As the COVID vaccine continues to become available to more and more individuals, employers are becoming a popular option for administration. On March 12, Indiana gave clearance to all employers with more than 1,000 employees to offer the vaccine, and other states are expected to follow suit.

As the trusted worksite health provider for hundreds of employers nationwide, Marathon Health has developed a 6-step playbook for how to stage a successful employee vaccination clinic, along with documenting our top 10 lessons learned after administering the vaccine to thousands of employees across the country.

Step 1: Register Your COVID Vaccine Event with Local and State Health Departments

Requirements vary by state, but at the minimum, all states are requiring the CDC Covid-19 Vaccination Program Provider agreement to start the process. Once that application is processed and approved, an agent from the state will reach out to the local health center to work with them on next steps.

Next steps generally include a licensed provider completing registration with their state immunization registry, completing training, and certifying the clinic has the appropriate equipment to administer the COVID-19 vaccine.

To get more information by state on how to get started with the registration process, visit

Step 2: Logistical Planning

The next critical step is logistical planning with two primary workstreams: space planning and securing the appropriate equipment.

The most important thing you can do is convene a cross-functional group at the very beginning. “This was the most important thing we did,” says Jessica Lifford, an industrial hygienist at BAE Systems in Kingsport, Tenn. “We collaborated and identified a ton of scenarios that we simply wouldn’t have considered without that variety of perspective.”

In your planning, include folks from human resources, employee supervisors, medical personnel, security, space planners, etc. The employers who managed a successful event also recommend a multi-threaded approach to accomplish more in less time.

For space planning, you need socially distanced space for check-in, administering the vaccine and monitoring of individuals after receiving the vaccine. “You don’t want your vaccination clinic to become a super spreader event,” says Terry Layman MD, SVP & corporate medical director for Marathon Health.

As far as equipment goes, several items are required such as cloud monitoring devices to ensure proper temperature storage, epi pens and oral antihistamines in the event of an adverse reaction.

Be sure to also build a budget. The vaccine itself is free and comes with the necessary personal protective equipment (PPE) and supplies (syringes, etc.), but there may be incremental costs required if you have to procure new medical or storage equipment, increase clinical staff to administer the COVID vaccine, or have to purchase additional PPE.

Step 3: Get Employees Scheduled for Their COVID Vaccine

This part of the process should start several weeks prior to receipt of the vaccination. “Of all the steps required, scheduling was the hardest part for us because we have three different shifts so there was a lot to consider,” Lifford says.

Extra time during this step of the process is also helpful because many employees will likely have concerns with receiving the vaccine. You want to have time to field those questions, provide advice and get people signed up.

“I spent many hours on the phone with colleagues hearing their concerns, sharing my perspective and answering questions,” says Lifford of BAE Systems. “I’ve been with the company for 18 years and have personal relationships with many of them and that was so helpful in doing what I could to make them feel comfortable and get their concerns addressed. “They trusted me, and I highly recommend that other employers have someone who can provide this outlet.”

Marathon Health included the vaccination option in the patient portal online so patients can schedule it like any other health service. Leverage team supervisors/managers to identify those interested and help spread the word and gather sign-ups. “We vaccinated people at the end of their shift so they could immediately go home after the monitoring phase,” says Lifford, who also added that corporate staff were allowed to complete their day from home after being monitored.

You should also have a back-up list of interested employees because you will no doubt have some call-offs or employees out sick and because the shelf-life is so short, you’ll want to be able to grab others that same-day so the doses don’t go to waste. There are also extra doses in the vials so a backup list will no doubt come in handy.

Also consider role redundancy in your scheduling because as many as 25% of those who receive the vaccine report feeling chills, fever and fatigue – enough to potentially prompt a sick day the next day. For example, don’t schedule 100% of your first-grade teachers or 100% of your security team on the same day.

Step 4: Receive the COVID Vaccines

You have to scenario plan for all three vaccines because you typically won’t know what you’re getting until you get the shipment notification. The clock starts when the vaccines arrive due to shelf-life requirements – Moderna has to be used within six hours for example.

Make sure you have all the necessary equipment set up ahead of time and be aware of the state and local requirements around inventory documentation – some require daily inventory counts be uploaded to guard against theft. Dose count per vial is another difference as well as the timeline between dose one and two.

Step 5 – 6: Administer the COVID Vaccine to Employees

The window between dose one and two varies depending on which vaccine you get. Moderna is 28 days, and Pfizer is 21 days. And of course, the Johnson & Johnson vaccine is a one-time shot.

This stage is also critical to keep in mind the local and state regulations. Each state has different requirements for logging daily inventory levels and proof of vaccination – make sure you adhere to these. Leverage your EMR so patient records are updated appropriately. Some EMR tools can also push vaccine records to the appropriate state authority automatically. Marathon Health uses Athenahealth EMR and it provides that feature.

Becoming a vaccine site is a huge benefit for your employees and there is a lot to consider when planning. Leverage your health center partner to ensure a smooth event and to take advantage of all the lessons learned from other employer vaccine clinics.

“I’m so proud of how the worksite health industry has stepped up to provide this critical service during an unprecedented health crisis,” said Bruce Hochstadt, MD, Executive Vice President of Clinical Growth & Strategy for Marathon Health.


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