COVID-19: Program Information for Vaccinators

Webinars for Vaccinators

Join our weekly webinars every Tuesday from 9:00-9:30 a.m.! Please email your questions ahead of time and we will do our best to answer them during the webinar.
View recorded webinars: 11/11/20 or 11/17/20.

The information on this webpage is intended for COVID-19 vaccinators.

Multiple COVID-19 vaccines are currently in trial phases II or III at the Food and Drug Administration (FDA). For more information about which products are in trial, please visit the COVID-19 Vaccine Tracker. The Wisconsin COVID-19 Vaccine program recently submitted a draft vaccination delivery plan and executive summary to the Centers for Disease Control and Prevention (CDC). This plan will be updated as it evolves.

Wisconsin will receive vaccine after it has been approved by the FDA.

 

COVID-19 Vaccinator Enrollment Process

Background

The Wisconsin COVID-19 Vaccine program is now enrolling entities that wish to vaccinate. By enrolling in the program, entities and their vaccinators will be approved to administer COVID-19 vaccine in Wisconsin, once a safe and effective vaccine is made available.

Steps to enroll

Please follow the steps below to enroll in the program. Please use Google Chrome when navigating the enrollment tool. Email us if you have any questions!

Step 1: Log in to the COVID-19 Vaccine Enrollment Tool using your Department of Administration (DOA)/Wisconsin Logon Management System username and password.

  • If you do not have a DOA/Wisconsin Logon, please register here.
    • Select Self-Registration. After you accept the user agreement and fill in your personal profile information, select “DHS Health Reports” under “Systems You Will Access.”
    • After your registration is complete, proceed to the enrollment tool.
  • If you do have a DOA/Wisconsin Logon, then proceed to the enrollment tool and logon using your DOA/Wisconsin Logon username and password.

Step 2: Generate your forms.

Note: Once demographic information is entered and site type is chosen, you may NOT go back to change them.

  • Enter demographic information into the COVID-19 Vaccine Enrollment Tool.
  • Scroll down to the bottom of the page and select the “Generate Forms” button, which will generate forms specifically for your organization.
    • Your organization name and a tracking number will be prepopulated on the forms.
    • You can have your vaccine sites use this information to ensure they are using your organization-specific forms.

Step 3: Complete and sign your forms.

Note: Additional instructions are provided as hover text over the blue bars within each of the forms. All signatures must be present on a form before submission.

  • Complete your section A form.
  • Complete a section B form for each physical address where you will administer COVID-19 vaccine.
    • Example 1. A single physical location long-term care facility would need to fill out one section A form and one section B form.
    • Example 2. A large health system with two retail pharmacies and a long-term care facility would need to fill out one section A form and three section B forms because they are planning to administer COVID-19 vaccine at each site.
    • Example 3. A large health system has three large hospitals containing several clinics and a pharmacy within each physical location would only need to fill out one section A form and three section B forms because they are planning to administer COVID-19 vaccine at each site.

Step 4: Submit all your forms.

Note: You may submit forms A and B for the same organization from any DOA/Wisconsin Logon Management System login. Only submit the completed forms that were specifically generated for your organization with the tracking ID in step 2 above.

  • Navigate to the page “Submit Forms” at the top left of your web browser.
  • With all of your forms completed and signed, upload them into their respective places.
  • Scroll down to the bottom of the page and select the “Upload Files” button.

Step 5: If necessary, please respond to and correct information if DHS staff reach out. If corrections are needed, we will reach out to the primary contact listed on the section B form.

Step 6: DHS staff will work to verify your enrollment. Once your information is verified, the primary contact listed on the form will receive an email from DHS with next steps for your clinic.

COVID-19 Vaccinator Enrollment Process Q&A (Updated 11/17/2020)

The questions and answers address the following topics:

  • General enrollment
  • Filling out the forms
  • Correcting and submitting forms
  • Vaccine delivery and redistribution (Updated 11/16/20)
  • LTC Pharmacy Partnership program
General enrollment questions

Q: How do I enroll?
A: Please follow the steps outlined in the section above. Once you log into the enrollment tool, there is blue hover text in the instructions that provides additional details.

Q: Should I enroll in the COVID-19 Vaccine program if my organization is already a Vaccines for Children (VFC) and/or Vaccines for Adults (VFA) provider?
A: Yes you need to enroll. This is a new program and all providers need to sign the CDC COVID-19 Vaccine agreement regardless of VFC/VFA status.

Q: Do pharmacies that are partnering with LTC through the LTC Pharmacy Partnership need to enroll in the Wisconsin COVID-19 program, too (with the exception, at this time, of CVS and Walgreens sites)?
Yes. Please see below for additional details.

Q: Is there a certain web browser I must use for the enrollment tool?
A: Yes, please use Google Chrome. Do not use Internet Explorer or Microsoft Edge. If you do submit your forms in the wrong browser you may get an error. If this happens, please regenerate the forms and resubmit them in another browser.

Q: Where can I find additional instructions to complete the enrollment forms?
A: In the instructions in the enrollment tool you will see blue text. When you hover your mouse over the blue text, additional information will pop up.

Q: How do I know what the next steps are after I submit the enrollment forms? (Updated 11/17/2020)
A: If there are no follow-up questions from the DHS enrollment team, we will verify your forms. Once verified, our training team will email you with next steps in the process.

Q: Is there a deadline to enroll?
A: No. Enrollment is ongoing.

Q: How do I electronically sign my agreement?

  • Use Google Chrome to download the forms.
  • Save the forms to your to desktop.
  • Complete your forms in Adobe (not in a web browser such as Internet Explorer).
  • Follow the instructions found in the enrollment tool to upload your forms and complete your signature.
Questions about filling out the forms

Q: How many section A forms need to be submitted?

A: Only one section A form needs to be submitted for the entire organization.

Q: Which sites in my organization need to fill out the section B form?

A: Complete one section B form for each site that will be administering COVID-19 vaccine.

  • If vaccine is being taken to an off-site clinic two consecutive days or more, then a section B form is needed.
  • If vaccine is taken more than once to an off-site clinic, then a Section B form is needed.
  • If vaccine is taken to an off-site clinic only one day, then no section B form is needed.

Examples:

  • If an off-site clinic is planned Monday and Friday, then a section B form is needed for the off-site clinic.
  • If an off-site clinic is planned for Monday and Tuesday (two consecutive days), then a section B form is needed for the off-site clinic.
  • If an off-site mass vaccination clinic is planned by a site for just Monday, no section B form is needed for that off-site clinic.

Q: Is there a limit to how many section B forms can be filled out for every section A form?

A: No, there is no limit.

Q: What if a location has more than 25 providers to list on its Provider Agreement?

A: If a section B location has more than 25 providers to be listed, an additional section B form will need to be submitted.

Q: What if sites begin submitting section B forms before the organization’s section A form is submitted?

A: Section B forms will not be registered until the corresponding section A form is verified. Once both sections are submitted and verified, an organization and sites will be registered.

Q: Which providers should be included on my section B form?

A: Any provider, who can prescribe, that will be administering the COVID-19 vaccine.

Q: If additional sites are identified after my original submission, can I submit additional section B forms at a later date?

A: Yes, please make sure to match your organization name on the originally submitted forms.

Q: What if I don’t know my IIS identifier?

A: Please include either:

  • Your WIR ID.
  • If you do not know or have your WIR ID, enter your VFC PIN.
  • If you do not have a VFC PIN, please contact the dhscovidvaccinator@wi.gov
Questions about correcting and submitting forms

Q: I have signed the forms incorrectly and when I submitted it, I got an error. I fixed the signature (per the Signature Instructions), and the enrollment tool still will not accept my forms. What should be done?

A: Unfortunately you will need to generate a new version of the forms, refill it out, sign it correctly, and then resubmit it to the enrollment tool.

Q: What if I need to update information on the forms?

A: You will need to refill out the form and resubmit it. Your organization or site name will need to be identical to the previously submitted form.

Q: When will I know if my forms were submitted correctly?

A: After your forms have been submitted, you should receive a confirmation screen which will indicate that your forms have been submitted correctly.

Questions about vaccine delivery and redistribution – Updated 11/18/2020

Q: What are any restrictions that are in place for the delivery window to receive vaccine?

A: There are several. You will need to have your primary vaccine coordinator onsite to receive vaccine. You will also need to have a window that complies with the rules listed below:

  • There needs to be two (2) delivery windows, one morning and one afternoon (for selected days).
  • You must have a one-hour spacing, between the morning (first) and afternoon (second) delivery windows:
    • 7:00 a.m. – 12:00 p.m.
    • 1:00 – 4:00 p.m.
  • If you are selecting Monday as a delivery day, you must also have at least one delivery window of four or more consecutive hours on a weekday other than Monday.

Q: How will my organizations be able to redistribute the COVID-19 vaccine?

A: You will need to email dhscovidvaccinator@dhs.wisconsin.gov to have the redistribution form emailed to you along with instructions for completion. Reply back to the email to return it. This agreement is similar to the section A form you already completed. You will need to have your medical director (or equivalent) and chief executive officer (or chief fiduciary) complete and sign this agreement. Please be aware, your organization will only be able to redistribute COVID-19 vaccine to a provider location that has completed a section B form and successfully registered with the Wisconsin COVID-19 vaccination program.

Some of the COVID-19 vaccine products have stringent storage and handling requirements and, therefore, redistribution should be limited.

Q: Are there restrictions on when COVID-19 vaccine can be delivered to sites?

A: Yes, your sites must indicate they can receive vaccine delivery, at minimum:

  • One day per week other than a Monday.
  • A delivery window of four consecutive hours that does not encompass the noon hour.
Questions about the long-term care Pharmacy Partnership program

Q: Do pharmacies or long-term care through the Pharmacy Partnership for Long-Term Care Program need to know anything special about enrolling in the Wisconsin COVID-19 program?

A: Pharmacies: Local pharmacies that wish to provide COVID-19 vaccine and are not part of the CDC Pharmacy Partnership for Long-Term Care Program will need to enroll in Wisconsin COVID-19 Vaccine program.

CVS and Walgreens pharmacy sites: You do not need to enroll in the Wisconsin COVID-19 Vaccination program at this time because your national chains have a direct contract with CDC to provide vaccine(s) during the first phase through the Pharmacy Partnership for Long-Term Care Program. We will reach out to you in later phases when it is time to enroll in the Wisconsin COVID-19 Vaccination program.

Nursing homes and assisted living facilities: If you do not have a vaccinator for your residents identified yet, we recommend that you participate in the Vaccine Pharmacy Long-Term Care Partnership.

Through the program you can partner with a pharmacy to manage and administer COVID-19 vaccine to your residents. Your pharmacy partner (except Walgreens and CVS) will need to enroll in the Wisconsin COVID-19 Vaccine program.

Questions about billing information - new 11/10/2020

Q: What do we need to know about billing?

A: CDC will share more information about reimbursement claims for administration fees as it becomes available.

Vaccine Planning Guidance (Updated 11/6/2020)

DHS developed vaccine guidance based on CDC's COVID-19 vaccine planning assumptions. We will update the information as we learn more from our national planning partners.

Communication Resources

You play a critical role in helping build confidence in COVID-19 vaccination. An important part of preparing for a safe and effective COVID-19 vaccine is sharing information about the vaccine with the public. As one of the most trusted sources of information about vaccines, you can share the resources and information the CDC has developed around COVID-19 vaccine planning, recommendations, and safety monitoring. You can also share CDC's list of 10 things health care professionals need to know about COVID-19 vaccination plans with your coworkers and staff. We will disseminate additional materials and resources as they are developed.

The Children's Hospital of Philadelphia's Vaccine Education Center has in-depth resources for general audiences about COVID-19 vaccine and the approval process.

Last Revised: November 24, 2020