Form Approved OMB
Approval No. 0920-1352 Expiration
Date: 10/31/2024
Vaccination for Critical Workforce Groups and Disproportionately Impacted Populations (VAC)
VAC1 Critical workforce groups (CWG) and disproportionately impacted populations (DIP) prioritized for COVID-19 vaccine
VAC2.a-b PHEP Role determining prioritized populations for limited supply of COVID-19 vaccination
a. At the start of vaccine availability
b. During the refinement of priority vaccination groups
VAC2.c Vaccine administration capacity
VAC2.d Equitable access to vaccine services
VAC3.a-e PHEP role communicating targeted vaccination plans with
a. Incident management stakeholders
b. Vaccine administrators
c. CWG employers for directed outreach
d. DIP community partners for culturally sensitive message development
e. DIP community partners to amplify directed outreach
Public reporting burden of
this collection of information is estimated to average 189
minutes per
response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. An
agency may not conduct or sponsor, and a person is not required to
respond to a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to
CDC/ATSDR Information Collection Review Office, 1600 Clifton Road
NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1352).
VAC4.a-k. Vaccine management and administration activities)
a. Vaccine supply
b. Vaccine shipment
c. Vaccine transport
d. Vaccine storage and handling (including cold chain management)
e. DVC preparation and supplies
f. DVC locations
g. Vaccine preparation
h. Vaccine administration
i. Vaccine documentation
j. Vaccine adverse event tracking
Post DVC actions, documentation, or demobilization
b. PHEP capabilities supported COVID-19 vaccination efforts
c. Monitored Best Practices for Temporary, Off-Site, or Satellite Clinics
VAC5.a-d Vaccine Administrators
a. Recruitment
b. Credentialing
c. Training
d. Safety and Health Monitoring
VAC5.e Vaccination administrators were recruited from
VAC6.a-k COVID-19 Vaccination Activities (for each select either performed without challenges, performed with some challenges,
performed with major challenges, unable to perform, or not applicable)
a. Vaccine supply
b. Vaccine shipment
c. Vaccine transport
d. Vaccine storage and handling (including cold chain management)
e. DVC preparation and supplies (equipment)
f. DVC locations
g. Vaccine preparation
h. Vaccine administration staff (personnel resources)
i. Vaccine documentation (monitoring and tracking)
j. Vaccine adverse event tracking
k. Post DVC actions, documentation, or demobilization
VAC6.l COVID-19 Vaccination Campaign Strength
VAC6.m COVID-19 Vaccination Campaign Area for Improvement
VAC6.n COVID-19 Vaccination Campaign root cause analysis
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Garcia, Albert (CDC/DDPHSIS/CPR/OD) |
File Modified | 0000-00-00 |
File Created | 2022-03-03 |