Practice Title: Protecting the Vulnerable: Vaccinating HCWs and Skilled Nursing Facilities in Los Angeles County
Department: Los Angeles County Department of Public Health
Size: Large (Population of 500,000+ people)
State: California
Summary of Practice:
The most vulnerable individuals to COVID-19 during the first phase of the pandemic in Los Angeles County were healthcare providers and those residing in skilled nursing facilities (SNFs). Immunizing these vulnerable populations as soon as vaccines became available was a critical strategy to reduce morbidity and mortality and protect local healthcare capacity.
The roll-out of COVID-19 vaccine began during the most challenging time of the pandemic, during the largest surge in cases and deaths in the winter of 2020-2021. With a limited supply of COVID-19 vaccine, vaccine eligibility was determined by prioritization developed at federal and state levels. Local planning was essential to further refine the prioritization categories and assist in implementation based on local trends of transmission. After the determination was made that the first tier of vaccine would focus on healthcare workers (HCWs) and skilled nursing facilities (SNFs), planning and collaboration with key stakeholders intensified to better refine prioritization across the population of HCWs.
In order to address the various challenges that existed, the LA County Department of Public Health (LAC DPH) developed a novel multipronged strategy consisting of early strategic planning with healthcare partners and community stakeholders; distribution of vaccine directly to SNFs for local use; vaccine distribution through a hub and spoke model in hospitals; daily open calls with LAC DPH experts to answer healthcare facility questions; call lines for the public; liaison groups to interface with occupational settings; and strike teams in SNFs to quickly vaccinate HCWs and residents. This comprehensive approach was able to deliver vaccine to HCWs and SNF residents quickly and was able to curb soaring trends in morbidity and mortality. New cases among HCWs dropped from a weekly high of 1,987 at year end to below 50 cases/week by early April with deaths dropping from 24 to 5 cases per week by mid-February. In SNFs, cases dropped from 1,109 to under 20 cases/week from the end of 2020 to early March and deaths dropped from 181 to less than 2/week by late March.
Protecting the Vulnerable: Vaccinating HCWs and Skilled Nursing Facilities in Los Angeles County
Category
Immunization