EMS Involvement in COVID-19 Vaccination Efforts - Results of a North Carolina Statewide Survey.

The COVID-19 pandemic has necessitated the vaccination of large numbers of people across the United States, mobilizing public health resources on a massive scale. The purpose of this study is to determine how emergency medical services (EMS) clinicians and agencies in North Carolina have been utilized in these vaccination efforts. This retrospective survey was sent to EMS medical directors and EMS system administrators for all 100 county EMS systems in North Carolina. Participation was voluntary, and survey questions asked about the contribution of EMS systems to vaccination efforts, the levels of EMS clinicians being utilized, the activities carried out by those clinicians, and any identifiable barriers to EMS involvement in COVID-19 vaccination efforts. Ninety-eight of the 100 counties in North Carolina responded to the survey, with 88 contributing to vaccination efforts in the communities. Reasons cited by the 10 counties for not being involved in vaccination efforts include: county health departments not needing assistance (two counties), vaccine hesitancy amongst clinicians and the politicization of COVID (three counties), inadequate staffing (one county), and the presence of "robust vaccination clinics" in the community (one county). An additional 12 counties listed staffing shortages as limiting their vaccination efforts. Among the counties supporting vaccine efforts, activities included planning and logistics (54 counties), non-medical roles (38 counties), vaccine preparation (35 counties), medical screening pre-vaccination (41 counties), vaccine administration (74 counties), medical observation post-vaccination (79 counties), and home vaccinations (53 counties). Of the 74 counties that used EMS personnel in vaccine administration, 27 used EMTs (37%), 36 used Advanced EMTs (49%), and 73 used Paramedics (99%). This study demonstrates the large role that EMS clinicians and systems have played and continue to play in COVID-19 vaccination efforts in the state of North Carolina, including planning and logistics, patient screening and observation, vaccine preparation and administration, and home vaccination. Furthermore, it supports the expanded use of EMTs as a potential vaccination workforce. As the public health response to this pandemic continues, EMS clinicians and systems are a valuable resource to their communities and states.