December 14, 2020 

 

Partner in Health: 

 

The Maricopa County Department of Public Health (MCDPH) is in the final planning stages for providing COVID-19 vaccine to people who are at highest risk of contracting COVID-19 based on their occupational and individual risk factors. This includes many of you, who provide direct care and services to people who are or could be COVID-positive. 

  

Because supply will be limited at the outset and to ensure equitable distribution of those limited doses,(MCDPH) is following the guidance of the CDC’s Advisory Council on Immunization Practices (ACIP) and the Arizona Department of Health Services Vaccine and Antiviral Prioritization Advisory Committee (ADHS VAPAC).  

 

The first allocation of vaccine doses will be prioritized to individuals that ACIP has recommended to be in Phase 1A: those working in a healthcare setting, especially those with the most potential exposure to COVID-19, as well as residents and staff of long-term care facilities.  

 

To determine your eligibility, please complete this pre-screen survey as the first step to scheduling an appointment. Your response will help MCDPH determine your eligibility and connect you with your assigned regional vaccine provider, based on the location of your primary worksite.   

 

Things to know about the pre-screening:  

 

• COVID-19 vaccine will be available to Phase 1A individuals by appointment only, and completing this pre-screening survey is required to make your appointment. 
• Long term care residents/staff are mostly being vaccinated through a federal pharmacy vaccine program. 
• You will be asked to provide your employee ID or other ID (such as a driver's license number) as part of the screening process. This will be used for identification purposes only. 
• COVID-19 vaccines are free, however, insurance information will be requested during appointment scheduling so that an administration fee can be billed to insurance if you are insured. There will be no out-of-pocket costs requested during your appointment time and you should not receive a bill. 

• Priority will be given to those who meet exposure and risk thresholds. You will be notified when vaccine is available to you. The process may take several days, so please be patient while you await your notification.  
• Any healthcare provider who provides direct patient care of any type (including environmental services and laboratory workers) will be included in Phase 1A. If you are determined to be eligible for vaccine in Phase 1A, you will receive a notification with details on where and how to set up an appointment. 
• Healthcare providers who do not provide in-person, direct patient care (administrators and telemedicine providers) will be included as essential workers early in Phase 1B but are not eligible for vaccine in 1A since they are not at increased risk of exposure in their work. 
• The information collected in this screening tool will only be accessed by MCDPH and will not be shared outside of public health.   
• Vaccination sites for healthcare workers will not be open for an extended period of time, so we encourage you to sign up today or you may have to wait until later phases.  

  

If you have any questions regarding COVID-19 vaccine pre-screening or need help filling out this form, please email COVID19prescreen@maricopa.gov 

 

Still deciding if you want to get the vaccine? Take a look at Maricopa.gov/COVID19vaccine1A and please complete the prescreening survey. The survey does not commit you to getting the vaccine, and after you complete it, you will receive more information about how and when you can get the vaccine. 

 

On behalf of Marcy Flanagan, Executive Director of MCDPH and myself, we thank you for your support of Public Health.