COVID-19 Vaccine IT Overview: Vaccine Allocation, Distribution, Administration, Data, and Reporting

The Vaccine Tracking System (VTrckS) is the Centers for Disease Control and Prevention’s (CDC) vaccine order management system, which supports routine vaccination with almost 80 million doses of vaccine annually. CDC will use VTrckS as its platform for ordering all COVID-19 vaccines. VTrckS users—the 64 state, local, and territorial public health jurisdictions and enrolled national provider organizations (i.e., the Department of Veterans Affairs, Department of Defense, Indian Health Service, Bureau of Prisons, and pharmacy chains participating in COVID-19 vaccination) will use VTrckS to:

• View vaccine allocations for each program
• Place and manage vaccine orders for their providers
• Generate reports throughout the vaccine distribution process, from vaccine order placement through distribution
• Track vaccine shipments

As part of the overall IT infrastructure to support COVID-19 vaccination, VTrckS can receive or exchange data with the following systems or organizations:

• VTrckSExIS Portal: Jurisdictions and federal and commercial partners will connect with the portal or directly with VTrckS to submit vaccine orders, enrolled provider master data, as well as vaccine inventory, return, and wastage information. In return, VTrckS provides vaccine shipment data via downloads to the jurisdictional IIS.
• McKesson, the VTrckS logistics contractor: McKesson receives orders from VTrckS, directs vaccine manufacturers to ship vaccines, and transmits vaccine shipment details from providers to VTrckS.
• Federal data and reporting systems: The Immunization (IZ) Data Lake will receive data feeds from VTrckS related to provider data, orders, shipments, inventory, and allocations.

Immunization Information Systems (IISs) were formerly known as “immunization registries.” All 64 jurisdictions have or will soon have web-based IISs. Some IISs are hosted by vendors in the cloud, while others use secure servers housed by the jurisdiction. The IISs vary by jurisdiction in several ways:

• Systems have varying capacity to automate processes and to handle a large volume of data.
• There can be significant variations in data quality across IISs, sometimes due to data reporting policies.

Vaccine recipients and enrolled providers (e.g., clinics, healthcare systems, pharmacies) use IISs to access people’s vaccination records. The 64 jurisdictions use their IISs to support providers by:

• Creating a centralized data repository for vaccination information specific to that jurisdiction
• Approving vaccine orders from enrolled providers and submitting orders to VTrckS
• Monitoring vaccine distribution and changes in vaccine inventory, including accounting for wasted, spoiled, expired, and transferred vaccine
• Providing vaccination coverage assessments

Most IISs can:

• Provide unidirectional or bidirectional data transmissions for providers
• Connect with local/state Health Information Exchanges
• Connect to the IZ Gateway to share and receive information from national providers and other IISs

In addition, IISs collect data from public and private healthcare provider organizations (e.g., electronic health records), health information systems (e.g., vital statistics, state Medicaid agencies), and pharmacies. IISs share these data with the IZ Gateway, CDC, and other jurisdictions if an agreement is in place. IISs also share vaccination records with healthcare providers and individuals.

As part of the overall IT infrastructure to support COVID-19 vaccination IISs connect with:

• VTrckS for information on submission of vaccine orders; access to vaccine allocations; submission of data on wasted, spoiled, or expired vaccines; and viewing of user reports
• VAMS (see below for details),  if used by the jurisdiction
• Federal data and reporting systems: IISs send vaccine administration data to CDC via the IZ Gateway or through submission of extract files to the CDC Data Clearinghouse

The VaccineFinderexternal icon website helps people find providers who offer select vaccines. VaccineFinder also allows healthcare providers to list their vaccination locations in a centralized, searchable database and to track vaccine supply.  VaccineFinder will serve two roles in the COVID-19 vaccination program:

1. Inventory reporting (required for all COVID-19 vaccine providers): Providers will report on-hand COVID-19 vaccine inventory each day through VaccineFinder.
2. Increase access to COVID-19 vaccines (optional for COVID-19 vaccine providers): Once there is enough supply, COVID-19 vaccination providers may choose to make their location visible on VaccineFinder, making it easier for the public to find provider locations that have COVID-19 vaccine available. CDC will direct the public to use VaccineFinder to find locations offering COVID-19 vaccine.

As part of the overall IT infrastructure to support COVID-19 vaccination VaccineFinder sends data to and receives data from the IZ Data Lake.

The IZ Gateway is a cloud-based message routing service intended to enable data exchange between IISs, other provider systems, and the IZ Data Lake. The IZ Gateway enables centralized data exchange and eliminates the need for multiple, individual, point-to-point connections. The IZ Gateway enables IISs, federal agencies, and providers to update, query, and report immunization data.

• The IZ Gateway allows:
• IISs to report data to the COVID-19 Data Clearinghouse
• Cross-jurisdictional queries and data exchange
• Multijurisdictional providers to share data with multiple IISs via a central connection
• VAMS data to be routed to the IIS where applicable

Vaccine Administration Management System (VAMS) is an optional web-based application that supports planning and execution for temporary, mobile, or satellite COVID-19 vaccination clinics.

VAMS has modules to support four specific user groups:

• Public health jurisdictions: VAMS allows jurisdictions to provide end-to-end vaccination and manage vaccination clinics. Specific functions include:
  • Adding clinics and clinic administrators
  • Adding employers/organizations and employer coordinators
  • Actively managing lists of clinics for jurisdictions (adding, deactivating, importing clinic information)
  • Managing jurisdiction vaccine inventory
  • Providing VAMS-related support to clinics and employers
• Healthcare providers: VAMS facilitates patient scheduling, vaccine administration workflow, and patient monitoring. Specific functions include:
  • Supporting social distancing requirements within the scheduling feature
  • Tracking vaccine inventory and usage
  • Creating patient vaccine administration records
    Note: VAMS does not support vaccine ordering. Ordering is done through the normal vaccine ordering process (i.e., VTrckS).
• Employers/organizations: VAMS allows these groups to bulk input employees, who will receive an email to register in VAMS so they can schedule an appointment to receive a COVID-19 vaccination.
• Vaccine recipients: VAMS provides an easy way for COVID-19 vaccine recipients to schedule vaccination appointments, receive a record of vaccination, and receive appointment reminders for the second dose of the specific vaccine they received if and when a second dose is needed.

As part of the overall IT infrastructure to support COVID-19 vaccination VAMS connects with IISs via federal and data reporting systems and sends data to IISs through the IZ Gateway or COVID-19 Data Clearinghouse.

The COVID-19 Data Clearinghouse is a cloud-hosted data repository that receives, deduplicates, and deidentifies COVID-19 vaccination data that are then used to populate the IZ Data Lake with deidentified data for analytics.

The COVID-19 Data Clearinghouse allows healthcare providers to search for a patient, see what brand of COVID-19 vaccine they received, and see when they received their first dose of COVID-19 vaccine to ensure dose matching and appropriate vaccination intervals to complete the vaccine series.

The IZ Data Lake is a cloud-hosted data repository to receive, store, manage, and analyze deidentified COVID-19 vaccination data. CDC, jurisdictions, federal agencies, and pharmacy partners will use the IZ Data Lake to store and process administration, coverage, logistics, inventory, ordering, distribution, and provider data. VAMS, IISs, pharmacies, VTrckS, and VaccineFinder will provide data for the IZ Data Lake. The IZ Data Lake will also aggregate and analyze data and provide data summaries and analytics via these reporting hubs:

• Data Storefront
• Department of Health and Human Services’ HHS Protect data hub
• Operation Warp Speed’s Tiberius platform, a COVID-19 vaccine distribution planning, tracking, modeling, and analysis application