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{"sheet":"READ THIS - Instructions","index":0,"n_rows":32,"n_cols":4,"rows_kept":32,"cut":false,"hidden":true,"merged":[[27,3,27,7],[30,1,30,9],[31,1,31,9],[21,3,21,9],[22,3,22,9],[23,3,23,7],[24,3,24,8],[25,3,25,9],[17,3,17,9],[18,3,18,9],[19,3,19,9],[20,3,20,9],[26,3,26,9],[12,1,12,9],[13,3,13,8],[14,3,14,9],[15,3,15,9],[16,3,16,9],[7,1,7,9],[8,1,8,9],[9,1,9,9],[10,1,10,9],[11,1,11,9],[2,1,2,9],[3,1,3,9],[4,1,4,9],[5,1,5,9],[6,1,6,9]]}
[]
[]
[null,"Instructions  (Version 1.0, December 2020)"]
[]
[null,"Purpose of this Tracking Worksheet:"]
[null,"Please use this worksheet to help log and track the number of residents who are vaccinated for COVID-19. When you enter COVID vaccination data for each resident in the Tracking Worksheet, and select a reporting week, the data to be entered into NHSN will be automatically calculated on the Reporting Summary. "]
[null,"Summary Instructions:"]
[null,"Any residents admitted to your facility should be added to the Tracking Worksheet.  When residents are vaccinated, enter the vaccination information onto the Tracking Worksheet.  When residents are discharged, enter the discharge date onto the Tracking Worksheet. NOTE: Residents who are discharged do not need to be deleted off the Tracking Worksheet but should be entered on the worksheet by entering the Resident Discharge Date. When a reporting week is selected, only those who were current residents during the reporting period will be included in the Reporting Summary.  Only vaccinations, contraindications, and other conditions, including adverse events should be reported for the reporting week hence, this information will be displayed in the Reporting Summary. If data entries are made in error, they can be removed with the \"delete\" key; Using the \"Backspace\" key may not delete the entry and may return a warning."]
[null,"Detailed Instructions:"]
[null,"NOTE: In order for this spreadsheet to operate at 100%, please ENABLE MACROS and save as \"Excel Macro Enabled Workbook\""]
[null,"A. The red Asterix (*) is required for reporting to NHSN. Note: The other boxes are for optional NHSN reporting "]
[null,"B. Enter data in rows (from left to right) when entering vaccine data for each resident"]
[null,"C. Steps for Entering Resident Vaccination Data on the TrackingWorksheet tab:"]
[null,null,1,"Enter the unique (*Facility ID#) for the reporting facility"]
[null,null,2,"Select the (*First Day of the Reporting Week) that you plan to generate the report"]
[null,null,3,"Enter the (*Resident Admit Date) to the facility. A date must be entered. If unknown choose a date before the first reporting week (e.g., 12/1/2020)"]
[null,null,4,"Enter the (*Resident Discharge Date) from the facility (when applicable)"]
[null,null,5,"Enter resident’s first name, last name, DOB (date of birth) or Other identifier"]
[null,null,6,"Enter date the resident vaccinated with dose 1  (*Vaccinated with Dose 1)"]
[null,null,7,"Select vaccine name from the drop-down box (*Dose 1 Vaccine Name)"]
[null,null,8,"Enter date the resident vaccinated with Dose 2 (*Vaccinated with Dose 2)"]
[null,null,9,"Select vaccine name from the drop-down box (*Dose 2 Vaccine Name)"]
[null,null,10,"Enter date for any (*Adverse Event Noted) "]
[null,null,11,"Enter date for any (*Contraindications Noted)"]
[null,null,12,"Enter date the resident declined COVID vaccine (optional)"]
[null,null,13,"Select YES/NO if the resident was vaccinated at another location (optional)"]
[null,null,14,"Select YES/NO if the resident has a previous positive COVID-19 test"]
[null,null,15,"Enter any additional comments (optional)"]
[null,null,16,"Click on the \"ReportingSummary\" Tab to see data to be entered into NHSN for the reporting week."]
[]
[null,"IMPORTANT **DO NOT send this form to NHSN, this form is to ONLY be used by your facility for COVID vaccine data collection and record keeping purposes**"]
[null,"Please refer to the TOI (Table of Instructions) for further details on NHSN reporting at https://www.cdc.gov/nhsn/ltc/weekly-covid-vac/index.html"]

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[]
[]
[]
[null,"Instructions  (Version 5.0, June 2021)"]
[]
[null,"Purpose of this Tracking Worksheet:"]
[null,"Please use this worksheet to help log and track the number of residents who are vaccinated for COVID-19. When you enter COVID vaccination data for each resident in the Tracking Worksheet, and select a reporting week on the Weekly Summary, the data to be entered into the OHA survey will be automatically calculated on the Weekly Summary sheets. NOTE: If you are reporting into NHSN, the data to be entered will be automatically calculated from the Weekly Summary sheet."]
[null,"Summary Instructions:"]
[null,"Any residents admitted to your facility should be added to the Tracking Worksheet.  When residents are vaccinated, enter the vaccination information onto the Tracking Worksheet.  When residents are discharged, enter the discharge date onto the Tracking Worksheet.                     \nNOTE: Residents who are discharged do not need to be deleted off the Tracking Worksheet but should be entered on the worksheet by entering the Resident Discharge Date. When a reporting week is selected, only those who were current residents during the reporting period will be included in the Weekly Summary.  The All Resident Summary will capture all residents who were in the facility since the introduction of vaccines, regardless of the reporting week selected. \nNOTE: If data entries are made in error, they can be removed with the \"delete\" key; Using the \"Backspace\" key may not delete the entry and may return a warning. Deleting or inserting rows on the Tracking Worksheet may result in calculation errors. Please delete or clear contents of cells rather than removing or adding rows."]
[null,"Detailed Instructions:"]
[null,"A. The red Asterix (*) is required for reporting. Note: The other boxes are for your own surveillance tracking."]
[null,"B. Enter data in rows (from left to right) when entering vaccine data for each resident"]
[null,"C. Steps for Entering Resident Vaccination Data on the TrackingWorksheet tab:"]
[null,null,1,"Enter the unique (*Facility name) for the reporting facility"]
[null,null,2,"Enter the (*Resident Admit Date) to the facility. A date must be entered. If unknown choose a date before the first reporting week (e.g., 12/1/2020)"]
[null,null,3,"Enter the (*Resident Discharge Date) from the facility (when applicable)"]
[null,null,4,"Enter resident’s *first name, last name, DOB (date of birth)"]
[null,null,5,"Enter date the resident vaccinated with dose 1  (*Vaccinated with Dose 1)"]
[null,null,6,"Select vaccine name from the drop-down box (*Dose 1 Vaccine Name)"]
[null,null,7,"Enter date the resident vaccinated with Dose 2 (Vaccinated with Dose 2)"]
[null,null,8,"Select vaccine name from the drop-down box (Dose 2 Vaccine Name)"]
[null,null,9,"If you selected \"Unspecified\" for dose 1, Select YES/NO if the vaccination series is complete"]
[null,null,10,"Enter date for any (Adverse Event Noted) "]
[null,null,11,"Enter date for any (*Contraindications Noted)"]
[null,null,12,"Enter date the resident *declined COVID vaccine"]
[null,null,13,"Select YES/NO if the resident was vaccinated at another location (optional)"]
[null,null,14,"Select YES/NO if the resident has a previous positive COVID-19 test"]
[null,null,15,"Enter any additional comments (optional)"]
[null,null,16,"Click on the \"WeeklySummary\" and Select the Week of data collection first day (Monday) from the dropdown. Once selected, the data to be entered into the OHA Survey for the reporting week will be populated."]
[]
[null,null,17,"Click on the 'Save Summary Worksheet' button to save an excel worksheet for OHA weekly reporting."]
[null,null,18,"Access the OHA reporting survey (https://epiweb.oha.state.or.us/fmi/webd/CovidVax) to report summary data to OHA."]
[null,null,19,"Click on the \"AllResidentSummary\" Tabs to see the All Resident data."]
[null,null,null,"NOTE: If reporting to NHSN, use the data on the \"WeeklySummary\" Tab to enter into NHSN."]
[null,"IMPORTANT **This form is to ONLY be used by your facility for COVID vaccine data collection and record keeping purposes**"]

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[]
[null,"COVID-19 Vaccination Tracking",null,null,null,null,"*Facility Name:",null,null,null,"   (Enter your Facility Name Here)"]
[null,"for Residents of Long-Term Care Facilities",null,null,null,null,"Vaccination type:",null,null,"COVID_19"]
[null,"TRACKING WORKSHEET",null,null,null,null,null,null,"*First day of Reporting Week (Monday):","2020-12-14",null,"  *Select the Monday of the start of the week you are reporting"]
[null,null,null,null,null,null,"Last day of the reporting week (Sunday):",null,null,{"$f":"IF(ISBLANK(J4),\"-\",J4+6)","v":"2020-12-20"},null,"   Last day of the reporting week automatically populated"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"**ENTERING DATA IN THIS COLUMN MAY RESULT IN ERRORS**"]
[null,"*Resident Admit Date","Resident Discharge Date","*Resident     Last Name (Enter name)","*Resident First Name (Enter name)","*Date of Birth (DOB) (Enter Date)","*Vaccinated with Dose 1 (Enter date of vaccination 1)","*Dose 1 Vaccine Name (choose from drop-down)","Vaccinated with Dose 2 (Enter date of vaccination 2)","Dose 2 Vaccine Name (choose from drop-down)","Is Vaccination Series Complete? Select Yes/No if cell is red","Adverse Event Noted This Week? (Enter date of event)","*Contra-Indication Noted (Enter date of Contra-Indication)","*Declined COVID Vaccine (Enter date of Declination)","Vaccinated at Another Location? Select: Yes/No","History of laboratory postive COVID-19? Select: Yes/No","Additional Comment (optional)","Fully Vaccinated Date\n(this field is automatically calculated) "]
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{"sheet":"WeeklySummary","index":3,"n_rows":35,"n_cols":10,"rows_kept":35,"cut":false,"hidden":false,"merged":[[31,1,31,2],[25,1,25,2],[30,1,30,2],[9,1,9,2],[11,1,11,2],[20,1,20,2],[1,1,1,2],[2,1,2,2],[4,9,4,15],[9,3,11,3],[1,4,3,14],[5,3,6,14],[8,9,8,16]]}
[]
[null,"Weekly COVID-19 Vaccination Summary for Residents \nof Long-Term Care Facilities",null,null,"This sheet automatically populates summary counts for OHA reporting based on your Tracking Worksheet. The cells highlighted in red below are required to report on a weekly basis to OHA.\nNOTE: If your facility also reports to NHSN, please utilize this WeeklySummary sheet for reporting."]
[null,"TRACKING WORKSHEET"]
[]
[null,"Facility Name:",{"$f":"TrackingWorksheet!J2","v":0},null,"Access the OHA reporting survey (link):",null,null,null,null,"https://epiweb.oha.state.or.us/fmi/webd/COVIDVax?homeurl=http://www.healthoregon.org/coronavirushcp"]
[null,"Vaccination type: COVID-19 ",{"$f":"TrackingWorksheet!J3","v":"COVID_19"},"*Select the reporting week for OHA (and NHSN). These dates should match the reporting week you are submitting data for on the OHA (and NHSN) reporting forms."]
[null,"*Week of data collection first day (Monday): ","2021-05-24"]
[null,"Week of data collection last day (Sunday): ",{"$f":"IF(ISBLANK(C7),\"-\",C7+6)","v":"2021-05-30"}]
[null,"Date Last Modified:"]
[null,"Weekly Vaccination Coverage for Current Residents",null,"Weekly Percentages"]
[null,"1. *Number of residents staying in this facility for at least 1 day during the week of data collection",{"$f":"SUM(Calculations!D:D)","v":0}]
[null,"2. *Number of residents in Question #1 who have received COVID-19 vaccine(s) at this facility or elsewhere:   "]
[null,"2.1. Only dose 1 of Pfizer-BioNTech COVID-19 vaccine ",{"$f":"SUM(Calculations!E:E)","v":0},{"$f":"IFERROR(C13/C11,0)","v":0}]
[null,"2.2. Dose 1 and dose 2 of Pfizer-BioNTech COVID-19 vaccine",{"$f":"SUM(Calculations!F:F)","v":0},{"$f":"IFERROR(C14/C11,0)","v":0}]
[null,"2.3. Only dose 1 of Moderna COVID-19 vaccine ",{"$f":"SUM(Calculations!G:G)","v":0},{"$f":"IFERROR(C15/C11,0)","v":0}]
[null,"2.4. Dose 1 and dose 2 of Moderna COVID-19 vaccine",{"$f":"SUM(Calculations!H:H)","v":0},{"$f":"IFERROR(C16/C11,0)","v":0}]
[null,"2.5 Dose of Janssen (J & J) COVID-19 vaccine",{"$f":"SUM(Calculations!I:I)","v":0},{"$f":"IFERROR(C17/C11,0)","v":0}]
[null,"2.99 Complete COVID-19 vaccination series: unspecified manufacturer ",{"$f":"SUM(Calculations!L:L)","v":0},{"$f":"IFERROR(C18/C11,0)","v":0}]
[null,"Number of residents in Question #1 who completed vaccine series",{"$f":"C14+C16+C17+C18","v":0},{"$f":"IFERROR(C19/C11,0)","v":0}]
[null,"Number of residents in Question #1 who are fully vaccinated \n(≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine) ",{"$f":"SUM(Calculations!AP:AP)","v":0},{"$f":"IFERROR(C20/C11,0)","v":0}]
[null,"3. Number of residents in Question #1 with other conditions:"]
[null,"3.1 *Medical contraindication to COVID-19 vaccine",{"$f":"SUM(Calculations!P:P)","v":0},{"$f":"IFERROR(C22/C11,0)","v":0}]
[null,"3.2. Offered but declined COVID-19 vaccine",{"$f":"SUM(Calculations!Q:Q)","v":0},{"$f":"IFERROR(C23/C11,0)","v":0}]
[null,"3.3. Unknown COVID-19 vaccination status",{"$f":"C11-SUM(C13:C18)-SUM(C22:C23)","v":0},{"$f":"IFERROR(C24/C11,0)","v":0}]
[null,"3.4. History of laboratory-confirmed SARS-CoV-2 infection",{"$f":"SUM(Calculations!R:R)","v":0},{"$f":"IFERROR(C25/C11,0)","v":0}]
[null,"COVID-19 Vaccine(s) Supply"]
[null,"4.1. If your facility has enrolled as a COVID-19 vaccine provider, has your facility received any COVID-19 vaccine(s) by the end of the week of data collection? [Yes, No, Other]"]
[null,"  Please briefly describe your answer. "]
[null,"4.2 If your facility has enrolled as a COVID-19 vaccine provider, was your COVID-19 vaccine supply sufficient to vaccinate your facility’s residents by the end of the week data collection? [Yes, No, Other]"]
[null,"  Please briefly describe your answer. "]
[null,"Adverse Events following COVID-19 Vaccine(s)"]
[null,"5. * Number of residents with clinically significant COVID-19 vaccine adverse events identified this week"]
[null,"5.1. Pfizer-BioNTech COVID-19 vaccine",{"$f":"SUM(Calculations!M:M)","v":0}]
[null,"5.2. Moderna COVID-19 vaccine",{"$f":"SUM(Calculations!N:N)","v":0}]
[null,"5.3. Janssen (J & J) COVID-19 vaccine",{"$f":"SUM(Calculations!O:O)","v":0}]

{"sheet":"AllResidentSummary","index":4,"n_rows":32,"n_cols":4,"rows_kept":32,"cut":false,"hidden":false,"merged":[[1,4,4,13],[27,1,27,2],[28,1,28,2],[7,3,9,3],[1,1,1,2],[2,1,2,2],[7,1,7,2],[9,1,9,2],[17,1,17,2],[22,1,22,2]]}
[]
[null,"COVID-19 Vaccination Summary for ALL Residents of Long-Term Care Facilities"]
[null,"TRACKING WORKSHEET"]
[]
[null,"Facility Name:",{"$f":"TrackingWorksheet!J2","v":0}]
[null,"Vaccination type: COVID-19 ",{"$f":"TrackingWorksheet!J3","v":"COVID_19"}]
[null,"Date Last Modified:"]
[null,"Vaccination Coverage for ALL residents since the introduction of vaccines",null,"Cumulative Percentages"]
[null,"1. *Number of residents staying in this facility for at least 1 day since the introduction of vaccines",{"$f":"SUM(Calculations!U:U)","v":0}]
[null,"2. *Number of residents in Question #1 who have received COVID-19 vaccine(s) at this facility or elsewhere:   "]
[null,"2.1. Only dose 1 of Pfizer-BioNTech COVID-19 vaccine ",{"$f":"SUM(Calculations!V:V)","v":0},{"$f":"IFERROR(C11/C9,0)","v":0}]
[null,"2.2. Dose 1 and dose 2 of Pfizer-BioNTech COVID-19 vaccine",{"$f":"SUM(Calculations!W:W)","v":0},{"$f":"IFERROR(C12/C9,0)","v":0}]
[null,"2.3. Only dose 1 of Moderna COVID-19 vaccine ",{"$f":"SUM(Calculations!X:X)","v":0},{"$f":"IFERROR(C13/C9,0)","v":0}]
[null,"2.4. Dose 1 and dose 2 of Moderna COVID-19 vaccine",{"$f":"SUM(Calculations!Y:Y)","v":0},{"$f":"IFERROR(C14/C9,0)","v":0}]
[null,"2.5 Dose of Janssen (J & J) COVID-19 vaccine",{"$f":"SUM(Calculations!Z:Z)","v":0},{"$f":"IFERROR(C15/C9,0)","v":0}]
[null,"2.99 Complete COVID-19 vaccination series: unspecified manufacturer ",{"$f":"SUM(Calculations!AC:AC)","v":0},{"$f":"IFERROR(C16/C9,0)","v":0}]
[null,"Number of residents in Question #1 who completed vaccine series",{"$f":"C12+C14+C15+C16","v":0},{"$f":"IFERROR(C17/C9,0)","v":0}]
[null,"3. Number of residents in Question #1 with other conditions:"]
[null,"3.1 *Medical contraindication to COVID-19 vaccine",{"$f":"SUM(Calculations!AG:AG)","v":0},{"$f":"IFERROR(C19/C9,0)","v":0}]
[null,"3.2. Offered but declined COVID-19 vaccine",{"$f":"SUM(Calculations!AH:AH)","v":0},{"$f":"IFERROR(C20/C9,0)","v":0}]
[null,"3.3. Unknown COVID-19 vaccination status",{"$f":"C9-SUM(C11:C16)-SUM(C19:C20)","v":0},{"$f":"IFERROR(C21/C9,0)","v":0}]
[null,"3.4. History of laboratory-confirmed SARS-CoV-2 infection",{"$f":"SUM(Calculations!AI:AI)","v":0},{"$f":"IFERROR(C22/C9,0)","v":0}]
[null,"COVID-19 Vaccine(s) Supply"]
[null,"4.1. If your facility has enrolled as a COVID-19 vaccine provider, has your facility received any COVID-19 vaccine(s) by the end of the week of data collection? [Yes, No, Other]"]
[null,"  Please briefly describe your answer. "]
[null,"4.2 If your facility has enrolled as a COVID-19 vaccine provider, was your COVID-19 vaccine supply sufficient to vaccinate your facility’s residents by the end of the week data collection? [Yes, No, Other]"]
[null,"  Please briefly describe your answer. "]
[null,"Adverse Events following COVID-19 Vaccine(s)"]
[null,"5. * Number of residents with clinically significant COVID-19 vaccine adverse events identified"]
[null,"5.1. Pfizer-BioNTech COVID-19 vaccine",{"$f":"SUM(Calculations!AD:AD)","v":0}]
[null,"5.2. Moderna COVID-19 vaccine",{"$f":"SUM(Calculations!AE:AE)","v":0}]
[null,"5.3. Janssen (J & J) COVID-19 vaccine",{"$f":"SUM(Calculations!AF:AF)","v":0}]

{"sheet":"Calculations","index":5,"n_rows":1001,"n_cols":42,"rows_kept":1001,"cut":false,"hidden":true,"merged":[]}
[]
[null,"Blank Entry?","Patient UID","Resident for at least 1 day of the week?","Pfizer-BioNTech only dose 1","Current Resident - Pfizer 2 Dose","Current Resident - Moderna 1 Dose","Current Resident - Moderna 2 Dose","Current Resident - Janssen Dose","Current Resident- Completed series unspecified","Currrent vax series complete?","Current completed series unspecified","Residents had adverse event after Pfizer-BioNTech during the reporting week","Residents had adverse event after Moderna during the reporting week","Residents had adverse event after Janssen during the reporting week","Contraindication before end of week?","Declination before end of reporting week?","Current Resident Past Covid +?",null,"Min Vacc Date","Resident for at least 1 day cumulative?","Pfizer-BioNTech only dose 1 cumulative","Pfizer-BioNTech dose 1 and dose 2 cumulative","Moderna only dose 1 cumulative","Moderna dose 1 and dose 2 cumulative","Janssen dose cumulative","Unspecified dose cumulative","vax series complete?","completed series unspecified","HCP had adverse event after Pfizer-BioNTech since reporting began?","HCP had adverse event after Moderna during the reporting week","HCP had adverse event after Janssen during the reporting week","Contraindication cumulative","Declination cumulative","Infection cumulative","Complete series","Fully Vax Pfizer","Fully Vax Moderna","Fully Vax Janssen","Fully Vax unspecified","Fully vax complete","Fully vax"]
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[]
[null,"Drop Down Dates (Mondays)",null,"Vaccine Manufacturers",null,"Vaccine Manufacturers",null,"Pfizer 2nd Dose List",null,"Moderna 2nd Dose List"]
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