Appl Clin Inform 2021; 12(05): 1074-1081
DOI: 10.1055/s-0041-1739517
Research Article

Rolling Up the Sleeve: Equitable, Efficient, and Safe COVID-19 Mass Immunization for Academic Medical Center Employees

Samuel McDonald
1  Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Mujeeb A. Basit
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
3  Department of Internal Medicine/Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Seth Toomay
4  Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Christopher McLarty
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Susan Hernandez
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Chris Rubio
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Bruce J. Brown
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Mark Rauschuber
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Ki Lai
5  University of Texas Southwestern Health System, Dallas, Texas, United States
,
Sameh N. Saleh
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
6  Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
DuWayne L. Willett
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
3  Department of Internal Medicine/Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Christoph U. Lehmann
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
7  Departments of Pediatrics, Population & Data Sciences, and Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Richard J. Medford
2  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
8  Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, United States
› Author Affiliations

Abstract

Background Novel coronavirus disease 2019 (COVID-19) vaccine administration has faced distribution barriers across the United States. We sought to delineate our vaccine delivery experience in the first week of vaccine availability, and our effort to prioritize employees based on risk with a goal of providing an efficient infrastructure to optimize speed and efficiency of vaccine delivery while minimizing risk of infection during the immunization process.

Objective This article aims to evaluate an employee prioritization/invitation/scheduling system, leveraging an integrated electronic health record patient portal framework for employee COVID-19 immunizations at an academic medical center.

Methods We conducted an observational cross-sectional study during January 2021 at a single urban academic center. All employees who met COVID-19 allocation vaccine criteria for phase 1a.1 to 1a.4 were included. We implemented a prioritization/invitation/scheduling framework and evaluated time from invitation to scheduling as a proxy for vaccine interest and arrival to vaccine administration to measure operational throughput.

Results We allotted vaccines for 13,753 employees but only 10,662 employees with an active patient portal account received an invitation. Of those with an active account, 6,483 (61%) scheduled an appointment and 6,251 (59%) were immunized in the first 7 days. About 66% of invited providers were vaccinated in the first 7 days. In contrast, only 41% of invited facility/food service employees received the first dose of the vaccine in the first 7 days (p < 0.001). At the vaccination site, employees waited 5.6 minutes (interquartile range [IQR]: 3.9–8.3) from arrival to vaccination.

Conclusion We developed a system of early COVID-19 vaccine prioritization and administration in our health care system. We saw strong early acceptance in those with proximal exposure to COVID-19 but noticed significant difference in the willingness of different employee groups to receive the vaccine.

Protection of Human and Animal Subjects

This study was formally reviewed and approved as quality improvement by the UT Southwestern Medical Center Human Research Protection Program and deemed not to require Institutional Review Board oversight.


Supplementary Material



Publication History

Received: 12 April 2021

Accepted: 07 October 2021

Publication Date:
17 November 2021 (online)

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