COVID-19 Vaccination: Vaccine, Safety Injection Equipment,

Vaccine
Wastage
Number of Wastage Factor of
Number of
Doses per Factor of Injection
Target Doses per Vial Required Required
Target Vaccine Safety
Population Number of Number of Equipment
(Default: 5) Doses Vials
(Default: 2) (Default: 1.11)
(WF: 1.11)

2 5 1.11 - - 1.11

Notes:
1. Yellow shaded columns contain embedded formula.
2. Corresponding default values are included per column; default values are subject to change once updated information is available.

2021
POPULATION:

BRGYS:

Prov/City/ PHL.pop.% Eligible pop.

RECIPIENT Mun POP.
0 1.6 -
1) Frontline Health Workers
(Hospitals, TRCs and
TTMFs) 0 0.57 -
0 0.56 -

b) Public health workers

(all RHU/CHO personnel;
PHO, PDOHO, CHD and
CO field workers)
and LGU contact tracers
0 0.38 -
c) Barangay Health
Workers including
BHERTS
 d) Other NGAs (DSWD,
DepEd, DILG,
0 0.12 -
BJMP & Bureau of
Correction)

2: Indigent Senior Citizens 0 3.5 -

3: Remaining Senior
0 5.3 -
Citizens

4: Remaining Indigent 0 12 -
Population

5: Uniformed personnel
(PNP, AFP, PCG, BFP, 0 0.5 -
CAFGU)

TOTAL TARGET POPULATION 22.93 -

ection Equipment, Manpower and PPE Requirement Computation
Safety Injection Equipment HR
Target Duration of Number of
Required Vaccinees per Vaccination in Members per
Required Required
Required Number of Day Days VT
Number of Number of
Number of Safety
Mixing Vaccination
AD Syringes Collector (Default: 100) (Default: 7) (Default: 6)
Syringes Teams
Boxes

- - - 100 7 - 6

nce updated information is available.

Computation
PPE for Vaccination Team
Number of Buffer Stock
Face Mask for PPE
per Day Required Required
Number of Number of
(Default: 2) (Default: 1.10) Face Mask Face Shield

2 1.10 - -
 COVID-19 Vaccination: Vaccine, Safety Injection Equipment,
Vaccine
Wastage
Number of Wastage Factor of
Number of
Doses per Factor of Injection
Target Doses per Vial Required Required
Target Vaccine Safety
Population Number of Number of Equipment
(Default: 5) Doses Vials
(Default: 2) (Default: 1.11)
(WF: 1.11)

2 5 1.11 - - 1.11

Notes:
1. Yellow shaded columns contain embedded formula.
2. Corresponding default values are included per column; default values are subject to change once updated information is available.

2021
POPULATION:

BRGYS:

Prov/ City/ PHL.pop.% Eligible pop.

RECIPIENT Mun POP.
1.6 -
1) Frontline Health Workers
(Hospitals, TRCs and
TTMFs) 0 0.57 -
0 0.56 -

b) Public health workers

(all RHU/CHO personnel;
PHO, PDOHO, CHD and
CO field workers)
and LGU contact tracers
0 0.38 -
c) Barangay Health
Workers including
BHERTS
 d) Other NGAs (DSWD,
DepEd, DILG,
0 0.12 -
BJMP & Bureau of
Correction)

2: Indigent Senior Citizens 0 3.5 -

3: Remaining Senior
0 5.3 -
Citizens

4: Remaining Indigent 0 12 -
Population

5: Uniformed personnel
(PNP, AFP, PCG, BFP, 0 0.5 -
CAFGU)

TOTAL TARGET POPULATION 22.93 -

ection Equipment, Manpower and PPE Requirement Computation
Safety Injection Equipment HR
Target Duration of Number of
Required Vaccinees per Vaccination in Members per
Required Required
Required Number of Day Days VT
Number of Number of
Number of Safety
Mixing Vaccination
AD Syringes Collector (Default: 100) (Default: 7) (Default: 6)
Syringes Teams
Boxes

- - - 100 7 - 6

nce updated information is available.

Computation
PPE for Vaccination Team
Number of Buffer Stock
Face Mask for PPE
per Day Required Required
Number of Number of
(Default: 2) (Default: 1.10) Face Mask Face Shield

2 1.10 - -
 ACTIVITY PLAN AND CONTINGENCY PLAN

Region: _____________________________ Province/ City: _____________________________

Activities Indicator Target Baseline

BEFORE THE MASS IMMUNIZATION CAMPAIGN

1. Briefing and feedback with mayor, administrator, public # of briefing sessions with
information officer, MILG, MSSD and other key local mayor, administrator, and
officials other key local officials
conducted

2. Briefing and dialogues with local partners and local

leaders
a. Barangay chairmen, kagawad for health and sanitation, # of barangay chairmen,
and other local officials kagawad for health and
sanitation, and other local
officials given orientation on
the Covid-19 immunization
campaign

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)

b. Representatives from community-based organizations # of representatives from

(homeowners associations, senior citizens, women's community-based
groups, transport groups, youth groups, indigenous organizations given
peoples, etc.) orientation on theCovid-19
immunization campaign

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)

c. Religious leaders # of religious leaders given

orientation on the Covid-19
immunization campaign
- Prepare letter of invitiation/notice of meeting; send
invitation

- Conduct the meeting(s)

d. Representatives from private organizations and business # of representative from
sector private sector given
orientation on the Covid-19
immunization campaign

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)

e. NGOs, CSOs, civic, and other organizations operating in # of representatives of NGOs,

the city/municipality CSOs, and other organizations
given orientation on the
Covid-19 immunization
campaign

- Prepare letter of invitiation/notice of meeting; send

invitation
- Conduct the meeting(s)

3. Orientation/training of barangay health workers and

volunteers # of barangay health workers
and volunteers given
orientation on the Covid-19
immunization and key
messages

4. Development, production, and dissemination/posting

of communication materials
a. Development and/or printing of communication # of communication materials
materials developed
b. Distribution and posting/installation of streamers, # of streamers or posters
posters, and other communication materials (consider installed
public markets, transport terminals, ports, health facilities,
churches, commercial areas)

# of flyers distributed
5. Announcements via local public address system(s) - e.g. # of announcements made
mobile public address system, community megaphones regarding the Covid-19
immunization campaign

6. Facility-based awareness-raising activities for

parents/caregivers (group orientation; announcements;
barangay assemblies; family development sessions)

7. Awareness raising and engagement via the city # of posts regarding the
government's social media platforms (e.g. Facebook, Covid-19 mass immunization
Twitter, Instagram, Youtube) campaign
8. Awareness-raising activities for hard-to-reach or special # of awareness-raising
populations (e.g. areas with security issues, relocated activities for 'special'
populations, mobile and transient families, homeless) populations conducted

- Identifying hard-to-reach or special populations

- Conduct of local strategies to reach hard-to-reach or
'special' populations

9. City/Municipal-level launching or kick-off activity # of city-level kick-off

activities conducted
- Form committee; assign tasks
- Prepare programme or activity plan, with budget;
speeches or talking points
- Send invitations; coordinate logistics support
- Conduct kick-off activity

10. Pre-campaign monitoring (check for visibility of # of pre-campaign monitoring

communication materials e.g. streamers; awareness of activities conducted
senior citizens,other target populations about the
campaign; activities conducted by local officials and
partners in support of the campaign)

11. Documentation of pre-campaign activities (e.g. video, Type of documentation used

photo) (video, audio, photo,
narrative)

12. Coordination meetings on advocacy and social # of coordination meetings

mobilization conducted

DURING THE MASS IMMUNIZATION CAMPAIGN

1. Monitor the progress of immunization activities; check # of monitoring activities
for possible issues including refusals, rumours, conducted
misinformation; apply corrective actions, if needed

2. Continuing social mobilization activities (add details

below; some awareness-raising activities during pre-
campaign period may be continued until end of the
campaign period and/or when all children have been
immunized)

3. Home visits to follow-up masterlisted individuals who mi# of home visits conducted

AFTER THE MASS IMMUNIZATION CAMPAIGN

1. Post-campaign assessment meetings and other # of post-campaign
activities assessment meetings and
other related activities
conducted
2. Meetings with local partners to report on campaign # of meetings conducted
accomplishment and to thank them for their support;
agreements to maintain/sustain the partnership

3. Preparation and submission of campaign # of reports submitted

documentation report(s)
__________ Municipality/ Barangay: _____________________________

Time frame Responsible person/ unit Budgetary requirement

TOTAL AMOUNT REQUIRED
Date: _______________

funding source(s) Remarks

Vaccination Team Leader: _______________________________________________

No. of days Date of Immunization Vaccination Posts

10

11

12

13

14
_______________ Vaccination Team Supervisor: __________________

Eligible Daily Target to be

Assigned Vaccination Teams and Composite Teams
Population Vaccinated
n Team Supervisor: _____________________________

Transportation Mechanism
Transport Mechanism for Resources Needed with
for Vaccination Team and
Vaccinees Quantity
Composite Teams
 SUPERVISORY AND MONITORING SCHEDULE

Region: ________________________ Province: _______________________

City/Municipality:

Team Number and Name of

Name of Supervisor VT Leader Areas to Be Visited Mode of transport Start Date
Date Prepared: _______________________

Contact Numbers

End Date
VT Team Leader Supervisor
 LIST OF MONITO

Region: __________________________ Province: _____________________________

No. Name Office

10

11

12

13

14

15

16

17

18

19

20
 LIST OF MONITORS AND OBSERVERS

________________ City/Municipality: ________________________________

Period/Dates Available for Contact Number of

Areas to be Visited Monitoring Monitor/Observer
Email Add
 AEFI/AESI MANAGEMENT,

Region: __________________________ Province: _____________________________

No. of Composite
No. Vaccination Post Team Assigned No. of AEFI/AESI Kits

10

11

12

13

14

15

16

17

18

19

20
ESI MANAGEMENT, SURVEILLANCE AND RESPONSE PLAN

City/Municipality: ________________________________

Emergency Equipment Needed Referral Facility Contact Person/s

 Assigned Emergency Transport
Contact Details Vehicle
 BUDGET REQUIREMENT

Logistical Requirements Est. unit cost (PhP)

# of recording forms required
# of PPEs required
# of transport needed
TOTAL (PhP)

Mobilization
Manpower Requirements allowance
Total # of vaccination staff required
# of team supervisors
TOTAL AMOUNT

Activity Plan and Budget Unit price

TOTAL AMOUNT
MENT

Quantity needed Total cost (PhP)

- -
- -
- -
-

quantity Amount (PhP)

- -
- -
-

quantity Amount (PhP)