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Virginia begins planning for eventual COVID-19 vaccine
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Virginia begins planning for eventual COVID-19 vaccine

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In March Neal Browning receives a shot in the first-stage safety study clinical trial of a potential vaccine for COVID-19, the disease caused by the new coronavirus, at the Kaiser Permanente Washington Health Research Institute in Seattle.

Doses of an eventual COVID-19 vaccine are expected to make their way to Virginia just days after federal regulators clear the serum, and preparations have begun in Virginia for the immunization effort.

More than 500 organizations with physicians on staff have already expressed interest in helping administer the vaccine, according to the Virginia Department of Health, which has begun outreach efforts to prepare to administer the vaccine.

Elderly people living in congregate settings, who face an outsize risk for COVID-19 complications, as well as health care workers, are expected to be among the first groups to receive doses of the vaccine, federal and state officials say, though the federal government has not yet determined priority groups.

“We’ve been working with the state regarding the vaccine planning, and we’re making sure our members are registered to be a vaccine provider, and are receiving the information they need to prepare,” said Dana Parsons with LeadingAge Virginia, an association of not-for-profit nursing home and elderly care providers.

The worldwide race to develop a vaccine that is safe and effective is moving ahead at an unprecedented pace, with nearly a dozen vaccines undergoing large-scale clinical trials for a virus that had never infected humans a year ago. At least five of those vaccines are being financial backed by the U.S. government, which has guaranteed free doses to all Americans in phases.

Virginia’s gatekeeper

Virginia’s health agency will be the gatekeeper for vaccine administration in the state, at least in the early stages, according to the state’s draft vaccination plan submitted to federal officials earlier this month. When the Centers for Disease Control outlines priority groups, the state will coordinate distribution across the state depending on infection rates and other risk factors. And it will help fund much of that effort.

“We are having conversations with providers now, talking with hospitals, talking with long-term-care facilities,” said Christy Gray, who leads immunization efforts at the Virginia Department of Health. “It’s better to have these now and to be ready for when a vaccine is available.”

The plan also outlines the costs facing the state to administer the vaccine, even though the doses themselves will be funded by the federal government. The state anticipates it’ll need $71 million to help local health districts set up community clinics, and $3.4 million to pay for supplies like syringes and alcohol pads facilities will need to administer the vaccine. The state is also planning a $3 million public education campaign.

The state’s vaccine plan was first reported by the Virginia Mercury.

Availability

When supply of the vaccine is high enough to allow for broader administration, the state anticipates doses will become available at pharmacies, pop-up clinics by local health departments, grocery stores and higher-education institutions.

The effort also includes the state’s hospitals.

“Hospitals across the commonwealth are also developing internal and organizational processes for vaccinating staff members, patients and the communities they serve,” said Julian Walker, a spokesman for the Virginia Hospital and Health Care Association, the advocacy arm for the state’s hospitals.

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Access to the first doses will be much more limited. In addition to nursing home, long-term care facilities and health care workers, “priority groups” might also include: other essential workers in food distribution, child care, transportation and law enforcement; racial and ethnic minority groups at higher risk for the virus; people in correctional facilities; and people attending college in person.

While the federal government will set broad priority groups, if Virginia’s doses can’t meet that demand, the state will determine which subgroups will be first in line for the vaccine. The state recently created a new advisory group representing 90 organizations to help inform those decisions.

“Our intent is to ensure that the vaccine is accessible, affordable and actively distributed throughout Virginia, in the amount of doses we have at the time we have them,” Gray said. “We’re not going to send them all to Southeast Virginia at first. But that doesn’t mean that we will have enough for everybody at first.”

Gray said the advisory group is also thinking through likely barriers to access, and plans to ensure no one has to travel far to receive a dose of the vaccine.

The state is working to recruit providers that can administer the vaccine, particularly facilities that might be first up to receive doses. As of Oct. 11, 508 facilities had signaled interest to VDH.

Once vetted and trained, the state will provide facilities with supplies such as needles, syringes, alcohol swabs and personal protective equipment like face shieldsat no cost.

The state is asking all facilities planning to administer vaccines to register with the state’s immunization registry, which logs individual vaccine records and is only accessible by health professionals.

Uncertainties

Much uncertainty shrouds the state’s preparations for the COVID-19 vaccine. Aside from the lack of clarity about when exactly the vaccine will be ready, Gray said it’s also unclear whether individuals will need more than one dose, and what the time between those doses should be—which could complicate administration efforts.

Also unclear is what the storage needs will be for the serum. The state is planning for a vaccine that can sit at room temperature, one that requires ultra-cold storage at 80 degrees below zero, and anything in between.

“These are very basic questions that we are used to working with as it relates to vaccines,” Gray said. “I cannot emphasize enough how much we are continuing to learn about requirements and processes that are going to be included as part of the COVID-19 vaccine response. This is an ever-evolving process.”

The state’s plan also includes a large public communications campaign designed to explain the phased access to the vaccine and dispel concerns.

States like New York have sought to assuage skepticism by vowing to vet any federally approved vaccine. New York Gov. Andrew Cuomo said in September that he would assemble a panel of experts to review the vaccine’s safety and effectiveness, though it’s unclear what exactly that will entail.

Gray said public health officials in Virginia will review any publicly available information from manufacturers and the federal government about the effectiveness and safety of the vaccine, but did not throw into question her trust in the federal officials tasked with approving the vaccine.

“Anybody in the health care community wants to see that. It is common in science to look at your colleagues and what they’re doing and the data that they’re looking at. There is an unofficial capacity of reviewing what the recommendations say, but there is not a formal plan to have some formal decision made at this time,” Gray said.

“We can make any other decisions at a later time as needed. Those decisions will be made on the basis of science.”

mleonor@timesdispatch.com

(804) 649-6254

Twitter: @MelLeonor_

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