Steps to Submit First Responder Vaccine Prioritization Roster:
- Download the First Responder Vaccine Prioritization Worksheet in Links & Documents below
- One vaccine worksheet documents up to 500 names. If you are submitting more than 500 names, please submit additional worksheets.
- Complete the First Responder Vaccine Worksheet(s)
- Organization Name
- Public Health Region
- Information needed for entire organization roster:
- First Name
- Last Name
- Email Address
- Select Position from drop down
- Select Responders intent to receive the COVID 19 Vaccine from the drop down
- Select Responders prioritization from the drop down, based on the below definitions:
- Most risk – first responders included in Phase 1a are those that are expected because of their professional role to have direct patient contact with patients who are reasonably likely to have COVID-19:
- During their treatment and transport
- Prior to transport
- Moderate risk – first responders included in Phase 1a are those that are expected because of their professional role to have indirect patient contact with patients who are reasonably likely to have COVID-19. These first responders provide support to the direct patient contact/care providers.
- Lowest risk – included after Phase 1a: remainder of first responders. These workers are critical to maintain health infrastructure. These workers will be vaccinated as early as possible once Phase 1a is completed.
- Most risk – first responders included in Phase 1a are those that are expected because of their professional role to have direct patient contact with patients who are reasonably likely to have COVID-19:
- Submit the First Responder Stipend Worksheet(s) via the link below
Links & Documents:
NOTE: The worksheet has been updated to reflect total stipend amount based on the position and the eligible weeks. Please use the updated worksheet for new submissions.
NOTE: Additional update includes volunteer positions and part time state law enforcement.
- Download the First Responder Vaccine Prioritization Worksheet
- Submit your agencies First Responder Vaccine Prioritization Worksheet(s) by clicking here