With a patchwork of COVID-19 vaccination approaches unfolding across the nation, Washington Permanente Medical Group in Seattle has found a way to get patients in the door and have a needle in their arm in about five to 10 minutes.

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It allowed the health system to immunize nearly 47,000 people during the first eight weeks that vaccines were available.

Paul Minardi, MD, president and executive medical director of Washington Permanente Medical Group in Seattle discussed how they made those numbers a reality during a recent episode of the “AMA COVID-19 Update.”

To start, the group took a high-level operational approach.

“We have a defined population. We understood exactly where each one of the phases were. We identified all the people in that population, both at a state level, local level, and also inside of the organization level, and we were able to define then how many vaccines will we need, in what locations,” Dr. Minardi said. “Then, [we asked] what process will we need in people, process in systems, to be able to bring that all together and harmonize and orchestrate the entire end-to-end process.”


Leaders at Washington Permanente Medical Group—a member of the AMA Health System Partner Program—considered how they wanted to have people enter the buildings for the immunizations so that it was done safely, efficiently and with social distancing.

They considered screening questions to ensure people deeply understood risks associated with the vaccine.

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Before vaccine distribution, they built what they call an eVisit, which allows patients to check their eligibility for the vaccine and then links the eligibility directly to an appointment. When Washington entered their tier B1 phase that opened up vaccine eligibility to those 65 and older, and those older than 50 who lived in a multigenerational household, there were about 600 eVisits an hour.

“There was an initial surge, but we crafted and created each one of the components—both on phone and voice, as well as web and app—to make sure that we harmonized, and we were able and capable to be able to manage all of that,” Dr. Minardi said.

Before Washington Permanente Medical Group began to vaccinate people, they ran simulations at several sites to work out any hiccups, create efficiencies and improve the effectiveness of the entire process, Dr. Minardi said.

“We couldn't be more proud of what we've done, and we've continued to improve since we embarked on vaccinating the population,” he said.

Beyond having systems ready to go, it was important to communicate within the Permanente Group and with the larger community to make sure people understood if they qualified for a vaccine and where they were in line to receive the immunization.

And the communication must continue, especially to help people understand vaccine supply and demand, tiering systems and eligibility for the vaccine, Dr. Minardi said.

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Permanente also is going directly to employer groups and using webinars to inform them about what is happening with the vaccine, and the organization has held a series of town halls every Tuesday since the pandemic began to serve as a source of truth. Dr. Minardi said they are talking about setting up more than a dozen sites on school campuses and gymnasiums, as well, to help vaccinate the areas school teachers in the public and private sector. 

All of the preparation, simulation and communication has helped ensure people have a good experience, prompting some to write letters to the editor of local papers such as The Seattle Times, Dr. Minardi said.

“At the end of the day, they become the best ambassadors for others to become vaccinated. They become the best people with telling their truths ... to other family and friends,” he said. “What we need as a community is to create that synchronous herd immunity that'll avoid all the variants, that'll avoid the fourth wave, if you will, and really end the pandemic.”

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