Richmond Times-Dispatch

States rampupforb­iggest vaccinatio­n effort in history 95%

- BY CANDICE CHOI AND MICHELLE R. SMITH

With COVID-19 vaccines drawing closer, public health officials across the country are gearing up for the biggest vaccinatio­n effort in U.S. history — a monumental undertakin­g that must distribute hundreds of millions of doses, prioritize who’s first in line and ensure that people who get the initial shot return for the necessary second one.

The push could begin as early as next month, when federal officials say the first vaccine may be authorized for emergency use and immediatel­y deployed to high-risk groups, such as health care workers.

“The cavalry is coming,” Dr. Anthony Fauci said this month. He said he hopes shots will be available to all Americans in April, May and June.

Vaccines being developed by Pfizer and the biotechnol­ogy firm Moderna have reported an effectiven­ess of about 95%. The good news came in one of the grimmest periods of the pandemic so far, with deaths, hospitaliz­ations and new infections surging across the U.S. — and turning up the pressure to get the vaccine effort right.

In Philadelph­ia, the health department is counting how many health care workers and others would be among the first in line. In Louisiana, officials are planning a remote exercise this week to play out different scenarios exploring how the process might unfold.

“If you get 10,000 doses, what are you going to do, versus 100,000 doses?” said Dr. Frank Welch, director of Louisiana’s immunizati­on program.

State and local officials are also planning for the likelihood that the first shipments will not be enough to cover everyone in high-priority groups.

Similar preparatio­ns are happening at the federal level. Welch listened in this month on a “war gaming” session by the U.S. Department of Health and Human Services.

For the vaccinatio­n effort to get off the ground, state officials have been readying systems to track supplies and who has been vaccinated. That informatio­n will be fed into a national network and will be critical in giving federal health officials an up-to-date picture of vaccinatio­ns around the country.

Providers such as pharmacies and doctors’ offices will also need to be able to look up records, so people do not have to return to the same place for their second shot. More than one vaccine could also become available, and doses cannot be mixed and matched.

“We not only have to bring people back for a second dose, but need to make sure that we have very good records of which vaccine they received the first time,” said Dr. Jinlene Chan of Maryland’s health department.

States already have immunizati­on registries, which will be used for COVID-19.

To better understand whether at-risk groups are getting vaccinated, the CDC wanted providers to report the race and ethnicity of the people they vaccinate. But pharmacies and other providers that do not always collect that informatio­n objected.

“We have to be careful not to put too many administra­tive burdens on providers that are already stressed,” said Mitchel Rothholz of the American Pharmacist­s Associatio­n, an industry group.

“The cavalry is coming,” Dr. Anthony Fauci said

this month. He said he hopes shots will be available to all Americans

in April, May and June.

To help people find doses in their area, the CDC wants to put informatio­n on a vaccine finder website.

Supplying that inventory informatio­n might be a staffing strain for some providers, including a hospital in Utah that said it only has one person who currently enters the informatio­n, said Jon Reid, who manages the state’s immunizati­on registry.

“And they don’t do it every day. They do it whenever,” Reid said. State officials in Utah plan to update the inventory, rather than ask each provider to enter it, he said.

States are also working to expand the number of pharmacies, doctors’ offices and other providers that can administer COVID-19 vaccines, to ensure shots are convenient­ly available.

But enrollment can be time-consuming, Reid said, because providers often need help filling out forms, getting technical systems working and going through inspection­s to ensure they can meet storage requiremen­ts. The Pfizer vaccine needs to be kept at minus 70 degrees Celsius (minus 94 F).

Reid does not expect smaller pharmacies to become COVID-19 vaccine providers.

Because of the likely need for two doses given three or four weeks apart, the Centers for Disease Control and Prevention is considerin­g ways of helping Americans remember the second shot, including issuing cards that people would get with their first shot, akin to the polio immunizati­on cards many older Americans remember carrying.

Many people will likely

need additional prodding. In a rural part of South Carolina, one community health center is planning multiple reminders, including text messages and calls from health workers.

Still, “there will still be some that slip through the cracks,” said Ann Lewis, CEO of CareSouth Carolina, which runs the health centers.

Distributi­ng doses is another issue. The Pfizer vaccine, which could be the first to get the green light, comes in shipments of nearly 1,000 doses.

“A minimum of 1,000 doses makes it very difficult to get smaller facilities vaccinated,” said Rich Lakin, director of Utah’s immunizati­on program.

Shipments might go to a hospital that is easily accessible to health care workers from multiple sites, Lakin said.

In North Dakota, providers receiving fewer than 1,000 doses will have them shipped to a state warehouse that can maintain the ultra-cold storage.

“We’ll break them down into the smaller quantities and then drive them to the provider,” said Molly Howell, the state’s immunizati­on director.

State and local health department­s will break up and redistribu­te shipments of other vaccines, which are expected to require orders of at least 100 doses, for smaller providers that do not need that many. But even if distributi­on goes smoothly, officials worry people will not want the shots. “If there’s going to be any real challenge, to be honest with you, it’s going to be convincing folks to get the vaccine,” said Patrick Peer, who runs the Good Neighbor Community Health Center in Columbus, Neb.

 ?? THE ASSOCIATED PRESS ?? Healthwork­ers process people at a drive- thru flu clinic in Carlton, Minn. The facility offered away to social distance in the coronaviru­s pandemic, but also served as a test run for the COVID-19 vaccines that health officials are only nowlearnin­g about.
THE ASSOCIATED PRESS Healthwork­ers process people at a drive- thru flu clinic in Carlton, Minn. The facility offered away to social distance in the coronaviru­s pandemic, but also served as a test run for the COVID-19 vaccines that health officials are only nowlearnin­g about.
 ?? THE ASSOCIATED PRESS ?? Carlton County, Minn., holds a drive- thru clinic. Such clinics may offer models for howCOVID-19 vaccines are handled.
THE ASSOCIATED PRESS Carlton County, Minn., holds a drive- thru clinic. Such clinics may offer models for howCOVID-19 vaccines are handled.

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