COVID-19 Vaccination Provider Enrollment, Vaccine Request, and Resources

Vaccine requests
Enrollment
Resources
Community vaccination program
Reporting adverse reactions
Patient education

Weekly Vaccine Requests

Providers must make a new request each week in order to receive vaccine. Request both first and second doses. Second doses are not sent automatically.

Vaccine Redistribution: For redistribution, please use the vaccine transfer form below. Vaccine transfers are approved on a case by case basis. Vaccine should be ordered directly through MIIX unless there is an extenuating circumstance
Vaccine Transfer FormPlease allow time for this process to be approved
Order via MIIX
for at least 100 doses of Moderna, 100 doses of Janssen*, 100 doses of pediatric Pfizer (ages 5 to 11), or 300 doses of adult (ages 12 and up) Pfizer vaccine.
Delivery: Moderna vaccine orders usually arrive in 1-2 days, and Pfizer orders in 3 days.
* Note: The FDA has limited Janssen COVID-19 vaccine use to certain patients. More information

Provider Enrollment

If your facility plans to administer COVID-19 vaccine, you must enroll as a COVID-19 provider.
For a healthcare personnel or healthcare facility to receive and administer vaccine priority groups, including healthcare staff, you must be enrolled as a COVID-19 vaccine provider.

Individual healthcare providers and personnel do not have to be enrolled as COVID-19 vaccine providers to be vaccinated against COVID-19.

COVID-19 Community Vaccination Program

MSDH is offering funding from the CDC to ensure greater equity and access COVID-19 vaccine by those disproportionately affected by COVID-19. MSDH needs the assistance of enrolled immunization providers to administer COVID-19 vaccination within their local communities. Populations that have been disproportionately affected by COVID-19 include, but are not limited to:

People in racial and ethnic minority groups
People living in rural communities
People who are underinsured or uninsured
Communities with high social vulnerability index

Requirements and enrollment application

Vaccine Resources

Letters of authorization, facts sheets and resources for providers and recipients.

Planning and Training

Reporting Adverse Reactions (VAERS)

The preferred way to submit an adverse reaction report to the CDC's Vaccine Adverse Event Reporting System (VAERS) is with their online form.

Submit an online report to VAERS
The online VAERS Report must be completed and submitted in the same 20-minute session; it cannot be saved and edited at a later time.

Alternate method:

Download a PDF form to submit
This writeable PDF form can be downloaded and completed electronically on your own time.
Submit a completed PDF form
Submit a writeable PDF that you have completed offline.