Vaccine Administration for COVID-19
Field Operations Guide (FOG)

Staffing Vaccine Administration Sites

The number and type of staffing required to operate the vaccine administration site will depend on the following variables:

Availability of personnel

Availability of vaccine

Estimated demand for the vaccine

Hours of operations

Vaccine Administration Staff Licenses
Vaccine administration requires licensure. In the State of California, there are ten (10) licensed professions that are clearly allowed to administer vaccinations as stated in their scope of practice. The District has personnel in four (4) of these professions as part of our employee workforce.

Table 1. Professions Currently Allowed to Administer Vaccinations

Profession		Scope of Practice/Authority
Registered Nurse/Nurse Practitioner		California Business and Professions Code Section 2725(b)(2) - Nursing Direct and indirect patient care services, including, but not limited to, the administration of medications and therapeutic agents, necessary to implement a treatment, disease prevention, or rehabilitative regimen ordered by and within the scope of licensure of a physician, dentist, podiatrist, or clinical psychologist, as defined by Section 1316.5 of the Health and Safety Code. California Business and Professions Code Section 2725(b)(3) - Nursing The performance of skin tests, immunization techniques, and the withdrawal of human blood from veins and arteries.
Licensed Vocational Nurse		California Business and Professions Code Section 2860.5(a) A licensed vocational nurse when directed by a physician and surgeon may do all of the following: (a) Administer medications by hypodermic injection.
Physician Assistant		Medical Board of California – Physician Assistants A Physician Assistant performs many of the same diagnostic, preventative, and health maintenance services as a physician. These services include, but are not limited to, the following: administering immunizations and injections. California Business and Professions Code Section 3502(a)(1) - Physician Assistants The PA renders the services under the supervision of a licensed physician and surgeon who is not subject to a disciplinary condition imposed by the Medical Board of California or by the Osteopathic Medical Board of California prohibiting that supervision or prohibiting the employment of a physician assistant.
Physician (MD/DO)		California Business and Professions Code Section 2051 - Medicine The physician’s and surgeon’s certificate authorizes the holder to use drugs or devices in or upon human beings and to sever or penetrate the tissues of human beings and to use any and all other methods in the treatment of diseases, injuries, deformities, and other physical and mental conditions. California Business and Professions Code Section 2453(a) - Medicine It is the policy of this state that holders of M.D. degrees and D.O. degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons.

Table. 2. Optional Scope of Practice or Scope of Practice closely related to vaccination techniques

Profession

Scope of Practice/Authority

Medical Assistant

California Business and Professions Code Section 2069(a)(1)

Notwithstanding any other law, a medical assistant may administer medication only by intradermal, subcutaneous, or intramuscular injections and perform skin tests and additional technical supportive services upon the specific authorization and supervision of a licensed physician and surgeon or a licensed podiatrist. A medical assistant may also perform all these tasks and services upon the specific authorization of a physician assistant, a nurse practitioner, or a certified nurse-midwife.

Staffing Model

The staffing model below is adapted from LA County Department of Public Health models. Staffing can be adjusted to meet the needs of each site, and may change over time. The model presumes that a school-based vaccination site has three vaccination stations, each staffed with a Vaccinator and a Vaccine Registrar, who work together and provide a 1:1 ratio of staff to screen/document and vaccinate. A three-station site has two Vaccine Preppers to prepare vaccine for dispensing, and one Runner to deliver prepared syringes to the vaccinators. Staffing is scaled based on the number of vaccine stations.

A fully staffed vaccination site includes the following full-time positions:

Health Care Roles:

1 Medical Site Leader

2 Vaccine Preppers (one as lead)

1 Vaccinator per vaccine station (3-station standard set up; one as lead)

1 Reaction Observer

A Vaccine Coordinator and Back-up Vaccine Coordinator must be designated from among qualified staff performing in other roles on site.

Non-Health Care (Logistician) Roles:
Logisticians are non-medical staff who support in the following roles:

1 Site Support Leader (Site Leader from onsite COVID testing, if applicable)

1 Greeter

1 Gatekeeper

1 Vaccine Registrar per vaccination station

1 Vaccine Prep Runner

1 Observation Supporter

Staffing Reminder Highlights:

Upon arrival at the vaccination site, staff are to check-in daily with the vaccination site supervisor/lead. Employees are responsible for daily time entry using the COVID 19 Vaccination Site Daily Sign in Sheet and submitting the completed forms to their regular time reporters.

Vaccination site lead will ask current health screening questions found at http://www.lausd.org/covid19

If an employee answers "yes" to any screening question, they should be directed to return home and follow appropriate isolation/quarantine/illness procedures.

Vaccination site lead will conduct the LA UNIFIED Daily COVID-19 Staff Briefing Checklist with staff for the first 20 minutes of each day.

Employees should not have any direct contact with another person at any time.

All personal valuables should be left at home. Items such as keys and wallets should be secured in pockets to maximize security.

Employees must be aware of surroundings at all times. If something looks or seems suspicious, reports findings to the Site Lead immediately, or call 9-1-1.

If students are present, staff must follow the District’s Code of Conduct with Students.

Staff are to bring their own water, food and personal necessities. Communal amenities such as a refrigerator are not provided or to be used to reduce the chance of spread of infection. School site water fountains have been turned off to prevent communal use.

Site staff are expected to comply with all Los Angeles County Public Health directives and other applicable health and safety guidelines.