Health staff first to get vaccine

By Krista Allen
Special to the Times

KINLÁNÍ-DOOK’O’OOSLÍÍD, Ariz.

High-priority health care workers in Coconino County will get the first phase of a COVID-19 vaccine.

“We’re working on the logistics around being able to deliver and distribute the vaccination to our employees as well as other candidates for the vaccination,” said Dr. John Mougin, chief quality officer at Flagstaff Medical Center. “Health care leaders across the state are reviewing the efficacy and safety data as this becomes available, as everyone’s very interested … in the details around the vaccinations and the details about potential side effects and also how the testing went with these vaccinations.”

With COVID-19 cases now exceeding 8,500, county health officials are gearing up for the distribution of vaccines. The first are expected to arrive before the end of the month, according to the Coconino County Health and Human Services. Alongside health care workers, long-term care facility residents will also get the first phase of vaccination. “So we’ll be looking at that closely and commenting to that day as it becomes available,” Mougin said, adding that the vaccine will be distributed in phases.

“So, we hope, if things go as planned, we may see as many as 30 million patients or individuals (essential workers and high-risk individuals) vaccinated by the end of January (2021).

“We’re very excited about this news as this could change the landscape on COVID for the whole country,” he said.

Dr. Marjorie Bessel, chief clinical officer at Banner Health, agrees. She said she, along with her medical colleagues, refer to the COVID-19 vaccine as “the beginning of the end of the pandemic.”

“And yet I do want to caution that despite all the great and positive news that we are receiving about the vaccine, that is going to make a significant impact into 2021,” Bessel said, “it is not something that is going to change our trajectory or surge curve (this month).

“So, we’re … continuing to ask everybody to pay particular attention to the mitigation activities that will help us flatten the curve while still remaining positive that vaccine is on the way,” she said.

Gearing up for vaccine

Bessel said Banner Health is working with the state of Arizona – as well as other states – and the counties to be a distributor of COVID-19 vaccine where it makes sense.

“We expect to have three sites within the state … (this month) ready to go if and when we receive vaccine,” Bessel explained. “We continue to prepare and identify individuals who will be the highest priority.

“Those will be health care workers and first responders,” she said. “And we are working very closely with our counties and our states to make sure that we’re able to do that.”

Bessel said Banner Health is also preparing to safely handle the vaccine because Pfizer’s COVID-19 vaccine, which is moving closer to getting the OK in the U.S. (the U.S. Food and Drug Administration later this month will consider one developed by Moderna), requires cold storage. “And we are preparing to be ready for that,” Bessel said. “We are preparing to both document the administration of that vaccine as well as to provide reminders to those individuals when it’s time for their second dose (during the second phase). We remain committed to be ready by mid-December if vaccine comes our way by then.”

Banner Health is expecting to get its first batch of vaccines around Dec. 14.

Messenger RNA vaccines

Messenger RNA vaccines, also called mRNA, are likely to be some of the first COVID-19 vaccines authorized for use in the U.S., according to the Centers for Disease Control and Prevention.

These vaccines are a new type to protect against infectious diseases. To trigger an immune response, many vaccines put a weakened or inactivated germ into bodies. Not mRNA vaccines, which instead teach human cells how to make protein, said Mougin.

“The mRNA causes the body to produce a protein that’s expressed on the COVID-19 virus,” Mougin explained. “The body then develops an immune response against the protein. So, if you get exposed to it, your body will – hopefully – keep the virus from taking hold and prevent infection.”

Mougin said as far as safety data, phase 1 and 2 clinical trial safety data look good, but the phase III data is not out yet. Phase 3, he says, is a broader trial using 30,000 patients and it’ll provide a lot more about safety, which will be critical to health care workers in evaluating how they recommend using the COVID-19 vaccine.

“We’ve had a lot of discussions as to whether or not to make that vaccine mandatory (for NAH staff) to allow it to be voluntarily selected, et cetera,” said Flo Spyrow, CEO for Northern Arizona Health Care, “There will be a lot of issues that we need to address to that.

“But if we can protect our staff, we can be more assured of having the right staff at the right place, at the right level of care,” she said, “to care for our patients as they come to us with health-care needs.” The challenge though is the cold storage and the processing and handling of the vaccine carefully, said Mougin.

Plans for Native nations

“But there are plans to have points of distribution on the (nearby Native nations),” Mougin said. “That being said, at least the initial Pfizer vaccination is distributed in sets of 1,000. “So, for example, a small clinic would not get a distribution of 1,000 doses, they would have to go to one of the distribution centers that have those doses to get vaccinations,” he said. “There’s going to be a lot of logistics around it.”

Mougin said that will get easier over time as more options become available. “But initially, there is a logistical challenge to get the vaccination to everybody that needs it,” he added. “But there are groups working on accomplishing that.”

Bessel added that because there will not be enough COVID-19 vaccine for those who will want it, those who do not want a vaccine will really play a fairly limited role in the initial rollout of vaccine. “Once we get more vaccine, once we have more companies that are able to provide vaccine besides Pfizer, those are issues that we will deal with later into 2021,” Bessel said. “We look forward to receiving vaccine.

“Certainly, all of the data that is being shared with us shows that the Pfizer vaccine and those that are right on the tails of that from other manufacturers is both safe and effective,” she said. “We look forward to learning more about those vaccines, communicating that both to our healthcare workers and first responders as well as to the public at large as vaccine does start to create the beginning of the end of this pandemic and into 2021.”

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