COVID-19 Long-Term Care Vaccination

Board of Health  - Emergency Rule

The State Board of Health approved emergency rules requiring vaccination for staff in licensed health care settings. The Board met August 30 to consider a request from Governor Polis to implement rules requiring licensed health care facilities to require their personnel -- including employees, direct contractors, and support staff -- who interact with individuals seeking medical care to receive the COVID-19 vaccine. 

According to the emergency rule, each facility shall develop and implement a policy and procedure to ensure 100% of employees, direct contractors, and support staff have obtained full COVID-19 vaccination status in accordance with the schedule below: 

  • All employees, direct contractors, and support staff must have received their first dose of the COVID-19 vaccination no later than September 30, 2021. 

  • All employees, direct contractors, and support staff must have received their second dose of the COVID-19 vaccination (if applicable) no later than October 31, 2021. 

  • All employees, direct contractors, and support staff must obtain a subsequent, or booster, dose of the COVID-19 vaccination should one be recommended by the Advisory Committee on Immunization Practices (ACIP), in accordance with the recommended timelines. 

  • An employee, direct contractor, and support staff member who was diagnosed with COVID-19, or who received monoclonal antibody treatment or convalescent plasma treatment, shall obtain their vaccination in a timeframe that is in accordance with the recommendations of Centers for Disease Control and Prevention (CDC), ACIP, and the individual’s licensed independent practitioner. 

  • On or after October 31, 2021, each facility shall ensure all newly hired employees, direct contractors, or support staff members have obtained full COVID-19 vaccination status.  

  • Beginning October 1, 2021, each facility shall report its COVID-19 vaccination rate to the department on the first (1st) and fifteenth (15th) day of the month.

CDC and FDA Booster Dose Guidelines

The director of Centers for Disease Control and Prevention (CDC) has endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendation for a booster shot of COVID-19 vaccines in certain populations. The Food and Drug Administration’s (FDA) authorization and CDC’s recommendation for use are important steps forward as we work to stay ahead of the virus and keep Americans safe.

Governor Polis signed Executive Order D 2021-137 making every Coloradan who is 18 years of age and older and six months past their second dose of the Pfizer or Moderna vaccine, or two months past their Johnson & Johnson vaccine, eligible for the safe and effective COVID-19 booster. Additionally,  Public Health Order 21-01 includes a provision requiring providers to administer second shots and any additional or booster shots regardless of where the individual received prior vaccinations. It also requires providers to administer vaccine to any individual who self-attests that they meet the criteria approved by the FDA and recommended by  CDC. Finally, it requires vaccine administrators to submit vaccination and demographic data to CDPHE within 48 hours of administration.

There are now booster recommendations for all three available COVID-19 vaccines in the United States. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.

Public Health Order 20-20 (Eighth Amended) - September 27, 2021
Booster Vaccine Clinics
  • The eighth amended Public Health Order 20-20, addresses COVID-19 Booster Dose Clinics.

    • By October 25, 2021 and in accordance with Food and Drug Administration (FDA) approval and Advisory Committee on Immunization Practices (ACIP) recommendations for any COVID-19 vaccine authorized or approved for a booster dose, each facility that has a population that is eligible for a booster dose shall complete a COVID-19 booster dose clinic for current eligible residents and staff.

    • By October 1, 2021, each facility shall schedule a COVID-19 booster dose clinic and communicate the confirmed clinic date and vaccine provider via email to

Ongoing Vaccination Plans

Additionally, with the eighth amended Public Health Order 20-20, each facility must establish and maintain a COVID-19 mitigation plan that promotes vaccine confidence and acceptance and must continue to offer vaccinations to all consenting staff and residents. Each facility shall submit to CDPHE a plan which details how the facility ensures vaccinations are offered and provided to all consenting staff and residents. A template for this plan is available here. Minimally, this information must include:

  1. How the facility assesses and addresses the vaccination status of new staff and residents;

  2. The identification of designated staff who coordinate vaccination information, administration and tracking of the vaccination status of staff and residents on an ongoing basis,

  3. Ongoing measures to promote vaccine confidence and acceptance, and; 

  4. The vaccination status of all current staff and residents.

Submission of this information may be completed utilizing this form and must be submitted via email to Plans were due June 14, 2021. This plan must be kept current by the facility and be presented for review during health facility inspections.

Highly Recommended: Facility COVID-19 Vaccination Coordinator and Backup Coordinator complete Colorado Immunization Information System (CIIS) training and obtain access to the CIIS system by following these start to finish steps and these instructions. Additionally, see the CIIS Enrollment Requirement Presentation.

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Continuing Vaccination:

The Residential Care Strike Team has outlined the following next steps for LTC facilities to continue vaccinations:

  • The facility identifies residents and/or staff requiring vaccination (we encourage you to work with other LTC facilities in geographic areas to run coordinated clinic(s), when possible, to meet vaccine minimums)

  • The facility contacts LTC pharmacy or retail pharmacy it typically utilizes for routine resident medications to determine vaccine availability  

  • If the LTC pharmacy or retail pharmacy the facility typically utilizes is unable to meet the request or the facility does not have a relationship with an LTC pharmacy or retail pharmacy, the facility contacts a LTC pharmacy from this mapped  list of LTC pharmacies willing to service facility location (geographically). Alternatively, here is a list of providers (.pdf) 

  • LTC pharmacy fulfills request and schedules vaccinations with the facility contact (or in some instances LTC pharmacy provides vaccine/vital supplies and facility nurse(s) vaccinates identified residents and/or staff at facility)  

  • If LTC pharmacies near a facility location are unable to meet the request, the facility should utilize the following:

  • If unable to locate vaccinator through available resources provided, the facility should contact

  • For residents and staff who are able to go to an offsite vaccine clinic, use the Where can I get vaccinated? site to locate available options.

Strike Team Assistance:

If your LTC pharmacy would like to become a COVID-19 vaccine provider, please email: and to get started.