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Organization vaccine pop-up clinic interest survey

 

This information will be kept private and confidential in accordance with the Employer Vaccine Promotion Survey Privacy Notice

 

The New Jersey Department of Health (NJDOH) is conducting a survey of New Jersey employers to assist in the COVID-19 public health emergency response vaccination effort to ensure fair and equitable distribution of COVID vaccines for individuals eligible to receive vaccine in New Jersey.  This survey will allow NJDOH to gauge the interest of employers in hosting a temporary vaccine pop-up clinic to further enhance vaccine coordination efforts.  Other than for that purpose, the information you provide is confidential and will only be shared with the entities noted below and will not be shared with any other person, company or federal or State agency unless sharing it is required by law.   Please read the rest of this Privacy Notice for more detailed information.

 

Is completion of this survey required?

No. Completion of the survey is not required but is strongly encouraged.  Survey responses will allow NJDOH to better understand and serve the needs of New Jersey employers and further enhance vaccine coordination efforts.  

 

What categories of information does the survey collect about your organization?

NJDOH will collect certain information about your organization, including your contact information, the number of workers you employ, and your organizations’ interest in hosting a temporary vaccine pop-up clinic.

 

Why is it necessary that the survey collect this information?  

This information is necessary in order for NJDOH to gauge the interest and volume of employers interested in hosting a temporary vaccine pop-up clinic, especially in geographic areas with low vaccination rates, to further enhance NJDOH’s vaccination coordination efforts.

 

With whom does NJDOH share information in the survey?  

NJDOH may share the information provided in the survey with the Governor’s Office, the NJDOH COVID-19 Vaccine Support Call Center (Vaccine Call Center), or Vaccine Administration Providers.  Vaccine Administration Providers include New Jersey Local Health Departments, health care facilities, homecare agencies, pharmacies and other organizations authorized to schedule and administer COVID-19 vaccines.  More information on Vaccine Administration Providers is available in the New Jersey COVID-19 Vaccination Plan. [1]  The Vaccine Call Center is supporting the New Jersey COVID-19 Vaccination Plan on behalf of the NJDOH.  Lastly, NJDOH will share information collected in the survey with other third parties only if required to do so by law.

 

Will my organization be contacted based upon my response to the survey?

Your organization may be contacted by NJDOH, the Governor’s Office, the Vaccine Call Center, or a Vaccine Administration Provider to host a temporary vaccine pop-up clinic, after NJDOH has gauged the volume of interest and need for temporary vaccine pop-up clinics at employer-based sites.

 

How and when will survey response information be shared?

After you complete the survey, NJDOH may share the information with the Governor’s Office and use the information to gauge volume of interest and need throughout the State for temporary vaccine pop-up clinics, especially in geographic areas with low vaccination rates.  Depending upon the volume of interest and need throughout the State, NJDOH may share your organization’s information with the Vaccine Call Center or a Vaccine Administration Provider to assist in identifying a Vaccine Administration Provider to meet your organization’s needs.  The Vaccine Administration Provider will use the information you provided in the survey to contact you and to coordinate a no-cost temporary on-site vaccine clinic. All Vaccine Administration Providers are enrolled as New Jersey Immunization Information System users pursuant to New Jersey Immunization Law (N.J.S.A. 26:4-131, et seq.) and Rules (N.J.A.C. 8:57-3.1, et seq.) and are required to maintain the confidentiality of COVID-19 vaccination information in accordance with the Emergency Health Powers Act (N.J.S.A. 26:13-1, et seq.).

 

Can I correct information I entered into the survey?

There is no option to correct information your organization enters into the survey.  If your organization is contacted by NJDOH, the Governor’s Office, the Vaccine Call Center, or a Vaccine Administration Provider identified to assist your organization, you may correct or clarify any information with that agency or entity at that time.

    

Is information collected by NJDOH in this survey confidential and secure?

Yes, as stated above, the information gathered about your organization by the survey will be used only for public health vaccination purposes in the COVID-19 public health emergency response.  Information you provide in this survey will not be monetized or sold.  All Vaccine Administration Providers have been authorized to administer COVID-19 vaccinations and are required to maintain the confidentiality of COVID-19 vaccination information in accordance with the Emergency Health Powers Act (N.J.S.A. 26:13-1, et seq.).  

 

NJDOH will share information collected about your organization in the survey with a third party only if required to do so by law.  This means that NJDOH will defend the confidentiality of your information under the Emergency Health Powers Act if it is requested by a third party unless the law that the third party requestor is relying upon to request the information is determined to override the confidentiality protections provided under the Emergency Health Powers Act.  

 

In addition, to protect the confidentiality of the information gathered about your organization by the survey, NJDOH adheres to federal and State laws and generally recognized Information Technology industry security frameworks, namely:  the Federal Information Security Modernization Act of 2002 (FISMA), 44 U.S.C. 3541 et seq.; the Center for Internet Security (CIS) critical security control standards, and the Cloud Security Alliance (CSA) Cloud Controls Matrix (CCM).  NJDOH also complies with the Statewide Information Security Manual issued by the New Jersey Office of Homeland Security and Preparedness (OHSP), in collaboration with the NJ Office of Information Technology.  These frameworks are designed by information technology specialists to protect your confidential information from a data security breach.  

 

Contact:

Please direct any questions to the State of New Jersey’s Vaccine Support Call Center at supportnjvss@doh.nj.gov or 855-568-0545.

 

Need More Information:

More details on COVID-19 vaccination are available at https://covid19.nj.gov/vaccine.

 


[1] New Jersey COVID-19 Vaccination Plan: 

https://nj.gov/health/legal/covid19/NJ%20Interim%20COVID-19%20Vaccination%20Plan%20-%20Revised%2012-15-20.pdf