COVID-19 vaccine introduction toolkit
Achieving high uptake of COVID-19 vaccines will require effective planning, coordination, and implementation of a range of strategies. To assist, this toolkit offers a set of practical guidance, training and information resources that are intended to support programmes, partners, health workers, civil society organizations, and other stakeholders.
The toolkit is organized in line with the guidance on developing a National Deployment and Vaccination Plan (NDVP - UPDATED) for COVID-19 vaccines. The updated NDVP Guidance supersedes the previous version published on 16 November 2020.
COVAX other partners are working to ensure that the infrastructure, resources and technical assistance are available to help make sure that COVID-19 vaccines can be delivered to all those in need.
For questions, comments, or feedback, please email [email protected].
- Developing a National Deployment and Vaccination Plan (NDVP)
- Submitting a National Deployment and Vaccination Plan (NDVP)
- Regulatory preparedness
- Indemnification and liability
- Costing and funding
- Supply and logistics
- Human resources and training
- Vaccine specific resources
- Vaccine acceptance and uptake (demand)
- Vaccine safety
- Data and monitoring
- Evaluation of COVID-19 vaccine introduction
- Additional resources
- Q&As
- Vaccines explained
Developing a National Deployment and Vaccination Plan (NDVP)
A National Deployment and Vaccination Plan is an operational plan to implement and monitor COVID-19 vaccination rollout in a country. The Vaccine Introduction Readiness Assessment Tool (VIRAT/VRAF 2.0) supports countries to assess readiness prior to introduction prioritize actions.
- Training on orientation to NDVP for COVID-19 vaccines helps national and sub-national focal points in countries to develop their NDVP and prepare for COVID-19 vaccine introduction. Access link here
- The role of community health workers in COVID-19 vaccination: implementation support guide is intended to support national governments in developing their national deployment and vaccination plans for COVID-19 vaccines by outlining the roles, needs and opportunities for community health workers to contribute.
- Guidance on operational microplanning for COVID-19 vaccination. This publication is a companion document to the Guidance on developing a national deployment and vaccination plan (NDVP - UPDATED).
Submitting a National Deployment and Vaccination Plan (NDVP)
The 92 COVAX Facility Advance Market Commitment (AMC) countries must (and all other countries are welcome to) submit their COVID-19 National Deployment and Vaccination Plans (NDVPs) to be allocated vaccines through the COVAX Facility. NDVPs can be submitted by the designated national focal point through the COVID-19 Partners Platform. NDVPs will be reviewed by Regional Review Committees on a rolling basis to inform their recommendations on the allocation of vaccines by COVAX.
For countries:
- The NDVP submission and review process document helps countries to prepare and submit their NDVP to the COVID-19 Partners Platform. This resource should be used in conjunction with the National Deployment and Vaccination Plan for COVID-19 vaccines (NDVP): Standard review form excel (see below).
Infection Prevention and Control for COVID-19 vaccination
The Infection prevention and control aide memoire is for policy makers, immunization programme managers, infection prevention and control (IPC) focal points at national, sub-national, and facility level, as well as for health workers involved in COVID-19 vaccination delivery. This document summarizes the key IPC principles to consider and the precautions to take for safely delivering COVID-19 vaccines.
- Training on infection prevention and control is available here: https://openwho.org/courses/COVID-19-IPC-EN
Regulatory preparedness
WHO Prequalification aims to ensure medicines, vaccines and other health products for supply to low-income countries are quality-assured, safe, effective and accessible to all populations.
The WHO Emergency Use Listing Procedure (EUL) is a risk-based procedure for assessing and listing unlicensed vaccines, therapeutics and in vitro diagnostics with the ultimate aim of expediting the availability of these products to people affected
by a public health emergency.
For a vaccine to be procured through COVAX, it must be listed for emergency use by WHO through the EUL. EUL decisions and documents can also serve as a reference point for countries in their own regulatory decisions.
- Information on COVID-19 vaccines, targeted at Regulatory Agencies, from WHO's prequalification team, including details on: vaccines eligible for WHO prequalification, vaccines under assessment, WHO List of Prequalified Vaccines, procedures and fees, post-prequalification procedures, prequalification reports, guidance documents, alternative evaluation pathways, and complaints handling. Access link here.
Indemnification and liability
- The COVAX No-Fault Compensation Program webpage brings more information on NFC for Advance Market Commitment (AMC) Eligible Economies. The Program provides fair, no-fault, lump sum compensation to eligible individuals who suffer certain serious adverse events after receiving vaccines distributed through the COVAX Facility until 30 June 2022.
Costing and funding
Costing:
- The COVID-19 Vaccine Introduction and deployment Costing tool (CVIC tool) supports credible COVID-19 vaccination costing to facilitate a dialogue with stakeholders, while maintaining sensitivity to protecting essential health services.
- What is the CVIC tool? This video, available in English, French and Spanish, shows the importance of COVID-19 vaccine costing and the role of COVID-19 Vaccine Introduction and deployment Costing tool (CVIC tool).
- Training on how to use the CVIC tool is available in English and French.
- The OpenWHO course CVIC tool: using the COVID-19 Vaccine Introduction and deployment Costing Tool targets national programme managers and personnel who have been involved in the costing, budgeting or financing processes of COVID-19 vaccine delivery in a country.
- COVID-19 vaccination costing Q&A provides a basic introduction on the importance of a good costing exercise for COVID-19 vaccine roll-out, how it can be done, and how to seek technical assistance.
- WHO Costing, Budgeting, Financing and Delivery of COVID-19 Vaccines webinar series align with countries’ immediate and medium-term needs. Session materials are also available online.
- The costs of delivering COVID-19 vaccine in 92 AMC countries report presents broad estimates of the costs of delivering COVID-19 vaccines to approximately 20% of the population in the 92 Advance Market Commitment (AMC) countries.
Budgeting:
- COVID-19 vaccination financing and budgeting Q&A provides a basic introduction into the possible financing and budgeting arrangements around COVID-19 vaccination roll-out.
Supply and logistics
- COVID-19 vaccination: Supply and logistics guidance helps national and subnational supply and logistics focal points to prepare and strengthen their supply chain strategies to receive, store, distribute and manage the COVID-19 vaccines and their ancillary products, in line with their national deployment and vaccination plan (NDVP).
- WHO Expanded Programme on Immunization Logistics Forecasting Tool explains how to forecast the needs for vaccines, equipment for safe vaccination, as well as cold chain and ambient storage capacities
for national immunization programmes. Access link here.
- Ultra-low temperature (ULT) storage and transport for vaccines - An overview of options and challenges. Some of the COVID-19 vaccines may need to be kept at ultra-low temperatures (ULTs) to maintain their potency. This resource provides immunization programme managers and cold chain managers an overview of the options to overcome the challenges in maintaining the vaccine in ultra-low temperature during storage and transport.
- Interim guidance on acceptance of available traditional vaccine supply with reduced shelf-life, 1 March 2021. The purpose of this document is to advocate to countries to consider acceptance of traditional vaccines with reduced shelf life and guide decision making tailored to specific situation at hand, referencing already existing WHO publications.
- Guidance on utilization of COVID-19 vaccines before the date of expiry help countries ensure that all COVID-19 vaccine doses are optimally utilized, and wastage is minimized.
- Guidance on selecting, commissioning, and using freeze-preventative vaccine carriers. This is an update to a document published on 21 April 2021 reflecting results of a study on the use of these specific vaccine carriers.
Human resources and training
- The COVID-19 vaccination training for health workers provides key information and job aides for vaccinators on how to safely and efficiently administer vaccines. Access link here
- COVID-19 vaccine simulation exercises help countries to prepare for strategies, communications, supply and logistics, vaccine safety and regulatory aspects of COVID-19 vaccination. Access link here
- Training on how to use COVID-19 vaccine simulation exercises is available in English
- Global Capacity Webinars provide helpful information on key aspects of COVID-19 vaccination for national/subnational focal points and health workers. Access link here
- The COVID-19 vaccine checklist is for frontline health workers planning a COVID-19 vaccination session. This checklist can help them to prepare and complete a COVID-19 vaccination session at a fixed post or outreach session.
- The Health Worker Communication for COVID-19 Vaccination Flow Diagram supports health workers by outlining key steps and messages, including for pregnant and lactating women, to communicate during a COVID-19 vaccination session. UPDATED
- Why are there extra doses of vaccine in the vaccine vial? – This job aid explains extra doses of vaccine in multi-dose vials and provides guidance for their use.
- The document on supportive supervision for COVID-19 vaccination is intended for supervisors who are supporting staff conducting COVID-19 vaccination. Use this checklist to prepare for and conduct supervisory visits, either on-site or remotely.
- How to manage COVID-19 vaccines without VVM at vaccination service points? This resource explains how WHO EUL COVID-19 vaccines without a vaccine vial monitor (VVM) should be handled at the vaccination site, to ensure that safe and potent vaccines are administered.
Vaccine specific resources
Vaccine-specific resources for COVID-19 vaccines that receive emergency use listing or prequalification. These resources are intended to support countries in preparing for COVID-19 vaccine introduction.
- AstraZeneca: The AstraZeneca ChAdOx1-S/nCoV-19 [recombinant] vaccine resource includes key information on the vaccine specific requirements. UPDATED
- The AstraZeneca ChAdOx1-S/nCoV-19 [recombinant] COVID-19 vaccine training video provides a brief (5 minute) overview of how to handle, prepare, and administer this vaccine
- COVAXIN® (BBV152): The COVAXIN® (BBV152, Bharath Biotech International Ltd.) COVID-19 vaccine resource includes key vaccine specific information.
- The Covaxin® COVID-19 vaccine training video provides a brief (5’) overview of how to handle, prepare and administer this vaccine.
- Janssen: The COVID-19 Vaccine Janssen (Ad26.COV2-S [recombinant]) vaccine resource includes key information on the vaccine specific requirements. This document has been updated in English. All language versions pending update.
- The COVID-19 Vaccine Janssen (Ad26.COV2-S [recombinant]) training video provides a brief (7 minute) overview of how to handle, prepare and administer this vaccine. UPDATED.
- The Janssen vaccine job aide aims to guide countries in managing the delivery and storage of the vaccine labelled and delivered in different storage temperatures.
- Moderna: The COVID-19 Vaccine Moderna explainer provides key vaccine-specific information.
- The Moderna mRNA-1273 COVID-19 vaccine training video provides a brief (6 minute) overview of how to handle, prepare, and administer this vaccine. (Update pending).
- NVX-CoV2373 recombinant, adjuvanted COVID-19 vaccine: The Covovax™ (SIIPL) and Nuvaxovid™ (Novavax) vaccine explainer includes key vaccine specific information.
- The CovovaxTM /NuvaxovidTM COVID-19 vaccine training video provides a brief (5’) overview of how to handle, prepare and administer these vaccines.
- Pfizer-BioNTech: The COVID-19 mRNA vaccine Comirnaty® (Tozinameran) provides key vaccine-specific information.
- Instructional training video - The Pfizer Comirnaty Tozinameran video (7 minutes) provides instructions on how to handle, thaw, and administer this vaccine. (Update pending)
- As more doses of the Pfizer-BioNTech COVID-19 vaccine become available to AMC countries through the COVAX Facility, the Country Readiness and Delivery team is developing several resources to support countries in the vaccine roll-out. A dedicated resource page on TechNet-21 has available resources, including:
- Training on handling, storing and transporting Pfizer BioNTech COVID-19 Vaccine COMIRNATY® (Tozinameran) is available in English, Arabic, French and Russian.
- COVID-19 Vaccine Rollout Technical brief on delivery strategies options
- Sinopharm: The Sinopharm COVID-19 vaccine (vero cell), inactivated vaccine resource includes key information on the vaccine specific requirements.
- Sinovac: The COVID-19 Vaccine (Vero Cell) Inactivated, CoronaVac vaccine resource includes key information on the vaccine specific requirements.
- The Administering the BIBP/Sinopharm and CoronaVac/Sinovac COVID-19 vaccines (immunizationacademy.com) training video, available in English and French, provides a brief overview on how to store and administer these COVID-19 vaccines.
- The OpenWHO COVID-19 vaccine specific resources course provides key information about COVID-19 vaccines through short instructional videos, vaccine explainers, job aids, topic briefings, and downloadable presentations.
Vaccine acceptance and uptake (demand)
- Demand package of guidance and tools to support countries in preparing for COVID-19 vaccination. Access link here
- The 10 Steps to Community Readiness: What countries should do to prepare communities for a COVID-19 vaccine, treatment, or test highlights 10 well established Risk Communication and Community Engagement (RCCE) principles.
Vaccine safety
- COVID-19 vaccines: safety surveillance manual highlights the importance for countries to include preparedness plans for COVID-19 vaccine safety and helps them to develop this plan in the NDVP, building on WHO guidance.
- The recognizing anaphylaxis training video provides a brief (4 minute) overview on how to recognize anaphylaxis vs. an immunization stress-related response.
- The identifying and managing anaphylaxis training video provides a brief overview on how to manage anaphylaxis.
- Vaccine safety poster for health workers on how to monitor and report COVID-19 vaccine, side effects
- The Adverse Events Following Immunization (AEFI) page comprises all AEFI resources including aide-mémoires, worksheet, updated AEFI manual as well as the pre-published document on anaphylaxis.
- Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19) aims to increase awareness about TTS in the context of COVID-19 vaccination and help healthcare providers in the assessment and management of potential TTS case.
Data and monitoring
- The Monitoring COVID-19 Vaccination guidance provides considerations for: minimum and optional data to collect as vaccines are being rolled out and delivered; key performance indicators and the anticipated use of these – to measure the performance of key components of the immunization system and to take corrective action when needed; and the use of information systems to collect, store, analyze and disseminate any relevant information.
- COVID-19 vaccination data are now available on the WHO Coronavirus (COVID-19) Dashboard: covid19.who.int. These data are viewed by selecting “Vaccination” from the dropdown panel on the left-hand side of the map. Currently, the dashboard incorporates information useful to track global vaccine rollout, including total vaccination doses administered, persons vaccinated with at least one dose, and start date of vaccinations, by country, territory and area.
Evaluation of COVID-19 vaccine introduction
Post introduction evaluation
Following new vaccine introduction into a routine immunization programme, the purpose of a post-introduction vaccine evaluation (PIE) is to evaluate the impact of the vaccine introduction on the country’s immunization programme and to rapidly identify problems needing correction as vaccination expands in country.
After COVID-19 vaccine introduction, in the mid- to long-term phase (between 6–18 months after introduction), a classic or full COVID-19 vaccine PIE (cPIE) is recommended. For countries interested in implementing the classic cPIE, please refer to the COVID-19 vaccine post-introduction evaluation (cPIE) guide: interim guidance, 25 August 2021.
Mini cPIE
The mini COVID-19 Post-Introduction Evaluation (mini-cPIE), also called the COVID-19 Vaccination Intra-Action Review (IAR), is a set of tools available to countries to review the early phase(s) of the roll-out of COVID-19 vaccine implementation. The mini-cPIE is a country-led facilitated discussion that aims to identify vaccine delivery challenges needing immediate corrective action and best practices for continual improvement and collective learning. The areas covered follow the National Deployment and Vaccination Plan for COVID-19 Vaccines (NDVP).
The mini-cPIE working documents (trigger question database, note taking template, and report template) are available here:
28 April 2021
Country COVID-19 intra-action review (IAR): Final report template Pillar 10, COVID-19 vaccination
28 April 2021
Country COVID-19 intra-action review (IAR): trigger question database
28 April 2021
Country COVID-19 intra-action review (IAR): Note-taking template pillar 10, COVID-19 vaccination
Countries are encouraged to begin using these working drafts for planning and implementation as needed. Given the evolving situation with the COVID-19 vaccine rollout, the trigger questions may be updated frequently based on feedback received. The mini-cPIE is recommended 2 to 6 months following COVID-19 vaccine introduction. Countries may adapt the questions as needed for their context.
This slide set provides an overview of how to conduct a mini COVID-19 Post Introduction Evaluation.
Watch the training recording: Mini-cPIE (COVID-19 Vaccination IAR) – What is it and how to conduct one?
Vaccine effectiveness guidance
Vaccine effectiveness and impact studies are needed to understand how the vaccine works in the real world. Guidance on how to conduct such studies, sample protocols, and other resources can be found here.
Additional resources
- Country readiness and delivery frequently asked questions to support countries as they prepare for COVID-19 vaccines. Access link here
- PAHO has also developed resources for the Americas regions to help governments to prepare introduction and successful roll-out of COVID-19 vaccines, as well as resources for the general public to answer questions related to COVID-19 candidate vaccines. Access link here
- Frequently asked questions - COVID-19 vaccines and breastfeeding based on WHO SAGE interim recommendations: This document provides answers to frequently asked questions (FAQs) about COVID-19 vaccination and breastfeeding. It is intended to assist health workers and the public, including mothers who are breastfeeding or expressing milk.
- Updated WHO Guidance on COVID-19 vaccination for pregnant and lactating women: This document provides background on evidence, WHO interim recommendations, tools and resources about COVID-19 vaccination during pregnancy and lactation.
- Safe Ramadan practices in the context of COVID-19 - This guidance focuses on SARS-CoV-2 transmission, public health and social measures, vaccination, and the use of masks in the context of Ramadan.
- Disability considerations for COVID-19 vaccination presents considerations and actions for the following stakeholders to ensure equity in access to vaccination against COVID‑19 for persons with disabilities.
- Joint note on means to protect health care from acts of violence in the COVID-19 vaccination rollout in fragile, conflict-affected and vulnerable settings outlines specific actions for consideration at operational level to ensure the provision of COVID-19 vaccines, unhindered by any acts of violence or obstruction.
- The guidance note and checklist for tackling gender-related barriers to equitable COVID-19 vaccine deployment provides a set of practical actions for countries to implement and ensure gender equality and equity in the deployment of COVID-19 vaccines.
Q&As
Coronavirus disease (COVID-19): Vaccines
Coronavirus disease (COVID-19): Vaccine access and allocation
Coronavirus disease (COVID-19): Vaccine research and development
Coronavirus disease (COVID-19): Vaccines safety
Coronavirus disease (COVID-19): Use of Emergency Use Listing procedure for vaccines against COVID-19
Vaccines and immunization: Vaccine safety
Vaccines and immunization: What is vaccination?
Vaccines explained
WHO's 'Vaccines Explained' series features illustrated articles on vaccine development and distribution. Learn more about vaccines from the earliest of research stages to their rollout in countries. For information on specific vaccines, please see above vaccine specific resources section.
Read all the 'Vaccines Explained' series.