccination uptake or coverage and enhance its strategies to reach populations in these areas.

More information can be found on the Texas Department of Health and Human Services website.

Utah

Phase 1A of Utah’s COVID-19 vaccination plan will target emergency departments, urgent care, primary care setting, COVID ward, ICU workers, health care workers with pre-existing conditions, housekeeping, and long-term care facility staff.  Phase 1B will include long-term care facility residents (Wave 1), first responders, EMS personnel, commercial and private sector partners such as pharmacies, doctors’ offices, and clinics (Wave 2), and federally qualified health centers, rural health clinics, and public health clinics (Wave 3).

Phase 2 of Utah’s COVID-19 vaccination plan will see additional partners able to administer vaccines.  The state will continue to make sure those eligible in Phase 1 are vaccinated.  Phase 3 will see the state focus on making the vaccine available to the public-at-large.

More information can be found on the Utah Department of Health website.

Vermont

Vermont’s four-phased approach in its COVID-19 vaccination plan begins with a “Jumpstart Phase.”  The Jumpstart Phase, or Phase 1a, will target high-risk health workers and first responders.  Phase 1b will focus on those of all ages with comorbid or underlying conditions at high-risk and older adults living in congregate or overcrowded settings.  Phase 2 will focus on K-12 teachers, school staff, childcare workers, critical workers in high-risk settings and face the highest risk of exposure, those of all ages with comorbid or underlying conditions which put them at moderately higher risk, those in homeless shelters or group homes for individuals with disabilities, those in prisons, jails, detention centers, and other facilities, and all older adults not included in Phase 1.

Phase 3 of Vermont’s plan will focus on young adults, children, and workers in industries and occupations essential to society’s functioning and at increased risk of exposure who were not included in the previous two phases.  The state will turn its attention to making the vaccine available to all residents in Phase 4.

More information can be found on the Vermont Department of Health website.

Virginia

Virginia’s COVID-19 vaccination plan is a three-phased approach.  Phase 1-A will focus on paid and unpaid persons serving in health care settings who can potentially be exposed to patients or infectious materials (directly or indirectly).  In contrast, phase 1-B will turn to other essential workers and people at higher risk of severe COVID-19 illness, including those aged over 65.  Phase 2 will make sure those in Phase 1 receive their vaccinations and move to other critical populations, as well as the general population.  Phase 3 will focus on making sure the vaccine is available to all Virginia residents.

More information can be found on the Virginia Department of Health website.

Washington

Possible Phase 1 groups targeted in Washington’s COVID-19 vaccination plan include high-risk workers in health care settings, high-risk first responders, people of all ages with comorbidities, older adults in congregate or crowded settings, and essential workers.  The state will move in Phase 2 to use a broad network of provider settings, including CHCs, pharmacies, primary care providers, community or business PODs, long-term care facilities, congregate living facilities, and occupational health clinics.  Phase 3 will focus on ensuring that all Washington residents have access to the vaccine.

More information can be found on the Washington Department of Health website.

West Virginia

West Virginia’s COVID-19 vaccination plan features a three-phased approach.  Phase 1-A will focus on health care personnel, defined as any paid or unpaid persons serving in health care settings who can potentially be exposed, directly or indirectly, to patients or infectious materials.  Phase 1-B will focus on the non-healthcare critical workforce, including any workers deemed necessary to maintain society’s functioning.  A vaccine will be made available to the public in Phase 2.  Phase 3 will see the COVID-19 vaccine integrated into routine vaccination programs.

More information can be found on the West Virginia Department of Health & Human Resources website.

Wisconsin

Wisconsin’s COVID-19 vaccination plan features a three-phased approach.  Health care workers will be targeted in Phase 1A, with health care entities serving as the critical vaccinators for individuals in their organization.  Phase 1B will target residents of long-term care or assisted living facilities, essential workers, and those over the age of 65.  Phase 2 will focus on those eligible from Phase 1 as well as other critical populations and eventually the public-at-large.  Phase 3 will see the vaccine available to all who need it.

More information can be found on the Wisconsin Department of Health Services website.

Wyoming

Wyoming will use a three-phased approach in its COVID-19 vaccination plan.  Phase 1a will focus on health care personnel likely to be exposed to or treat people with COVID-19.  Hospitals, Public Health Nursing Offices, and County Health Departments will complete healthcare provider populations’ vaccinations.  Phase 1b may include people at increased risk for severe illness from COVID-19, including those with underlying medical conditions, those aged over 65, and essential workers.  Phase 2 critical populations may include additional critical workers, those with underlying conditions, those in congregate settings, and people with limited access to vaccination services.  Phase 3 will focus on making a vaccine available to all people who are recommended to be vaccinated.

More information can be found on the Wyoming Department of Health website.

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