The COVID-19 vaccine is on its way to Dallas, but that doesn’t mean the pandemic will go up in smoke. The United Kingdom approved the vaccine last week, and the antidote is on the way to the United States within the month. Still, here in Dallas-Fort Worth, public health officials and hospital systems are busy climbing the logistical mountain of getting the medicine into the hands that need it most.
The state announced Friday that long term care residents would be added to those who would receive the vaccine after healthcare workers. The Dallas Morning News reported Friday that Dallas officials want first responders like police officers, firemen, and medics to be prioritized for the vaccine, but they may have to wait up to a month because of the limited supply and the state’s prioritization of healthcare workers.
As hospital systems work with local and state public health authorities, Dallas County Medical Director Dr. Philip Huang says his department is busy recruiting providers interested in distributing the vaccine. It isn’t as easy as hanging a clipboard on the wall and seeing who signs up. With several different vaccines on the way, each has its own requirements and procedures. One version requires two different doses three weeks apart, and the medicine must be kept in super-cold freezers. Other versions don’t need to be kept as cold and only require one shot. Patients need to be sure they are getting their second shot at the same location and getting the correct dose.
“Initially, there will probably be limited supplies. How is that allocated and distributed?” Huang wonders. “There are a lot of issues that we are working on with local and state partners, but there are also a lot of unknowns that we’re dealing with.”
Another issue is who will get priority. While a consensus has formed around providing vaccines to healthcare workers, the elderly and immunocompromised, and caregivers for the elderly, questions remain after that. Will there be further prioritization? What about teachers, those who grow and process food, or other essential workers? It will be a difficult task.
“There’s a lot more granular detail that’s going to be needed when you get to where the rubber meets the road at the ground level,” Huang says. “We’re having some discussions about that and the recommendations.”
Hospital systems, too, are trying to find answers about their role in the vaccine distribution.
“We don’t know when or how many doses we’ll get, so we’re trying to get prepared for that,” says Dr. Brett Stauffer, the chief quality officer at Baylor Scott & White Health. Some systems are more extensive than others, while others are better suited for outpatient services like vaccine distribution. “How do we make it as accessible as possible for everybody in North Texas but still tailor it for how their systems are constructed and organized?”
Providers have to follow federal regulations in the vaccine distribution, adhering to the CDC rules, and maintaining the cold storage chain. Within 24 hours of giving the vaccine, providers must create a report to send to the state immunization registry. The ultra-cold storage may be an issue for smaller or rural providers, who may not have the equipment to store that version of the vaccine. Huang says there could be a way to make the doses portable with dry ice or even shipping containers, but storage may be limited, and some doses would have to be administered quickly.
Huang says cost shouldn’t be a factor in receiving the vaccine. Federal dollars will cover the uninsured population, while insurance should cover the vaccine’s cost for those with insurance or Medicare and Medicaid.
“The ability to pay should not be a barrier,” Huang says.
But the most significant challenge right now may be beyond the control of healthcare logistics professionals: trust in the vaccine. The Pew Research Center has been monitoring the American public’s likelihood to receive a vaccine since the beginning of the pandemic. In May, 72 percent of the U.S. said they were likely to receive the vaccine. That number dropped to 51 percent in September, with only 21 percent of respondents saying they would definitely welcome the vaccine. Trust in the vaccine has since rebounded, and in November, 60 percent of those surveyed said they were likely to take the vaccine. Still, nearly two in 10 people said they would “definitely” not get the vaccine when it is available.
The theme of the year for healthcare has been rolling with change. Whether it is adjusting to who can or cannot be seen in the hospital, creating new wings and space for a surge of patients, or revamping airflow, workflow, and personal protective gear, the abnormal has become normal for those the industry. Huang, too, is playing it by ear and doing his best to communicate what he knows.
“At this point, a lot of it is just keeping everyone up to date regarding the latest in this situation,” he says. “Because it is changing so much every day.”