Plans forming for vaccine distribution

A COVID-19 vaccine may still be months away, but distribution plans are already in the works, with experts saying the 2009 H1N1 pandemic offers Ohio’s health departments a road map for what they can expect.

Nearly 11 years ago, health departments across the country had to mobilize to distribute a new vaccine for what experts feared was a return of the deadly H1N1 influenza.

Mass vaccination clinics popped up around Columbus, said Dr. Mysheika Roberts, Columbus Public Health commissioner.

“We had mega clinics for people to come in and get the H1N1 vaccine,” Roberts said. “We are prepared to do something similar to that. But this time we'd like to do as many of them as possible at a drive-thru clinic.”

As with most new vaccines, Roberts said she remembers health care workers, first responders and those with major pre-existing health conditions being first to get the H1N1 shot. She expects a similar process to be followed after a

COVID-19 vaccine is available.

Regardless of when or how a COVID-19 vaccine becomes available, Roberts said there’s one thing Ohioans can do to better protect themselves until then — get a flu shot. While COVID-19 is deadly on its own, Roberts said it could be made worse if someone contracts the virus and the flu at the same time

It’s possible the state or hospitals and nursing homes may require their staffs to receive the vaccine, said Dr. Carlos Malvestutto, an infectious-disease physician at Ohio State University’s Wexner Medical Center.

In 2009, most states and hospitals required staff members to get an H1N1 vaccine. Malvestutto, who was at Bellevue Hospital in New York City at the time, said he had to get one for his job.

The Centers for Disease Control and Prevention has yet to issue guidelines on who will get a COVID-19 vaccine first. But the White House already has told states to be ready to distribute a vaccine by Nov. 1, though it’s unclear if one will be approved and available by then.

Gov. Mike Dewine has said the state won’t wait for vaccine approval to figure out how to dole it out to local health agencies, pharmacies and hospital systems. An Ohio Department of Health spokeswoman said last week that the state is still working on its distribution plan.

“We in Ohio are doing what we can do, and what we can do is get ready for whenever that day is,” Dewine said this month. “It can’t come soon enough, but we obviously want it done right ... whenever that day comes we will be ready.”

Likewise, Columbus Public Health and Franklin County Public Health aren’t waiting either.

Most vaccines need to be kept cold, and the city’s health department is looking into purchasing extra refrigeration equipment to do so. Franklin County Public Health already has purchased more storage equipment in an attempt to double its vaccine storage capacity, said county health commissioner Joe Mazzola.

“Our job is to make sure our community is prepared to take advantage of this vaccine when it becomes available, and we’re taking every step to make sure we’re ready for it,” Mazzola said. “This is the time to plan.”

The federal government plans to start deploying the first vaccine to states within a day of one being authorized by the Food and Drug Administration. The vaccine, when and if it comes, will be free to all Americans.

Approval of a vaccine could come later this year or sometime in January, according to a federal plan released Wednesday.

Experts often compare the COVID-19 pandemic to the 1918 H1N1 pandemic that killed 675,000 Americans, according to the CDC. Although the 2009 outbreak proved far less deadly, it can serve as a good starting point for how to distribute a vaccine fast, said Kelly Moore, associate director of education for the national Immunization Action Coalition and a professor of health policy at Vanderbilt University in Nashville, Tennessee.

Things have to improve though, Moore said, especially given the fact that a COVID-19 vaccine will pose new challenges that flu vaccines have never before presented.

Most people will need two doses, administered three to four weeks apart, for the vaccine to be effective, according to documents from the U.S. Department of Health and Human Services. But there’s concern some people won’t show up for the second shot.

Some of the vaccine candidates currently in Phase 3 trials also might need to be stored at sub-zero temperatures. Moore said one might even need to be shipped with and stored on dry ice.

While urban areas like Columbus have plenty of large buildings and parking lots for vaccine clinics, rural areas pose more of a problem, Moore said.

That’s where pharmacies may come in. Many rural areas don’t have a doctor’s office or a hospital nearby, but they do have a pharmacy, Moore said.

Yet the biggest issue states face in deploying a COVID-19 vaccine is money, Moore said. While money has been allocated for testing, Moore said little to none has been set aside to help states distribute the vaccine when it’s ready.

“Public-health systems haven’t been adequately funded for several years,” Moore said. “I really wish we would start funding public health like we fund our military. We never say: ’OK, we decided we’re going to go to war so we need to start a military.’” mfilby@dispatch.com @Maxfilby