With COVID-19 cases, hospitalizations and deaths surging, there’s great anticipation for the first vaccine, which is likely within days of reaching the first hospitals, but the rollout will be complicated and the supply very low at first.
State health officials and infectious disease experts this week have pleaded with the public to wear masks, socially distance and avoid gatherings over Christmas with anyone outside of your household. It will be many months before vaccines are widely available to the public, and in that time, thousands more could get sick and die.
UAB Hospital is one of six sites selected by the Alabama Department of Public Health to receive initial shipments of the Pfizer vaccine possibly by mid-week next week.
UAB is to receive approximately 10,725 initial doses, which will be administered to front-line UAB Hospital personnel, clinical staff and emergency medical services teams from UAB’s seven-county region and other hospitals within Jefferson County.
“It won’t be available in quantities sufficient enough for us to stop this surge right now,” UAB’s Dr. Sarah Nafziger, co-chair of UAB’s Emergency Management Committee, speaking to reporters Friday about the vaccine. “But it’s a ray of hope, and it’s something to help us begin to flatten the curve and hopefully prevent future surges, like the one that we’re experiencing now.”
Nafziger said UAB will be administering vaccines to hospital staff on an appointment basis at a local site, and to staff at outside hospitals at a drive-thru testing site on the hospital’s Highlands campus. UAB will notify those medical workers who’ve been pre-selected as having the greatest need for protection, she said.
Recent news that the Pfizer vaccine is at least 52 percent effective after the first of two required doses could mean that depleted hospital staff could soon start to see some relief.
“That could help us even before we get the second doses,” said Dr. Don Williamson, president of the Alabama Hospital Association and a former Alabama state health officer.
Having those health care workers protected to that degree, and able to continue working as we head into what will likely be a dark January, is going to be critical, Williamson explained.
Alabama could begin receiving a shipment of 41,000 doses of the Pfizer vaccine in a matter of days, arriving in batches of 1,000. It’s unclear how long it will take for the full shipment to arrive. Half will go to employees at those six hospitals selected as initial receiving sites, while the other half will be set aside for EMS workers, hospital staff at other hospitals and outside physicians’ offices who are at greatest risk from COVID-19, Williamson said.
Pfizer’s is a two-dose vaccine, but Williamson said the federal government has said to use all of those initial 41,000 doses and the government will provide the required follow-up doses three weeks later.
The Pfizer vaccine’s 95 percent effectiveness at preventing infection is promising, but the vaccine comes with its own challenges. It has to be stored in expensive ultracold freezers and it is only being shipped by the federal government in shipments of 1,000 doses, so accepting facilities must be able to store and administer that amount of vaccine.
Williams said “assuming there’s no problems with storage,” those initial vaccines should all be administered within a week to 10 days.
An advisory panel of the FDA gave approval for the Pfizer vaccine on Thursday afternoon, and the agency is expected to give final approval later on Friday.
The Moderna vaccine, which doesn’t have that same ultracold storage requirement and will come in smaller quantities, is slated to be considered by the FDA in a matter of days.
“Moderna will dramatically increase the number of sites that can administer the vaccine and house the vaccine,” Williamson said. “For us, the first two weeks are probably the worst.”
Once the Moderna vaccine comes into play, many of those problems associated with the Pfizer vaccine should disappear, Williamson said, but vaccines will still be in short supply.
Williamson said planning the rollout of COVID-19 vaccines has been challenging for everyone involved.
“Trying to plan the largest vaccine initiative, certainly since polio, with so many unknowns, and especially with a vaccine that is so much more difficult to manage than the oral polio vaccine,” Williamson said.
“Not only do you have to manage the vaccine. You’ve also got to remember this is an infectious disease,” Williamson said. “So you’ve got to maintain social distancing between the people you’re vaccinating.”
Additionally, the Alabama Department of Public Health over the last several years has lost staff due to budget constraints, so the department has less staff able to help administer and oversee vaccinations.
“I know they don’t have as many nurses as they used to. That’s going to be an issue,” Williamson said. “I know the hospitals, the last thing they want to do is to divert staff who are taking care of COVID patients to give vaccines.”
The Alabama Board of Nursing recently adopted emergency rules to allow for temporary emergency licenses for nurses to return and help provide vaccinations, and hospitals outside of those initial six sites will be supplying their own staff to administer vaccines to their workers, Williamson said.
As for how shipments of vaccines will proceed in the future, Williamson said “what we have been told is that we will get more vaccines every week.”
Half of the second week’s shipment of the Pfizer vaccine will be allocated to the state’s nursing homes, Williamson said, and the following week, 25 percent of the shipment will go to those nursing homes.
John Matson, the spokesman for the Alabama Nursing Home Association, told APR this week that throughout the COVID-19 pandemic Gov. Kay Ivey and Alabama State Health Officer Dr. Scott Harris have made nursing homes a priority, and that it’s been no different with the vaccines.
Vaccines will be delivered and administered to residents and staff at nearly every nursing home in the state by pharmacies that are members of a partnership program through the Center for Medicare and Medicaid Services and the Department of Health and Human Services, Matson said.
Two Alabama nursing homes are located inside hospitals, and those facilities will use hospital staff at those locations to administer vaccines, he said.
Prior to COVID-19, Alabama had approximately 24,000 nursing home residents and 31,000 employees. Intake has dropped since the pandemic, Matson said, so the resident number is currently lower while staffing has remained much the same.
Matson said initially, nursing homes are to be allocated enough of the Pfizer vaccine to protect approximately 26,000 people. The partnering pharmacies will return to administer the second required doses 21 days after the first, he said.
“And then there would be subsequent allotments after that to bring us up to 52,000 doses, which is the amount the federal government estimates that’s needed,” Matson said.
Once vaccinations are administered in sufficient amounts to then allow for more admissions into nursing homes, Matson said, decisions will need to be made about whether to vaccinate new residents prior to admission or afterward.
“COVID-19 has been a very long journey, and it’s been a very difficult journey for residents, our staff and their family members,” Matson said. “And hopefully, this is what we need to finally put COVID-19 behind us.”
Dr. Mark Wilson, Jefferson County’s health officer, told reports Friday that it’s still unclear how long immunity from COVID-19 will last after vaccination, or if additional booster shoots will be necessary after a period of time.
“That’s information that is still to be determined,” Wilson said.
Asked how long it may be before the broader public will have access to vaccines, Wilson said: “This is where people are going to have to be patient.”
“We don’t know exactly how long it’ll be, but I think our expectation should be, that might be late spring or early summer,” he said.