State COVID-19 Vaccine Distribution Plans
Last updated March 24, 2021.
Child Care Aware® of America is reviewing each state’s plan to understand where child care providers fall in line. We also advocate that providers are treated equitably as a first step in ensuring access. This page is updated as plans evolve.
In December 2020, the Centers for Disease Control and Prevention (CDC) approved two COVID-19 vaccines for adults. States are now planning how to give out the vaccine based on recommendations from the CDC while there are still limited doses available. The CDC recommends that health care workers and long-term facility staff and residents receive the vaccine first in Phase 1a. After that, they recommend that people ages 75 and older and frontline essential workers, including child care providers, receive the vaccine under Phase 1b. In Phase 1c, the CDC recommends that people between ages 65-74, people aged 16-64 with high-risk medical conditions and other essential workers not included in Phase 1b receive the vaccine.
On March 2, President Biden directed states to prioritize child care and K-12 staff for vaccination. He is challenging states to provide at least the first vaccine dose to both sectors by the end of March. Pharmacy locations that are part of the Federal Retail Pharmacy Program are now giving priority to child care workers throughout March.
The CDC has released information for child care staff on who can access the vaccine under the new directive and how they can schedule an appointment. You can also visit vaccinefinder.org to find out where the vaccine is available in your community.
The CDC also released a helpful COVID-19 Vaccine Toolkit for School Settings and Child Care Programs that provides information, materials and ideas to get the word out about the vaccine availability to child care staff.
The Role of States in Vaccine Distribution
States and local governments also play an integral role in the distribution of the vaccine. States submitted their interim plans to the CDC in mid-October 2020. Their plans were based on the CDC’s Interim Playbook. The Playbook emphasizes close collaboration between public health, external agencies and community partners. Jurisdictions had to plan for three phases:
1. Limited supplies of vaccine doses available;
2. Large numbers of vaccine doses available; and
3. Enough vaccine doses for entire populations.
States continue to update their plans as more federal guidance and information about the vaccine is released. All state’s plans must include 15 critical areas (such as administering capacity, tracking, managing inventories, distribution priorities, etc.). But, they have flexibility with the components of their plan and are not required to follow federal recommendations. The National Academy for State Health Policy found a couple of key differences when comparing initial state plans:
• The number of phases states have often vary, which makes it difficult to compare phases among states. States use between two to five phases, with some using subcategories within a phase (i.e., 1-A, 1-B)
• Some states detail which populations are covered in different phases. However, others only list who’s included in the first phase or two, and are waiting on more federal guidance before making further decisions.
State Vaccination Plans & Child Care
Prior to the new guidance from President Biden, states frequently updated their plans based on supply and made many changes since their interim plans were submitted in October 2020. Most states initially issued plans with phases that based vaccine eligibility on risk of exposure associated with occupation and existing medical conditions. Child care providers were generally prioritized for the COVID-19 vaccine after health care workers and long-term care facility staff and residents.
To date, child care providers had been prioritized as follows:
- 39 states grouped child care providers and K-12 educators together in the same phase. Successful advocacy efforts in Kentucky resulted in child care providers being moved into the same phase as K-12 educators in February.
- Connecticut and Arizona are unique in that they initially moved toward age-based eligibility beginning in March, but had still prioritized child care and K-12 staff in vaccination efforts.
- In addition to Washington D.C., five states – Florida, Oklahoma, Ohio, Utah, West Virginia and Wyoming prioritized some or all K-12 employees over child care. Florida and West Virginia announced they were vaccinating K-12 educators over the age of 50.
- Two other states, Indiana and Texas, have not made it clear when child care providers (and K-12 educators) will be eligible to access the vaccine. Indiana will likely take an age-based approach moving forward.
- Maine, Rhode Island and Vermont are now vaccinating their populations based on age, despite previously having a phased-approach where child care and K-12 educators were grouped together.
Child Care Resource & Referral (CCR&R) agencies work with states to let providers know when and where vaccines are available to them. For example, in North Carolina, the Division of Child Development and Early Education partnered with CCR&Rs, Smart Start and child care health consultants to get the word out to child care providers about the vaccine. California CCR&R Network held a webinar sharing examples of county-level partnerships that facilitate plans to vaccinate child care providers. To increase access, California set aside 10% of its incoming vaccines for child care workers and K-12 staff.
Who does the term “child care worker” apply to within the plans? It’s often not clear if the definition includes all delivery settings, CCR&Rs or others in the child care system (like licensing staff). Our coalition partners at Homegrown and the National Association for Family Child Care (NAFCC) have asked for more clarity around family child care and family, friend and neighbor care.