Q: What changes are going into effect now that most health units are moving to Phase 1C?

Question: What changes are going into effect, now that most health units are moving to Phase 1C?

Answer: There are a few changes to be aware of. First, health units are not serving groups in a sequence for Phase 1C, as had been the case for Phases 1A and 1B. Instead, vaccine clinics are open to all groups listed in the category at once.

Individuals served by Phase 1C include the following:

  • National Guard, not previously covered
  • Grocery workers
  • Public safety answering points (911)
  • COVID-19 vaccine manufacturing workers
  • Health care/public health workers not in Phase 1A
  • Public transit – including bus, taxi and ride share – workers
  • People age 16-64 with 1 underlying conditions
  • Blood bank workers not previously vaccinated
  • IT workers unable to work from home
  • All other essential workers per Cybersecurity & Infrastructure Security Agency (CISA) unable to work from home

While most of these groups are self-explanatory, two groups require more explanation:

  • Individuals aged 16-64 with 1 underlying condition are dependent on which type of vaccine is utilized at the vaccine clinic. If the Pfizer vaccine is used, individuals aged 16 to 64 with 1 underlying health condition can receive the vaccine. However, if the Moderna vaccine is utilized, individuals aged 18-64 with 1 underlying health condition may receive the vaccine.
  • All other essential workers per Cybersecurity & Infrastructure Security Agency (CISA) unable to work from home is a large group, encompassing the majority of working North Dakota adults.

Finally, Custer Health and Bismarck-Burleigh Public Health has altered how you sign up for your COVID-19 vaccine. Individuals who qualify under Phases 1A, 1B or 1C, and are interested in receiving their vaccination must go to https://www.ndvax.org/ and proceed through the following steps:

  • Click ‘Find a Clinic’ button
  • Search for the vaccine clinic you would like to attend. When you find your event, click on the ‘Sign Up for a COVID-19 Vaccination’ button that corresponds with that event. If the event does not have this button, that vaccine clinic has been filled and no longer has available appointments.
  • Click on the appropriate time slot that you would like to attend at the clinic, scroll to the bottom of the screen and click the ‘Save and Continue’ button.
  • Enter information requested to complete your appointment for the vaccine clinic. If you do not have an appointment secured for the vaccine clinic, you will be unable to receive vaccine at the clinic.

If you are unable to schedule an appointment online, or need assistance scheduling a COVID-19 vaccine appointment, please call BBPH at (701) 355-1540 and select Option 1 to speak to a representative, or call Custer Health’s Mandan office at (701) 667-3370 or toll free at 1-888-667-3370. More information is available online at https://www.bismarcknd.gov/2015/COVID-Vaccine-Info and https://www.custerhealth.com/vaccine-information.

Phase 1C is comprised of up to 165,000 in North Dakota who may be vaccinated. Upon completion of Phase 1C, Phase 2 (general public) vaccination will begin.

I really want to get the COVID-19 vaccine. How do I get it?

I really want to get the COVID-19 vaccine. How do I get it?

There are a few different avenues you may utilize to receive a COVID-19 vaccine: Public Health, as well as your local healthcare providers, and some pharmacies. For the sake of this blog post, we will assume that you are receiving your vaccine through public health.

The North Dakota Department of Health has created an online COVID-19 Vaccine Locator that tracks availability across the state. For more information visit https://www.health.nd.gov/covidvaccinelocator. Please note the inventory availability is updated daily based on provider vaccine inventory. North Dakota providers who are not receiving vaccine through the North Dakota Department of Health may have vaccine available that is not indicated in the vaccine locator.

What are Priority Groups?

The first thing you need to determine is which priority group you are in. The North Dakota Department of Health has determined three priority groups (called Phases) that will receive the vaccine prior to it being opened up to the general public. Within each phase are smaller groups (called Tiers) that are given order priority. For more information about phases/tiers, visit https://www.health.nd.gov/covid-19-vaccine-priority-groups.

  • Phase 1A includes healthcare workers, first responders and long term care residents and staff. As of January 25, 2021, all regions have completed, or have nearly completed, this phase.
  • Phase 1B includes older individuals, people with underlying health conditions, other congregate settings, child care workers, and employees of preschools and K-12.
    • Persons age 75 and older
    • Persons age 65-74 with two or more high-risk medical conditions
    • Staff and persons living in other congregate settings (i.e., corrections, treatment centers, homeless shelters, etc.)
    • Persons age 65 and older with one or more high-risk medical conditions
    • Persons age 65 and older with or without high-risk medical conditions
    • Persons with 2 or more high-risk medical conditions, regardless of age
    • Child care workers
    • Workers employed by preschools or Kindergarten through 12th grade: (Teachers, nutritional services, aides, bus drivers, principals, administrative groups, custodians, etc.)
  • Phase 1C includes essential workers and people of any age at increased risk for COVID-19
    • National Guard, not previously covered
    • Workers enabling access to human food (i.e., grocery workers), not including restaurant workers
    • Public safety answering points (911)
    • Manufacturing related to the development or supply of COVID-19 vaccine
    • Other healthcare/public health workers not included in Phase 1A
    • Free standing clinical laundries
    • Public transit, including bus, taxi, ride share
    • Persons age 16-64 with one or more high-risk medical conditions
    • Blood bank workers not previously vaccinated
    • Information Technology
    • All other essential workers per Cybersecurity and Infrastructure Security Agency (CISA)

How do I sign up?

Bismarck-Burleigh Public Health (Eligibility Determination Survey) and Custer Health (Vaccination Interest Survey) both have created surveys that will get you started on the road to COVID-19 vaccination.

By completing this survey, you will identify your appropriate tier know when you can receive the COVID-19 vaccine. Please note that by completing this survey you have not secured your COVID-19 vaccine. Presently, both vaccine interest surveys are only open to individuals in Phase 1B. As Phase 1C gets closer, the surveys will open to these additional groups.

As vaccine is made available, public health units will contact individuals who have completed the interest survey and were placed in the appropriate phase/tier to attend a vaccination clinic and receive vaccination. At this time, Pfizer and Moderna vaccines are being utilized at public health unit vaccine clinics, meaning you will need to receive two rounds of the vaccine 21 days (for the Pfizer) 28 days (for the Moderna) apart. Individuals wanting to be vaccinated will reserve their appointment time through a link shared by the health units. Please note that if you have not reserved your appointment time, you will not be able to receive a vaccine at a public health vaccination clinic.

What do I do the day of my vaccination?

Bismarck-Burleigh Public Health is conducting its vaccine clinics at Bismarck Event Center (located at 315 S Fifth Street in Bismarck). Custer Health is conducting its vaccine clinics through its office (located at 403 Burlington Street SE) in Mandan.

Once you have that appointment time reserved, there are just a couple of reminders:

  • Be sure to wear a mask to your vaccine appointment. Universal precautions have made a huge impact in dropping our overall positive case count – take care of your fellow humans!
  • Wear loose-fitting clothing. You will be getting your vaccination in your upper arm, so make sure you won’t need to shed clothes in order to get your shot.
  • You should receive a vaccination card or printout that tells you what COVID-19 vaccine you received, the date you received it and where you received it.
  • Once you receive your vaccine, you will need to be monitored for 15-30 minutes, depending on your history of allergic reactions. For more information, visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/allergic-reaction.html. You may want to use your monitoring time to get signed up for V-Safe.
  • Sign up for V-Safe at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html. This online symptom monitoring system uses text messaging and web surveys to quickly tell CDC if you have any side effects after receiving the COVID-19 vaccine.
  • If you are receiving your first round of the COVID-19 vaccine, be sure to register for your follow-up dose.

What should I expect after receiving the COVID-19 vaccine?

Individuals receiving a COVID-19 vaccine have reported some side effects, including pain or swelling on the arm receiving the shot. Some individuals have also reported fever, chills, fatigue and headache. If you have pain or discomfort, talk to your healthcare provider about taking over the counter medicine such as ibuprofen or acetaminophen. If you have concerns about any potential vaccination side effects, it is important to discuss those with your healthcare provider prior to vaccination.

Other suggestions to help reduce pain:

  • Apply a clean, cool, wet washcloth over the area
  • Use or exercise your arm
  • Drink plenty of fluids
  • Dress lightly

In most cases, these side effects will last only a couple of days. If redness/tenderness where you got your shot increases after 24 hours, or if your side effects are worrying and do not seem to be going away after a few days, contact your doctor or healthcare provider.

A printable handout for what to expect after receiving your COVID-19 vaccine is available at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/pdfs/321466-A_FS_What_Expect_COVID-19_Vax_Final_12.13.20.pdf.

More Resources?

Q: Where can I find information about the City of Bismarck’s Pandemic Mitigation Strategy?


A: Information about the strategy is located at http://www.bismarcknd.gov/BismarckStrong. This page contains a variety of resources for multiple community audiences including the full Pandemic Mitigation Strategy document, a strategy highlights document, signage for businesses and an online occupant load calculator. More content is expected to be added to the page, too, so check back for updates.

How is COVID-19 going to effect Halloween this year?

A: Halloween may look a little different this year, but it doesn’t have to be drastically so for trick or treaters. They are still able to The CDC suggests the following five ways to make trick or treating safer:

  • Avoid direct contact with trick-or-treaters.
  • Give out treats outdoors, if possible.
  • Set up a station with individually-bagged treats for kids to take.
  • Wash your hands before handling treats.
  • Wear a mask (face covering).

One thing you may want to do is incorporate a cloth face covering as part of your costume. Get creative with it! Or, maybe this year, the most popular costume will be a medical professional – that isn’t bad either! However, please note that a costume mask is not a substitute for a cloth face covering. Masks should not be worn by children under the age of 2. And remember to bring the hand sanitizer if you are not able to wash your hands with soap and water. If touching many frequently-touched surfaces, be sure to liberally use sanitizer that has at least 60% alcohol content.

As is the case with all Halloween goodies, be sure to inspect everything before giving it to children to eat. While some people may not like the idea of wiping down each individual piece of candy, before giving it to their child(ren), doing this also ensures that you are examining candy for things like sharp objects that may have been placed in candy. No one likes to think that someone out there would want to hurt a child, but the reality is, it can – and does – happen. Either way, by cleaning candy or simply by inspecting it, make no assumptions about the candy before giving it to your children.

Any large gatherings pose an inherent risk that has become part of so many activities in 2020. This year’s outdoor Halloween activities might end up being more effected by weather than by COVID-19. It has been a cold end to October and Halloween night is projected to be windy and cold. And so, some of the outdoor activities, which may be safer environments, may be less enjoyable because of the temperatures projected in the 20s and 30s as day transitions to night.

But there are still things you can do as a family:

  • Go driving through the community looking at Halloween decorations.
  • Arranging a Halloween-themed scavenger hunt in your back yard or home.
  • Find a scary movie or two on TV or your preferred streaming service. Or better yet, come up with your own scary ideas and use your phone to make your own family scenes.
  • Design a scary scene in your front yard. If you incorporate a jack-o-lantern into your decorum, be sure to use battery-operated lights, and not lit candles.

For more information, visit these online sources:

Q: I have heard some people suggest herd immunity can be achieved if we all get exposed to COVID-19. Is this something that can be helpful?

A: Herd immunity, or community immunity, is defined by the Center for Disease Control (https://www.cdc.gov/vaccines/terms/glossary.html) as, “A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community. Also known as herd immunity.” Essentially herd immunity is what happens when a disease runs out of people that are susceptible.

However, at this point in the pandemic response, it is challenging to assume anything about COVID-19, because the world is learning more about it every day. Long-term effects of a COVID-19 infection are still mostly unknown. Additionally, according to Mayo Clinic, (https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunity-and-coronavirus/art-20486808) it is not clear if infection with the COVID-19 virus means a person is immune to future infections. Recently, stories (https://www.bbc.com/news/health-54512034 and https://www.npr.org/sections/coronavirus-live-updates/2020/10/12/922980490/scientists-confirm-nevada-man-was-infected-twice-with-coronavirus)  have been published reporting about individuals becoming infected with COVID-19 more than once. If it is possible for people to be infected multiple times with COVID-19, herd immunity may not be possible long-term due to availability of people that are susceptible.

Some in the medical community are against the notion of herd immunity because it eliminates prevention of a disease. Dr. Christopher J.L. Murray, the director for Institute for Health Metrics and Evaluation and a lead COVID-19 modeler, described herd immunity: “As a strategy, it simply means letting an awful lot of people die because we let the virus spread through the whole population, and it’s not really a strategy at all.” (http://www.healthdata.org/video/covid-19-myth-herd-immunity?fbclid=IwAR3rxptFGmLWdIz99WLexoRgjaGCOQ2S1_90ThUcaYfQaeIeZYsbaQ9llOg)

According to an article in The Lancet (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31924-3/fulltext), “Studies in June and July cast doubt on prospects for herd immunity: despite months of exposure, antibody surveys found a low seroprevalence, less than 10%, in cities in Spain and Switzerland. Commentators in The Lancet concluded that ‘in light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable.’”

In a recent Associated Press article (https://bismarcktribune.com/news/national/un-warns-against-pursuing-herd-immunity-to-stop-coronavirus/article_201e45b2-9865-586a-8b45-dbd1cbb31712.html) the head of the World Health Organization warned against the idea that herd immunity might be a realistic strategy to stop the pandemic, dismissing such proposals as “simply unethical.”

At a media briefing Monday, WHO director, General Tedros Adhanom Ghebreyesus said health officials typically aim to achieve herd immunity by vaccination. Tedros noted that to obtain herd immunity from a highly infectious disease, such as measles, for example, about 95% of the population much be immunized.

“Herd immunity is achieved by protecting people from a virus, not by exposing them to it,” he said.

In the absence of a COVID-19 vaccine, to reduce the risk of infection individuals must follow the universal precautions that have been in place through much of the pandemic response:

  • Avoid large events and mass gatherings.
  • Avoid close contact (within 6 feet) with anyone who is sick or has COVID-19 symptoms.
  • Stay home and/or keep distance between yourself and others if COVID-19 is spreading in your community.
  • If it is difficult to avoid close contact with other individuals, wear a face covering.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water is not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue.
  • Avoid touching your T-Zone (eyes, nose, mouth).
  • Clean and disinfect commonly used surfaces (doorknobs, light switches, counters, electronics, etc.) frequently.

Q: I’ve been tested, now what?

This information is provided by the North Dakota Department of Health

A: Following testing, you should monitor your health. Your next steps are dependent on your specific situation:

  • If you have COVID-19 symptoms (fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea) and are waiting for your test result, you need to isolate at home away from others.
  • If you are NOT a close contact, don’t have symptoms and are being tested for COVID-19, you need to practice physical distancing, and it is recommended that you take precautions such as mask wearing when you are at work or in public places.
  • If you have been identified by public health as a close contact to someone who tested positive for COVID-19, you need to quarantine at home for 14 days from the last time you were exposed.

When you receive your COVID-19 testing results:

  • If you test positive, you will need to stay home for 10 days from your symptom onset or from the date of the test, if you are asymptomatic.
  • If you test positive, you need to isolate from others until:
    • You are fever-free, without using fever-reducing medications for at least 24 hours AND
    • Your other symptoms have improved AND
    • It has been at least 10 days from the onset of your illness if asymptomatic, it has been 10 days since the collection date of your test.
  • If your test results are negative and you are NOT a close contact, you should continue to practice physical distancing and limit interactions as much as possible. You may participate in everyday activities (work, groceries, etc.) but should limit exposure to non-essential public gatherings/places.

If you have additional questions, feel free to contact the state COVID-19 hotline at 1-866-207-2880, Monday through Saturday, from 8 a.m. to 5 p.m. However, individuals seeking specific medical advice should contact their healthcare provider.

Additionally, you may want to create a list of people you have come in contact with, and places you may have visited. Waiting for your COVID-19 Test Results? Review some key steps that can help. You may also want to proactively automate this process by downloading the Care 19 Diary app to track places you have visited or the Care 19 Alert app to help track if/when you may have come in contact with someone who tests positive for COVID-19. Both apps are available for Android and IOS platforms.

More information is available through the ND Department of Health.