State spells out vaccine priority list
Health careworkers and first responders are right at the top
AUSTIN — Health care workers, first responders, Texans with chronic health conditions and several other “vulnerable populations” would be the first to receive a corona virus vaccine once one becomes available, state public health officials are proposing.
Under a plan released Monday, Texas again would form a publicprivate partnership for distribution of COVID-19 vaccine. Participation by health care providers and institutions administering the vaccine, as well as individuals receiving doses, would be voluntary.
The plan is similar to one the Texas Department of State Health Services created for allocating vaccine for the H1N1 or “swine flu” virus in 2009.
Through Friday, 1,044 Texas health care professionals, hospitals and long-term-care providers had signed up to eventually receive shipments of the coronavirus vaccine and administer them, department spokesman Chris Van Deusen said.
That was only nine days after Gov. Greg Abbott announced launch of the provider program, calling it a “proactive approach” to getting Texas ready for vaccine distribution.
Of the providers and facilities stepping forward, 237 were in the two public health regions that include Dallas-Fort Worth as well as Abilene and Wichita Falls, said Imelda Garcia, the department’s associate commissioner over laboratories and infectious disease programs.
“A provider could be a whole hospital system with multiple clinics,” she noted.
The Food and Drug Administration hasn’t yet approved a COVID-19 vaccine.
Of the three companies with vaccines in late-stage clinical trials in the UnitedStates, justone— Pfizer — has said that it could have initial results by the end of October.
The other two companies, Moderna and AstraZeneca, have been more vague, saying only that they hope for results before the end of the year.
If a coronavirus vaccine were to show results this year, it would shatter the previous record of four years for the development of a new vaccine.
Late Monday afternoon, Texas health commissioner John Hellerstedt announced the formation of a 17-member Expert Vaccine Allocation Panel. It will help the state make final decisions on who gets first access to the vaccine as it’s released by the federal government.
A “widely available supply,” or enough to reach the public at large, “is probably many months away,” Hellerstedt said.
Referring to “a steady increase in the number of folks hospitalized in the state of Texas since the beginning of themonth,” he stressed, “COVID-19 is a very real danger. … It’s a sneaky disease.”
In the distribution plan, which the state agency Friday sent to the federal Centers for Disease Control and Prevention, the state makes several assumptions.
They include guesses that “initial vaccine availability will not keep pace with demand” and that there will be times “when supply is insufficient even for the most vulnerable populations.”
The state department will have to “carefully consider” how to spread a precious, limited supply, the plan says.
Though an earlier draft had mentioned that unspecified “essential workers” should be at the front of the line, according to the TexasTribune, that phrase doesn’t appear in the final plan.
In a PowerPoint Garcia used to brief a state infectious disease preparedness task force about the plan onMonday, though, she mentioned that essential workers could include employees in “education (and) others with critical roles who cannot easily socially distance.”
The plan puts it more vaguely. “Prioritization will be based on some combination of job functions, exposure potential (i.e., hospital patient care workers, EMS, nursing homes), and individual risk factors for severe illness or poor outcomes,” it says.
It says two doses may be required and that at first, adults will be given priority over children — other than high-risk youths.
Recent polls of Texas adults by the Dallas Morning News and the University of Texas at Tyler have shown state residents are hesitant about taking a coronavirus medicine.
While in April, registered voters by 76 percent to 10 percent said theywere likely to take a COVID-19 vaccine, the margin in September narrowed to 57 percent likely, 25 percent unlikely.
“Individuals are not required by the state to receive the vaccine,” the plan says.
In answering questions by doctors and other members of the public Monday, Garcia noted only one of the companies with a vaccinein aPhase3clinical trial— Pfizer — is testing it on children.
None is studying pregnant women “and hence, these vaccines will not be approved for use in pregnant women,” she said.
In good news for people allergic to eggs, none of the vaccines currently advancing has “an egg component,” Garcia said.
Only one — again, Pfizer’s — would require storage at extremely low temperatures, of as lowas -112 degrees Fahrenheit, she said. But Pfizer is planning to package its vaccine in thermal wrappings that last up to 15 days, Garcia said.
Federal officials are urging states not to rush out to buy ultra cold freezers, she said. Regular freezers shouldwork fine for other vaccines being developed, she said.
Noting the state’s heavy reliance on the CDC’s guidance, she said:
“Everything I just said could completely change in the next few days.”
Van Deusen, the department spokesman, said Texas’ plan is likely to be tweaked “aswe receive feedback from the CDC, get more specifics on the process on the federal side, and learn more about which vaccines will become available first and when.”
The panel Hellerstedt created includes state public health and emergency preparedness experts, as well as four lawmakers — Sens. Lois Kolkhorst, R-Brenham, and Eddie LucioJr., D-Brownsville; and Reps. Stephanie Klick, R-Fort Worth, and Senfronia Thompson, D-Houston.
Hellerstedt said the panel’s “decisions will be difficult” because it’s unknown how much vaccine Texas will receive initially, nor “whether it will be just one vaccine available or suddenly within a week or two, several vaccines. We just don’t know.”
To sign up to be eligible to receive doses of the vaccine to administer to patients, doctors, other health care professionals such as pharmacists, hospitals and long-term care facilities must enroll in the state’s immunization registry known as ImmTrac2. They agree to identify “critical population groups” they serve and report data to the state about vaccine doses they administer.
Participants also agree to administer the vaccine to patients regardless of their ability to pay.
Askedfor abreakoutof the1,044 volunteers, Van Deusen said: “I don’t have it by type of provider.”
Using CDC definitions for “vulnerable and frontline populations,” the state plan identifies these groups as potentially to be designated as the first to receive the vaccine:
• Health care personnel, including Emergency Medical Services workers (more than 1 million, it estimates).
• Police, firefighters.
• Residents of nursing home, assisted living centers or independent living facilities (138,000).
• People with underlying medical conditions (9.5 million, of whom 7.6million are obese).
• People 65 and older (3.9 million).
• Members of racial and ethnic minorities, including tribal communities.
• People incarcerated or detained.
• People experiencing homelessness.
• Higher education students.
• Residents and employees of state mental hospitals and statesupported living centers.
• People with disabilities.
• Rural Texans.
• Uninsured or underinsured people.
In confronting H1N1 just more than a decade ago, Texas found a public-private joint effort would work best because it “harnesses more resources and improves the state’s ability to target certain populations.”