The U.S. Department of Veterans Affairs (VA) recently vaccinated its 1 millionth Veteran with the first dose of the COVID-19 vaccination. They began vaccinations in December, 2020 and in just a month and a half administered 1 million does of the COVID-19 vaccine to Veterans and VA health care workers. The VA is currently using the Pfizer-BioNTech vaccine with second doses given 21 days after the first shot and the Moderna vaccine with second doses given 28 days after the first shot.

“In addition to administering 1 million doses of the COVID-19 vaccine, VA has begun publishing the number of Veterans who have received Pfizer BioNTech or Moderna vaccines at each facility across its enterprise,” said Acting VA Secretary Dat Tran.  “The number of doses administered to Veterans at each facility will be updated daily on the VA COVID-19 National Summary website.” The summary publishes vaccine date daily as well as information on COVID-19 cases. As of February 25, 2021, the VA has vaccinated 1,471,228 individuals with their first dose and 785,255 have completed their course by receiving their second dose of the vaccine.

Out of these numbers, 264,167 employees received their first dose and 228,521 received their second dose. The VA is the nation’s largest health care system and employs more than 322,030 full time health care professionals and support staff. They are well on their way to ensuring their essential staff can receive the vaccine. Employees are working to vaccinate the VA’s health care personnel and Veterans most at risk as soon as possible. The VA makes the data about vaccine doses public as a step toward being as transparent as possible during the pandemic.

Currently there are more than 215 VA sites nationally providing vaccines. Currently the supply of vaccines is limited but once supply increases the number of sites will expand. The VA is following the current guidance from the Centers for Disease Control and Prevention and the VA COVID-19 Vaccination Distribution Plan. “VA guidance encourages local flexibility to maximize COVID-19 vaccine access and efficiency while limiting potential vaccine waste,” said Acting VA Under Secretary for Health Richard Stone, M.D. “In this limited supply phase, our COVID-19 vaccination strategy is balancing site-specific resources, facility needs, vaccine availability and status of the pandemic locally, as well as strict storage, handling and transportation parameters of available vaccines.”

VA is reaching out to Veterans who are eligible for vaccination. Veterans who would like additional information can visit the VA COVID-19 vaccines webpage, visit their local facility’s website or contact their care team. The goal is to offer the vaccine to all Veterans and employees who want it as supply increases.

“Combating human trafficking is a responsibility the Defense Department (DoD) takes very seriously,” Anthony M. Kurta, deputy assistant secretary of defense for military personnel policy, said during a recent seminar on Human Trafficking Awareness. “Human trafficking is modern-day slavery. It not only destroys the lives of those victimized, but also destroys countless families and poses a direct threat to the security and well-being of the entire world. Those who engage in human trafficking exploit the weak and the vulnerable and capitalize on those who patronize the sex-trade industry and those involved in forced labor. For those reasons, DoD is committed to continuing its aggressive stance against human trafficking, and will further training its personnel to expand awareness.”

One wouldn’t normally think of the DoD as working to prevent human trafficking, but the signs could be evident around DoD personnel. Some examples are a subcontractor could withhold passports and payments to employees. Some companies make workers pay a large fee to obtain a job on a DoD installation. The three most common forms of trafficking, according to the DoD’s Combating Trafficking in Persons office, are labor trafficking, sex trafficking, and child soldiering.

According to Kurta, the Defense Advanced Research Projects Agency recently received a presidential award for the development of the Memex program. It searches the deep web and connects open-source information to identify tracking patterns. U.S. law enforcements, military and intelligence entities are using it to stop human trafficking enterprises and bring traffickers to justice.

“Additionally, our Special Operations Command, partnered with the National Association to Protect Children and the U.S.  Immigration and Customs Enforcement Homeland Security Investigations to establish the Human Exploitation Rescue Operative Child Rescue Corps,” Kurta said. “Known as HERO, the group trains wounded, ill and injured service members in high-tech forensic and law enforcement skills to assist federal agents in the fight against online child sexual exploitation. HERO exemplifies the power of public-private partnerships to help combat trafficking in persons,” Kurta said.

The DoD also partners with the Joint Staff and combatant commands. According to Kurta, Joint training exercises are conducted that include trafficking in persons scenarios that will help ensure our forces understand their roles in preventing, recognizing, and reporting trafficking in persons incidents. The DoD will continue to invest in and develop a variety of robust training resources to help educate its total force to combat trafficking in persons. Such training also will include specialized training for DoD law enforcement and acquisition professionals, in addition to toolkits to assist leaders in developing their specialized training.

During the month of January, the DoD recognizes National Slavery and Human Trafficking Prevention Month. Military and DoD civilian personnel must take at least one Combating Trafficking in Persons training course every fiscal year. Kurta quoted from the proclamation declaring January as National Slavery and Human Trafficking Prevention Month: “There is no place in our world to allow modern slavery to persist,” he said. “We will do our part to strive for its total abolition.”

DoD says everyone can do their part in fighting trafficking. Incidents of human trafficking can be reported to the DoD Inspector General hotline at 1-800-424-9098, 703-604-8799 or DSN 664-8799, or at www.dodig.mil/hotline.

Like many health care providers, the VA is hard at work to distribute vaccines to Veterans in a phased plan based on the guidelines from the Centers for Disease Control and Prevention (CDC). Information is constantly changing so it is important to check with the VA for updates. You can also sign up to stay informed by filling out this simple form.

Can I Get A COVID-19 Vaccine?

The VA’s phased plan is in effect and these groups listed below are now being vaccinated at some VA health care facilities. (From the VA official website) There is a limited amount of the first 2 COVID-19 vaccines authorized by the Food and Drug Administration (FDA) and will be available at some VA health care facilities.

• VA health care personnel. Vaccinating our VA health care personnel helps us continue to provide care for Veterans.
• Veterans living in our long-term care facilities
• Veterans who receive care at VA and are at high risk from COVID-19 based on VA and CDC risk criteria. At many VA health care facilities, this group includes all Veterans who are at least 75 years old. Each facility will determine when Veterans in this group can receive a vaccine. They’ll base this decision on vaccine availability, local needs, as well as the strict storage and handling requirements of the vaccines.
• Family caregivers who are enrolled in our Program of Comprehensive Assistance for Family Caregivers (PCAFC) are eligible for vaccination when the Veteran they care for becomes eligible. If the Veteran you care for meets the criteria above, both you and the Veteran may be able to get vaccinated now. Vaccinating caregivers helps us support and protect Veterans.

Do not contact the VA about getting a COVID-19 vaccine. If you are receiving care at your local VA health facility, they will contact you and let you know when you can make an appointment. Only those who are currently eligible for the vaccine based on the VA and CDC risk criteria can receive a vaccine. Some VA health care facilities are hosting, large vaccination events or requesting Veterans to call for an appointment. They options are for those in the risk categories mentioned above at this time.

How was the COVID-19 Vaccine Plan Created?

The VA based their phased COVID-19 plan on guidance from the CDC (from the VA website).

• Risk of becoming infected with the virus
• Risk of severe illness and death from COVID-19
• Risk of spreading the virus to others
• Risk of harm to society if essential workers, including health care personnel, are unable to work

There are many factors that can determine what your risk of server illness is. Death or severe illness from COVID-19 increases with age. If you have certain health problems like diabetes, heart disease, or obesity it will increase your risk of severe illness of death. Lifestyle factors such as living in a group home also increases your risk.

Going Forward

Currently the 2 authorized COVID-19 vaccines require special handling and storage which limits its distribution to VA facilities with proper storage. There is a limited supply of vaccines but as soon as more vaccines are available VA care teams will let you know your options. Veterans have the choice if they want to get the vaccine or not. Your choice will not affect your VA health care or benefits. Once more vaccines are available the VA plants to offer a free a COVID-19 vaccine to all Veterans who receive VA health care that want one.

Resources for More Information

• Apply to receive VA health care.
• Updates on the VA COVID-19 vaccine plan.

For answers to general questions about getting a vaccine call 800-698-2411 TTY:711

That is a good question as the Pfizer and Moderna COVID-19 vaccines continue their slow rollout. Shots have not been getting in arms as fast as expected. Alex M. Azar, the secretary of Health and Human Services encouraged state governors to expedite uptake, if needed by expanding eligibility for the vaccines so that no doses go to waste during an Operation Warp Speed briefing, “States can … accelerate vaccine administration by moving on to providing vaccinations to broader populations right now. There is no reason that states need to complete, say, vaccinating all health care providers before opening up vaccinations to older Americans or other especially vulnerable populations.”

Azar reiterated that the CDC and the Advisory Committee on Immunization Practices have made recommendations with healthcare workers high on the list to get the vaccine but these are just recommendations. He stated it is up to the states how vaccines are delivered within the state. At this point it is more important to get vaccine into arms as soon as possible than to keep it locked up until the right candidates step up to get their shot.

“They should never stand in the way of getting shots in arms, instead of keeping vaccines in the freezer, or even, heaven forbid, wasting a dose of vaccine in a vial,” Azar said. “It’s more important to vaccinate. I have encouraged our governors, and I will continue to do so, that if they are using all of the vaccine, that is … allocated, ordered, distributed, shipped — and they’re getting it into healthcare provider’s arms, every bit of it, that’s great. But if for some reason their distribution is struggling, and they’re having vaccines sit in freezers, then by all means you ought to be opening up to people … 65 and over. You ought to be making sure that the nursing home patients are getting vaccinated.”

Another way to speed up vaccine delivery, Azar said, will be with the early launch of the federal “Pharmacy Partnership” program, which will eventually cover more than 40,000 pharmacy locations within 19 pharmacy chains and associations across the U.S. “This partnership allows states to allocate vaccines directly to these partners and these partners can then administer vaccines to particular groups, like those over a certain age or in certain occupations, and eventually to the general public,” Azar said. “To help give states as many options as possible for vaccine administration, we’re launching the program this week and states can choose particular partners to send vaccines to now.”

“Nearly 20 million doses of vaccine [have been] already delivered,” Army Gen. Gustave F. Perna, the chief operating officer of Operation Warp Speed said. “We have delivered that to over 13,000 different locations throughout the United States … simultaneously, fair and equitable distribution of vaccines so that everybody has the opportunity to distribute simultaneously to the American people. I would tell you that it’s going very well and our goal is to maintain the steady drumbeat so that the states have a cadence of allocation, planning and then the appropriate distribution to the right places, as designated.”

The Department of Defense has established a Population Schema which details at what phase you can receive the vaccine.  There are two Phases and Phase one is broken into 3 subcategories. Basically 1a covers everyone involved in healthcare as well as the support care both military and civilian. 1b Critical National Capabilities and those about to deploy and DoD beneficiaries age 75 or older and essential workers. Phase 1c is DoD beneficiaries age 65-74 and those age 16 and older with increased risk for severe illness as well as essential workers not covered in previous phases. Lastly Phase 2 is everybody else age 16 and older.

Visit Health.Mil to get the latest update on getting the COVID-19 vaccine through the military healthcare system. Listed is all the sites that you can receive the vaccine once you are in the right phase.  Different sites can be in different phases, so it is important to check locally to see what phases your area is in.

You may also have the option to get the vaccine through your state’s healthcare system. Visit the CDC’s website for more information. There are tools to search options through your state. Demand for exceeds supply at this point. The key to getting the shot is to keep up on the most current information.

With two vaccines for COVID-19 now receiving an emergency use authorization by the U. S. Food and Drug Administration, the logistics of getting a shot in every arm is a huge logistic challenge. Tiberius is a software platform specifically developed for Operation Warp Speed (OWS) to plan and monitor the distribution of a COVID-19 vaccine. It provides the visibility necessary for a smooth transition from manufacturing the vaccine to allocating the vaccine down to provider level. Information from the U.S. Census, the Vaccine Tracking System and commercial logistics companies such a FedEx and United Parcel Service (UPS) was incorporated into the platform.

Challenging Logistics

The logistics include not only the manufacturing, supply chain, allocation, and delivery of the vaccine but also the kits to administer the vaccine which include needles, syringes and supplies.

There are 64 jurisdictions which include U.S. states, territories and large metropolitan cities will use Tiberius to determine where their allocated doses will go based on guidance from the FDA, CDC and the Advisory Committee on Immunization Practices on how to prioritize the administration of vaccines.  An algorithm was devised based on the census-derived percentage of the U.S. population over the age of 18. Initially the vaccine will be limited as the first doses arrive around the country, but Operation Warp Speed will continue to run the algorithm each week as the supply increases and determine how much vaccine will go to each jurisdiction.

“The federal government is running the algorithm, but the states will make the decision as to where the doses go, and we will comply with their decision and get those doses to the final destination,” said Paul Mango, the deputy chief of staff for policy at HHS.

Once the vaccine ships, Tiberius will also be used to provide information updates for jurisdictional partners, said Deacon Maddox, Operation Warp Speed chief of plans, operations, and analytics. “Like most of America, public health professionals are working through the challenges brought on by quarantines, telework and social distancing,” Maddox said. “While the pandemic stresses both people and systems, our expertise and technology tools provide a disciplined and deliberate approach to prioritize vaccine delivery and ease the burden of public health officials throughout the nation.”

The federal government provided training materials when Tiberius was launched Labor Day weekend and HHS funds a help desk and technology personnel for each jurisdiction.

Vaccine Distribution

Army Gen. Gus F. Perna, chief operating officer of OWS recently briefed the media on the COVID-19 vaccine distribution. As soon as the Pfizer-BioNTech vaccine received emergency use authorization from the FDA employees from Pfizer, UPS and FedEx began the work to pack the vaccine and get it shipped out. “The strategy is to get the initial Pfizer vaccine out to Americans right away,” he said. “As it becomes available, the vaccine is allocated in a fair and equitable manner to the states and territories, which stipulate the location and quantity needed,” he explained. The Moderna vaccine began shipment once it received emergency use authorization.

“The Centers for Disease Control and Prevention in collaboration with CVS Pharmacy, Walgreens Company, other pharmacies and the states created a very elaborate campaign strategy to get the vaccine to long-term health care facilities and first-line medical personnel who will be the initial priority group,” Perna said. “Our goal is every vaccine that goes out is safe and effective upon delivery. And, we wanted to make sure that deliveries occurred in the places where people could receive them and then begin administering the vaccine to the American people. And, it went incredibly well.” 

The federal government has purchased enough vaccines to meet the goal of vaccinating every American who wants it by the second quarter of 2021.

USAMMA Spearheads Military Distribution

The US Army Medical Materiel Agency (USAMMA) is spearheading the distribution for all branches of the services and is working with the Defense Health Agency’s Immunization Health Care Division. They are collecting the COVID-19 vaccine orders and submitting to the CDC. They will track the vaccine shipments from the vendors to each military location.

 USAMMA Distribution Operations Center Deputy Director Liz Andrews said, “the vaccine will ship directly from the vendor to several military medical treatment facilities throughout the U.S. where it will be used to immunize troops, as well as military beneficiaries and bolster their immunity against the pandemic.”

According to Andrews, one of the logistical challenges is the Pfizer vaccine must be kept at ultr-cold temperatures. She and her team can track not only the location of the vaccine but also its temperature throughout the distribution process. “This is a challenging mission but also very exciting. We are prepared to execute this mission and proud to be a part of Operation Warp Speed,” she said.

USAMMA was chosen for the mission because of their expertise in the distribution of military vaccines such as anthrax and small pox.

“The military hospitals are already used to working with us, so this made the process smoother for them as they were familiar with our systems and forms,” Andrews said. “The USAMMA Distribution Operations Center web development team also played a crucial role by swiftly adapting USAMMA’s existing vaccine ordering system, so it could be used for COVID-19 vaccine order processing. This was a total team effort, and we are just honored to be a part of this whole campaign.”

The Department of Defense will continue to play an important role in Operation Warp Speed until this pandemic is contained.