Rolling up their sleeves
When coronavirus vaccine reaches the Lehigh Valley, health networks are ready to get to work
The fevered pursuit of a vaccine to conquer the coronavirus pandemic appears to be paying off. But getting the shot — or, more likely, two shots — to the majority of the population will be a whole new challenge.
The logistical problem of jabbing hundreds of millions of arms is obvious. What makes it all the more daunting is how many people are reluctant to get a vaccine created on such a compressed timeline, nomatter how many studies show it to be safe and effective.
That problem is reflected in polls of health care workers and first responders who would be among the first in line for the shot, said Dr. Jeffrey Jahre, infectious disease specialist with
St. Luke’s University Health Network.
“A rough estimate is that
probably no morethan 50 or 60% will agree initially,” he said.
Vaccination is a hard-enough sell even in flu season, when a single shot can reduce the chance of getting the flu by about half or more, and makes the illness milder in those who do get it. In the 2018-19 flu season, only about 49% of Americans got a flu vaccine, according to the Centers for Disease Control and Prevention. That’s far below the agency’s 70% annual target.
At a news conference Thursday, Health Secretary Dr. Rachel Levine said part of the state’s vaccination budget will gotoward communication and outreach to persuade people the shots are safe. Thevaccinesweredeveloped under a federal program called Operation Warp Speed, which Levine considers a misleading name because it implies undue haste. Vaccines were developed so quickly because of the unprecedented simultaneous efforts of so manypharmaceutical companies.
Regardless of the level of hesitancy, the roll-out of a coronavirus vaccine — which experts say could begin by the end of November — will demand a nimble and efficient response fromproviders.
Of six vaccine candidates, all but one require an initial shot followed by a second about three weekslater. But scheduling is only part of the problem. Shipping and storage demands will limit how efficiently some of the vaccines can be administered.
Thecandidate from Pfizer Inc., for example — touted for a 90% efficacyrate in clinical trials — has to be stored at nearly 100 degrees below zero.
“It contains genetic material that can easily degrade,” said Dr. Alexander Benjamin, chief infection control and prevention officer with Lehigh Valley Health Network, where two ultra-cold freezers — each capable of storing anestimated 100,000-120,000 doses of the vaccine — stand ready.
Another candidate, from ModernaInc., uses the samekind of genetic material — synthetic RNA — to provoke an immune response, and had an efficacy rate of nearly 95% in trials. It requires cold storage at about 4 degrees below zero.
Once these vaccines are defrosted, they have to be used in a short time. Benjamin said that adds to the challenge. For example, an emergency medical technician who is frequently at a hospital emergency department might decide to get a flu shot on the spur of the moment, but it can’t work that way with cold-storage vaccines.
“Ideally they could just roll up to an emergency room and say, ‘I have time to get a shot,’ “Benjamin said. “Theseneedtobescheduled. I can’t have people say, ‘I’m going to show up’ and then not show, because then that clock is ticking.”
Dr. Anthony Fauci, the nation’s leading infectious disease expert, told a recent conference that cold-storage challenges could affect distribution around the world, according to Reuters.
“In a country like the U.K. and the United States we can address them and it still would be challenging. But probably muchmore challenging in countries in the developing world,” Fauci said.
Other vaccine candidates, however, were developed with different technology and require only ordinary refrigeration.
In St. Luke’s and LVHN, the Lehigh Valley is home to two enormous and efficient health care systems. Both are equipped to store the ultra-cold vaccines and to distribute any vaccine on a mass scale.
Precisely how the distribution will happen isn’t yet clear. The state has a plan to vaccinate health care workers, first responders and high-risk patients in two phases and the general public after that.
The plan has been submitted to the federal government for review.
But it’s unclear if distribution will be restricted to medical facilities or if it could be given in public places, as LVHNdoeswith its massive annual drive-thru flu shots clinic at Dorney and CocaCola parks.
Like other health officials, Jahre cautioned that no one should consider the pandemic over after the vaccines are rolled out. Even under the best circumstances, distribution will take months, and it will be some time before officials can judge whether virus transmission is under control.
“Don’t expect the vaccine in and of itself is going to be this magic bullet we’ve all been waiting for,” Jahre said.
He also cautioned that some of the emerging information on vaccine effectiveness has been coming from the companies themselves.
“I feel like this kind of information should not be coming from a CEO who may be concerned about stock prices and this sort of thing,” he said. “If it proves to be untrue, it’s going to defeat the aim not only of having a vaccine but having enough people who trust it. Let the FDA or others do the talking.”
Benjamin said reassuring the community about vaccination is something the networks can start doing now through educational outreach. Residents need to know that beyond the federal government and the drug companies themselves are local experts with an eye on safety.
“We want people to know that the product is being vetted,” Benjamin said. “That we’re going to be the first ones to put up the red flag if something is wrong.”