COVID-19 Vaccine Booster

December 21, 2021

OHCA strongly advises all long-term care settings to work with staff and residents to get booster shots as soon as possible, ideally before any holiday gatherings, and no later than the end of the year. We also encourage you to assist resident families and loved ones in making booster shot appointments if appropriate and if time allows lessening the likelihood that your visitors bring COVID-19 into your buildings.

Infection disease experts in Oregon and nationally are projecting that daily COVID-19 cases will skyrocket over the next few weeks due to the extremely contagious nature of the Omicron COVID-19 variant.

Getting your first or next booster clinic scheduled is a priority action item due to the emergence of the Omicron variant. The first step to operationalize vaccine boosters in your facility is to contact your long term care pharmacy partner to understand their distribution strategy for vaccine boosters and what resources they have available to support booster administration in your facility. Please review our booster clinic operations tips.

How to Coordinate or Get Support for a Booster Clinic in Your Facility

The Oregon Health Authority (OHA) is available to provide technical assistance and/or support for an onsite clinic, especially when you have residents that would be considered “home-bound” and getting to a retail clinic or another vaccine location is not safe or feasible. Complete the OHA form to request a booster clinic in your facility: Technical Assistance Request Form – COVID-19 Primary and Booster Vaccination Needs Assessment.

How to Get a Booster at a Community Pharmacy

Use this map to find COVID-19 vaccination sites, including initial doses as well as booster shots. Organizations providing vaccines include but are not limited to local pharmacies, Walgreens, Bi-Mart, Rite Aid, Fred Meyer, Safeway, Costco, Walmart, Albertsons, CVS and much more.

How to Get a Booster at a Vaccine Site

Oregon has opened several “high-volume” vaccination sites, which offer all three COVID-19 vaccines and are open to everyone eligible for vaccination or a booster. There is no cost and registration is not required.

View current sites and details here.

General Information

Updated Health Rule

August 19, 2021

Governor Kate Brown announced on August 19, 2021 updated health safety measures for health care workers in Oregon, including those who work in nursing facilities, assisted living facilities, and residential care facilities as well as other health care settings like hospitals. As a part of this update, the Oregon’s vaccination requirement for health care workers will no longer have a testing alternative. Health care workers will be required to be fully vaccinated by October 18 or six weeks after full FDA approval, whichever is later. Read the Member Alert here.

In-Home Care

In-home care agencies are not included in the Oregon vaccine mandate issued by the Governor. OHCA worked with the state to get clarity on how this emergency rule applied to in-home care agencies as these agencies typically provide care in a client’s home. In-home care agencies should note, however, that caregivers going into a nursing facility, assisted living facility, adult foster home, or other health care setting as defined in the rule to care for a client in that location will need to adhere to the rule. This means these caregivers must be vaccinated or undergo weekly testing. The agency will be responsible for seeking proof of vaccination and providing access to testing as necessary. The new rule goes into effect September 30, 2021 and is repealed January 31, 2022.

View Oregon’s new safety rule here.

Vaccine Efficacy and Safety

The Food and Drug Administration (FDA) released a detailed analysis December 8 of the COVID-10 vaccine from Pfizer and its partner BioNTech. The agency’s analysis finds “no specific safety concerns identified that would preclude issuance of an EUA.” Serious reactions were rare. Side effects are common, however, with a majority of study volunteers experiencing reactions at the site of injection, headaches and fatigue.

The analysis also affirms the previously stated vaccine effectiveness of 95 percent, assessed a week after two doses of vaccine. The vaccine doses are given 21 days apart.

The clinical data also suggest that the vaccine may be able to prevent COVID-19 after the first dose — 82 percent effective — though the FDA analysis says the available information doesn’t allow for a firm conclusion on that potential effect.

The analysis also shows the vaccine is effective including in elderly over the age of 65 and age over 75 and in minority populations. Just over 4 percent of the participants were over age of 75. Vaccine efficacy was equivalent in those under 55 and those over 55. This appears to be very safe vaccine with predictable reactions to a vaccine stimulating the immune response to make antibodies. The pattern was nearly identical in elderly over the age 55 but the actual rates were slightly different. There were six deaths in the trial: two with the vaccine and four with the placebo.

Find a Vaccine Clinic

There are many options to receive a free COVID-19 vaccine throughout the state. See below for full details, including options for getting vaccinated at a retail pharmacy.

Find and COVID-19 Vaccine in Oregon View Vaccine Information by County

Vaccination Reporting

ODHS released OAR 411-061 – COVID-19 Vaccination Reporting Requirement on June 1, 2021 The rule requires long term facilities to report the summary counts of total staff and residents, and vaccination status of staff and residents, including anyone with medical contraindications to the Oregon health Authority (OHA) on a weekly basis.

According to OHA, the timeframe between June 21 to July 5 shows 100 percent of nursing facilities and 85 percent of community-based care settings were registered for vaccine reporting. Nursing facilities had an average reporting rate of 95 percent and CBCs 65 percent.

Please note, OHA will be publicly releasing this data in August (view their preliminary aggregated report that was shared last month here) and is in the process of developing a long term care staff and resident vaccine dashboard.

If you have not yet registered for the portal or submitted your data, it is critical that you do so as soon as possible.

Weekly reporting became mandatory for long term care facilities, effective June 1, 2021, per the Oregon Administrative Rule (OAR) 411-061. For nursing facilities, reporting weekly COVID-19 vaccination data to NHSN will meet the OHA reporting requirement, but assisted living and residential care facilities will need to register and report the vaccination data via the OHA COVID-19 Vaccination Reporting Survey for Long-Term Care Facilities portal.

Tracking tools to assist with data gathering, FAQ documents and reference materials have been shared in the Oregon Department of Human Services (ODHS) Provider Alerts and vaccine reporting resources listed below can be found on the OHA website click here.

If you have any questions about the vaccination reporting please reach out to Lisa Iguchi at If you believe your facility is registered and has reported all vaccination data, please reach out to Lisa to confirm.

Pfizer COVID-19 Vaccine Booster

COVID-19 Booster Dose Preparation Checklist

The initial step to operationalize vaccine boosters in a community-based care setting is to contact your long term care pharmacy partner to learn their distribution strategy for the Pfizer vaccine boosters. It is important to note, the booster program is NOT being coordinated by the federal government like the initial vaccine rollout with vaccine clinics. The booster programming will be a coordinated effort involving each community and their pharmacy or another source (i.e., retail pharmacies or local public health) as part of each community’s ongoing vaccination plan.

Here is a preparation checklist. OHCA extends our gratitude to the Consonus Pharmacy team for sharing their best practices and ongoing consultation with OHCA. We have modified the checklist to be generic for most facilities. Again, the primary step is to connect with your long term care pharmacy partner.

Booster Dose Preparation Checklist

Step 1 – Review Your Vaccine Maintenance or Continuity Plan with your pharmacy or vaccine source.  Each plan should include policies and procedures on how new residents and new staff, or existing resident and staff can obtain first, second, or booster dose vaccines.

Step 2 – Focus on vaccinating staff and residents now. Continue to educate on vaccine safety and efficacy, particularly with staff as the October 18 vaccine mandate for health care workers approaches. See OHCA website for vaccine promotion information and materials.

Step 3 – Identify those who are immunocompromised. For residents, reach out to their physician to assess if they meet the criteria for a third dose. Talk with staff and encourage them to check with their health care practitioner.

Step 4 – Gather last dose dates for staff and residents.

  • Identify your sources to gather data of the last dose dates for residents and staff (Vaccine Administration Software, eMAR, Face Sheets, etc.)
  • Obtain access to your state IIS if not already done. See previous FAQ.
  • Create a list and prioritize residents/staff with the date they received their dose(s) of vaccine earliest in pandemic first (over eight months)
  • Document the brand of vaccine (Pfizer/Moderna/Johnson & Johnson) received. Focus on Pfizer. For the immediate future, focus on individuals who received the Pfizer vaccine. Note, if any vaccine contraindications or history of severe adverse reaction/ anaphylaxis that would exclude them from a booster dose
  • May consider further prioritization for booster doses in your facility if staggering is needed due to vaccinator resources

Step 5 – Start the consent process for booster doses/third doses if you are conducting onsite clinics.

  • Assess your organizational policies for vaccination of residents/clients and know the requirement for consent. Coordinate with your pharmacy partner.
  • Consider combining the consent process for influenza and COVID-19 for efficiency. Discuss planning considerations for both boosters and flu vaccines. See CDC Guidance.

Step 6 — Identify your facility vaccinators. If you are contracting with vaccinators, start securing resources. Again, work with your pharmacy to understand what approach/options they have to support boosters for example onsite clinics, partnerships, or retail partner strategies.

  • Some local public health agencies will potentially have resources for booster vaccines. Specifics will be made available at a future date.
  • Refresh education/competencies for in-house or other nurse vaccinators.

Step 7 – If you are doing on-site vaccination, be sure to have a Vaccine Administration Reaction Box (VARB). It is required to have Epi-Pen and diphenhydramine on-site when giving COVID-19 vaccinations. If you do not have a kit, check with your pharmacy. If you already have your VARB, check expiration dates and reorder the product as necessary.

Vaccine Distribution Timeline

View the Oregon Vaccine Sequencing Plan.

  • December 4, 2020 – Governor Kate Brown and Oregon Health Authority (OHA) officials announced details of the state’s COVID-19 vaccine distribution plan. Vaccines were shipped to Oregon and long term care residents and staff are among the first group of recipients. Review information from the Governor’s press release here and watch press conference here.
  • December 11, 2020 – FDA approves Pfizer vaccine
  • December 12, 2020 – Phase 1A Groups 1, 2, 3, 4 (Staff and residents of skilled nursing, memory care, residential care, and assisted living facilities, and home care workers) are eligible for Vaccine
  • December 18, 2020 – FDA approves Moderna vaccine
  • December 21, 2020 – Long term care providers received first doses of Pfizer Vaccine
  • December 22, 2020 – OHA shared details about the long term care COVID-19 vaccine rollout plan.
  • January 18, 2021 – 100% of nursing facilities complete first vaccine clinic
  • January 25, 2021 – Phase 1B begins, starting with Group 1 (Childcare providers, early learning, and K-12 educators and staff)
  • February 8, 2021 – Phase 1B Group 2: People 80 and older are eligible
  • February 10, 2021 – 100% of assisted living facilities and residential care facilities are assigned a pharmacy through the federal program or connected to a vaccination clinic resource
  • February 15, 2021 – Phase 1B Group 3: People 75 and older are eligible
  • February 22, 2021 – Phase 1B Group 4: People 70 and older are eligible
  • February 27, 2021  – FDA issues emergency use authorization for Johnson & Johnson vaccine
  • March 1, 2021 – Phase 1B Group 5: People 65 and older are eligible
  • March 29, 2021 – Phase 1B Group 6: Adults 45-65 with underlying health conditions, people living in low-income senior housing, senior congregate and independent living
  • April 17, 2021 – FDA pauses distribution of Johnson & Johnson vaccine
  • April 19, 2021 – All Oregonians older 16+ are eligible
  • April 27, 2021 – FDA lifts pause on Johnson & Johnson vaccine
  • May 10, 2021 – FDA authorizes Pfizer vaccine for 12-15 year olds
  • August 4, 2021 – Governor Kate Brown issues new COVID-19 safety rule that requires all health care workers (including nursing facilities, assisted living facilities, residential care facilities, and adult foster homes) to be vaccinated by September 30 or undergo weekly COVID-19 testing.
  • August 19, 2021 – Governor Brown announced that COVID-19 vaccines will be required of all healthcare workers in Oregon (including nursing, assisted living, and residential care facilities) by October 18 or six weeks after full FDA approval, whichever is later.

Any facility that did not enroll in the pharmacy program to select the location to receive the vaccine (CVS, Walgreens, or your own pharmacy), must contact OHA to be added to the distribution list. Contact (or visit here) for more information.


Interim Final Rule on COVID-19 Vaccine Requirements for LTCF and ICFs-IID

On May 11, 2021, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule on COVID-19 Vaccine Requirements. This rule applies to residents, clients, and staff of long term care facilities.

CMS also published a QSO memo to state survey agencies on how to operationalize this new requirement.

The rule went into effect on May 21, 2021, ten days from its publication for inspection in the federal register.

This rule specifies that long term care facilities must develop and implement policies and procedures to:

  • Educate all residents and staff about COVID-19 vaccines;
  • Offer vaccination to all residents and staff; and
  • Report to the CDC via NHSN certain data regarding vaccination status for residents and staff as well as any therapeutic treatments (e.g., monoclonal antibody) use. Note that this requires additional reporting via NHSN modules: reporting the Resident Therapeutics Pathway found on COVID-19 LTCF Module, as well as reporting via the Weekly HCP and Resident COVID-19 Vaccination Module. 

For more information, please contact

Vaccine Communication Toolkit

Physician orders for the vaccine are NOT required. Neither Walgreens nor CVS will require a physician order. The U.S. Department of Health and Human Services (HHS) secretary used his authority under the Prep Act to override all state and local laws to allow pharmacists to order and administer the vaccine.

Currently, the Centers for Medicare and Medicaid Services (CMS) has not issued any restrictions to encourage staff to receive that vaccine, including financial and other incentives.

Post-Vaccine Considerations

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