Rowan health director: Local vaccine distribution plan will require ‘all hands on deck’
By Natalie Anderson
SALISBURY — With the approval of two potential COVID-19 vaccinations right around the corner, Rowan County Public Health Director Nina Oliver says a countywide plan that will require “all hands on deck” has been formulated to ensure the more than 140,000 Rowan Countians receive a vaccine quickly and safely.
While there are more companies currently working to develop an effective vaccine, the Food and Drug Administration will be looking at two in the coming weeks. On Thursday, the FDA will publicly discuss the Emergency Use Authorization of the Pfizer-BioNTech COVID-19 vaccine, while Moderna Inc. is on the agenda for Dec. 17.
“From what I understand, the data looks very, very good,” Oliver said.
In a public briefing on last week, Gov. Roy Cooper said the state expects to receive the Pfizer vaccine first because it’s the first likely to be approved by the FDA. Unlike the Moderna vaccine, however, Pfizer requires extremely low temperatures, which Cooper said facilities across the state are able to support in more populated areas.
The first supply will be limited all across the nation, and North Carolina anticipates around 85,000 vaccinations in its first batch.
“As concerning as the numbers are, I and many other North Carolinians have newfound hope in the development of promising vaccines,” Cooper said. “What we know so far is this: safe, effective vaccines should be available soon. Our job is to be ready to get them to people as quickly and effectively as possible.”
During the previous week, state health officials reported, the Advisory Committee on Immunization Practices, convened by the North Carolina Institute of Medicine, met to develop a priority list for vaccine recipients. Using federal guidance, the committee developed a four-phased plan, with health care workers and long-term facility staff and residents among the top priority.
First in line, or Phase 1a, for the vaccine will be health care workers at high risk of COVID-19 exposure, as well as long-term care staff and residents. Health care workers include nurses, physicians, respiratory techs, dentists, hygienists, nursing assistants, environmental services staff, paramedics, home health workers, personal care aides, health care trainees and students, morticians/funeral home staff, pharmacists and health care cleaning staff.
Health care workers will receive the vaccine via hospital systems, while long-term care staff and residents will be served by CVS and Walgreens “strike teams” who will bring the vaccine to them directly.
Next on the list to prioritize, or phase 1b, are adults at high risk of COVID-19 complications, along with a select group of adults who are either aged older than 65 or have two or more chronic conditions that could exacerbate a case of COVID-19. Adults at high risk are prioritized based on their risk of exposure, while the other subset of population in this group could include migrant farm and fisheries workers in congregate housing, incarcerated individuals, homeless shelter residents, frontline workers and health care workers not included in the first phase.
Oliver said much of the county’s population falls within phase 1b. So, she anticipates many residents will be served then.
In the second phase, next up are the aforementioned groups of adults without two or more chronic conditions, education staff, other adults aged 18-64 who have one chronic condition and those aged 65 or older with one or no chronic conditions. North Carolina Department of Health and Human Services Secretary Mandy Cohen said last week it won’t be until January that the phase two group is able to receive the vaccine.
Phase three will include essential workers not vaccinated in the first two phases along with K-12 and college students. The fourth phase includes everyone else.
The state will determine how many vaccinations each county receives based on population and status of community spread. If Rowan County receives the Pfizer vaccine, Oliver said, the state will also provide enough dry ice to change out once. The dry ice has to be replaced every five days. On the 15th day, the vaccine has to be placed inside a refrigerator. The vaccine has to be used no later than day 20, Oliver said. Though, the county plans to distribute all vaccinations as quickly as possible before then.
Oliver said the West End Plaza, 1935 Jake Alexander Blvd. West, will serve as the drive-thru “point of dispensing site,” with three or four lanes available for vehicles to drive up and be vaccinated by nurses. While the details of the traffic flow are being determined, the county’s emergency management staff and law enforcement will assist. Other health care staff will be available as well to help run supplies and answer any questions.
But since that operation will require “all hands on deck,” Oliver said, non-essential medical services and services that aren’t required by law will be suspended, with “skeleton crews” of staff working in local health care settings.
Oliver said county government is currently talking to Rowan-Salisbury Schools to recruit school nurses as well as local nursing and clinical students.
The operational plan is based on a flu pandemic exercise completed last year at the West End Plaza, which included collaboration with county health department staff, local law enforcement, emergency management and the American Red Cross. The event wasn’t organized with COVID-19 on the radar, but it’s serving as a model now.
In a statement on Dec. 2, a spokesperson for the Salisbury VA Health Care System said vaccines it receives will be optional for veterans and employees and that veterans and employees in the Community Living Centers will receive top priority. Any veterans with appointments in high-risk areas will be reviewed for possible vaccination if clinically indicated.
Both veterans and employees will be prioritized based on risk factors.
Employees at the Salisbury VA have been asked whether they are interested in receiving the vaccine when it becomes available. Thus far, more than 400 have registered.
But public sentiment overall shows an uncertainty about taking a vaccine if one were ready sometime in the next year. A High Point University Poll of 1,000 adults conducted in November showed respondents are split between those who say they did intend to receive a COVID-19 vaccine if one were developed within the next 12 months (42%), those who do not intend to receive such a vaccine (31%) and more than one-quarter (27%) who are unsure or do not offer an answer. This is compared to an October poll that reported 37% of registered voters who said they did intend to receive a COVID-19 vaccine if one were developed this year. In that same poll, 36% said they did not intend to receive such a vaccine.
Oliver said people should rest assured knowing the vaccine development didn’t skip any steps and that just the timeline was sped up. More than 70,000 people participated in the human trials for the vaccines.
The vaccine is designed to mimic the illness, which prompts the body to creates antibodies that will ward off the “real germ” when it tries to enter, Oliver said.
“We want people to get vaccinated when it’s your turn,” Cooper said. “We have some concerns about people not wanting to be vaccinated. And if it is authorized by (the state’s) independent advisory board and approved by the FDA, I have confidence in it. I think most of our health care and health experts will have confidence in it. … In order for this to work, we need to get as many people vaccinated as possible.”
Cohen said preliminary data from both companies show the vaccines prevent people from getting COVID-19 at rates higher than many health experts were initially expecting.
“I think the thing that has been reassuring to me is that the scientists that I respect that I know have seen more of the data that I’ve been able to see at this point have all said that it is very positive,” Cohen said. “So we look forward to seeing more of that data. And again, vaccines are really only as effective at preventing COVID if everyone gets vaccinated. We can have these great tools, but we have to use them.”
Though the focus will be getting as many people vaccinated as quickly as possible, Oliver said health officials will continue working to mitigate health disparities and COVID-19 exacerbations among minority populations as well as ensuring they have equitable access to the vaccinations.
“Health equity is extremely important to me,” Oliver said. “That is part of public health’s job. That is definitely something that we’ll be looking at.”
Cooper said the vaccine will be free to all, including those who are uninsured or underinsured. Health care providers are being enrolled in the vaccination program based on their ability to reach priority populations.
But details are still undetermined about how to ensure people receive their second dose of the vaccination when it’s time, Oliver said. Additionally, Oliver said, it’s not yet known how effective the first dose is alone if someone doesn’t follow-up for their second round or what happens if someone receives their second dose late.
The county plans to provide reminder cards to those who are vaccinated about the need to have a second dose. Cohen said the state is currently developing a system to manage vaccine supplies and to ensure everyone gets both doses that’s required. Additional reminder methods from the state could include phone calls, text messages and emails, Oliver said.
As more people get vaccinated, health officials say it’s important to continue practicing the three Ws of washing hands, wearing a mask and waiting 6 feet apart from others.
“The three Ws are tools, whereas a vaccine is a positive weapon,” Oliver added.
Oliver and other health officials will host a virtual question and answer session at noon on Dec. 16 for local residents to get more information on the upcoming COVID-19 vaccines and the plans to distribute them. Questions can be submitted before the event at surveymonkey.
Contact reporter Natalie Anderson at 704-797-4246.
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