Distribution of vaccine will be ‘logistical nightmare’

Hurdles in the state include vast, rural spaces, uninsured population, public distrust

Rolling out a COVID-19 vaccine in New Mexico will present several obstacles that may be difficult to surmount, Department of Health officials told lawmakers Tuesday (Oct. 27).

From not yet knowing what drug may be approved by the federal government to distribution issues and public distrust of a vaccination itself, administering inoculations in New Mexico likely will be a “logistical nightmare,” said state Rep. Deborah Armstrong, D-Albuquerque, a member of the interim legislative Health and Human Services Committee.

A draft 60-page distribution plan the state sent to the federal Centers for Disease Control and Prevention on Oct. 16 also includes no target date for when a vaccine might be available to the public. The Department of Health and the governor’s office did not immediately respond to an inquiry into when vaccines might be widely available.

State health officials said they’re expecting a vaccine to be available to a select few critical workers in the health care industry by mid-November or December.

The Department of Health made the draft plan publicly available for the first time Tuesday.

Aja Sanzone, a top infectious disease doctor leading the state’s COVID-19 planning effort, and other health officials briefed the interim panel Tuesday on plans to distribute and administer a vaccine, which prioritize health care workers and first responders before it goes to the public.

Officials said vaccine challenges include:

• A vaccine must be kept at extreme subzero temperatures, then raised to room temperature in stages within a short window of time, before injected.

• A vaccine must be distributed in small batches because of unique temperature requirements.

• New Mexico has vast spaces and a largely rural setting.

• Many in New Mexico are at high risk of serious COVID-19 infection. About 18 percent of the population is age 65 or older, 19.5 percent of the population lives in poverty and 11.4 percent of residents under 65 are uninsured, according to the state’s vaccine distribution plan.

• Coordinating 23 Native American pueblos, tribes and nations with sovereign governments and varying health care systems adds to the complexity of administering a vaccination.

But perhaps the biggest hurdle, officials said, will be simply convincing enough people to get vaccinated. For New Mexico to reach immunity to the virus, at least 70 percent of state residents would need to take the vaccine.

That means health care providers and the Health Department would need to administer roughly 2.9 million vaccinations — a number that is more than double the average 1.1 million annual flu vaccine doses. Anti-vaccination sentiments and distrust of the expedited process could make it difficult to reach that number. And sate health officials said they are finding declining interest in a vaccine.

About 58 percent of Americans nationwide said this month they’d get vaccinated as soon as possible, according to a Department of Health presentation. That’s down from 69 percent in mid-August.

Sanzone said a public information campaign will be crucial to convincing enough people to take a vaccine to reach a critical mass that would slash community spread of the virus.

The speed at which a vaccine may become available is due to sharing information, conducting numerous vaccine trials at once and a massive, unprecedented collaboration between developers, Sanzone said.

“This is a historical populationwide immunization effort,” she said. “Something like we’ve never seen before.”

The rollout will be split into three separate phases: During phase one, vaccines will be limited to key health care personnel and likely in limited supply. The state will likely rely on experienced, large vaccine providers to administer a vaccine, according to the draft plan.

As supplies become more available, vaccines will expand to first responders, other health care providers and staff and service providers who have direct contact with people with COVID-19 or who work in facilities that care for large groups of people. Older patients, those with underlying conditions and other vulnerable populations and essential workers are next on the list.

In phase two, which has no projected date, a vaccine will be more widely available, with health care providers and pharmacies offering one.

The state plans to engage in “targeted outreach to specific economic sectors, extensive coordination with public schools, child care providers, institutions of higher education and particular industries such as the hospitality industry,” the draft plan said.

Phase three, which also has no projected date, is the scenario in which the state has sufficient supply of a vaccine and works on long-term storage, “communitybased actions” and more outreach “to overcome potential apprehension toward vaccination.”

In this phase, “All New Mexicans who wish to have a COVID-19 vaccine will be able to receive one,” the plan said.