Independent providers will benefit from vaccine distribution plan
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Dialysis providers from across the United States were happy to hear last month that the Biden administration approved federal distribution of the COVID-19 vaccine to dialysis clinics so they can begin vaccinating patients and staff.
It was a long and difficult path that kidney community leaders began in December 2020, but the CDC and officials in Washington, D.C. came to the realization that dialysis units can do this efficiently and safely.
A preliminary Medicare COVID-19 Data Snapshot (Medicare claims and encounter data for services provided Jan. 1, 2020 to Sept. 12, 2020) revealed that Medicare beneficiaries with end-stage kidney disease are four times more likely to contract the COVID-19 virus compared with patients aged 65 years or older and people with disabilities.
In that same report, it was also found that ESKD beneficiaries who have contracted the virus are seven times more likely to be hospitalized when compared with older patients or patients with disabilities. Data reported by the U.S. Renal Data System also strongly suggested a marked increase in mortality in this population as well.
Upon receipt of this information, the renal community recognized it was imperative to find a path for vaccination of this patient population.
CDC, providers meet
The leaders of many dialysis organizations from across the country came together to discuss potential vaccination pathways with the CDC. It was clear to all those at the table that time was of the essence. In the end, the final approved pathway for vaccination distribution would come through a network administrator model.
The CDC authorized Fresenius Medical Care North America and DaVita Inc. to maintain a direct contract with the CDC. These two organizations will serve as the network administrators for all other dialysis units (recipient organizations) in the country.
This will require a contractual arrangement between the recipient organizations and DaVita or FMCNA. The agreements include, but are not limited to, the following requirements:
- quarterly attestation to the network administrator that the recipient organization is compliant with the contractual requirements;
- confirmation that the recipient organization has the capacity for vaccine administration and hours for accepting the vaccine;
- the recipient organization will place orders through the network administrator who will place the vaccine order using the CDC vaccine order process and tracking system (VtrckS). This is the same system that other health care providers around the country are using to order and track vaccines;
- the recipient organization will maintain responsibility for receiving, managing and administering the vaccines in a manner to eliminate the possibility of wastage;
- the recipient organization will provide the network administrator with all information required for CDC reporting of vaccinations;
- the network administrator will provide the training for recipient organizations; and
- the network administrator will strive to assure equitable access for all recipient organizations.
Dialysis providers have a long history of vaccinating patients in the unit. COVID-19 vaccines do require some unique considerations. As Priti R. Patel, MD, MPH, who leads the CDC's prevention, surveillance and response activities related to dialysis patient safety, said in a recent webinar: “We are being given the public trust to distribute this vaccine in a manner to prevent any wastage.”
Vaccine use
Each vaccine has its own requirements for how it must be stored, the number of doses per vial, the amount of time the doses must be administered after the vial has been opened and the manner in which a dose must be drawn up.
As well, the reporting requirements are also an important part of the management process. This will include the date and time of each vaccine administration, monitoring and reporting of any adverse reactions and any waste of vaccine.
Across the United States, some dialysis facilities have worked to get their patients vaccinated through local and state health departments. Hospital-based programs have also worked with their medical centers to get dialysis patients vaccinated. This network administrator model is completely voluntary but can provide dialysis providers with a pathway to get our vulnerable patients with ESKD vaccinated.
For more information on registering with the network administrator model, visit:
www.renalhealthcarevoices.org/new-covid19/vaccine .
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