The federal government could grant emergency use authorization to COVID-19 vaccines as soon as next week, potentially getting doses in the hands of Connecticut hospitals by mid-December.
While official statewide distribution plans are still being finalized, health providers do know enough about the upcoming vaccines in order to take some immediate steps in preparation, with little time to spare.
“Our planning timeline is very compressed,” said Dr. Michael Parry, director of infectious diseases at Stamford Health.
Connecticut hospitals and health providers, in cooperation with state departments, are doubling down on purchasing equipment like storage freezers and getting health care workers up to speed with immunization reporting systems in order to be ready to go when COVID-19 vaccines arrive.
And the expedited process is not without logistical and financial challenges.
“It is unprecedented, but then this pandemic is unprecedented,” Parry said. “We have to have a plan in place, we have to have all the infrastructure, that is the IT infrastructure as well as the physical infrastructure, we’ve got to have staff lined up to do the vaccinations, the intake, the record keeping and tracking.”
Independent advisory groups to the U.S. Food and Drug Administration are set to review Pfizer’s COVID-19 vaccine on Dec. 10. Uniquely, this vaccine will need to be kept at minus 70 degrees Celsius, even colder than temperatures in Antarctica, in order to preserve its effectiveness.
That means it can be stored for a short time in dry ice or for longer periods in specialized ultra-cold freezers, which have quickly become a popular commodity.
“Most pharmacies, doctor’s offices don’t have freezer capacity, let alone a minus-70-degree freezer,” Parry explained. “We do and most hospitals do, because they store specimens that are required to be held at those low temperatures.”
Connecticut hospitals that already have these freezers have reported purchasing more in order to expand their storage capacities.
Parry said Stamford Hospital already had two ultra-cold freezers, which house biological specimens. The health system recently purchased a third.
These ultra-low freezers can come with a high price tag, costing on average between $10,000 and $15,000 each.
Keith Grant, senior system director of infection prevention at Hartford HealthCare, said the health system now has three such freezers after purchasing more. The freezer space for COVID-19 vaccines will serve the network’s seven acute-care hospitals.
“In our luckiest process, we’re going to have hundreds of thousands of vaccines to millions of vaccines to distribute,” he said, “individual freezers having the capability of holding over 250,000 vaccines.”
Pfizer’s storage requirements and states’ eagerness for COVID-19 vaccines have put pressure on the supply chain and financial pressure on health providers.
“There’s been a squeeze on pretty much everything,” said Dr. Frederick Browne, chief medical officer at Griffin Health. “We used to spend pennies for gloves, and now they’re much more expensive -- masks, freezers. We knew about the minus 70 [degree] freezer, so we put our order in probably in the summer to get it. And now we’re going to get it in December.”
State Department of Public Health officials said during a November vaccine advisory group meeting that a majority of health networks and their hospitals already have or will soon have the freezer storage, but about five hospitals indicated that they will not.
“It may very well be that for those hospitals that don’t have the capacity, we use a hub and spoke model,” said DPH acting Commissioner Deidre Gifford, “where we are storing the vaccine at the hubs that have the ultra-cold storage, and simply transporting the vaccine on dry ice as it’s used to those facilities that don’t have that storage capacity.”
Gifford said financial assistance from the federal government has been limited, but with the money Connecticut does have, some of it will be set aside for ultra-cold freezers should the state need to purchase some.
However, other COVID-19 trial vaccines will not need the ultra-cold storage. That includes Moderna’s vaccine, another top contender that will get a federal review on Dec. 17.
Parry and other health leaders maintain optimism for the vaccines and their efficacy and safety outcomes in clinical trials.
“The studies so far show that the side effects that occur within a couple days of the shot are very similar to other vaccines,” Parry said. “Low-grade fever, a little aching, maybe headache, a sore arm -- we would certainly educate the patients to look for those. But we don’t anticipate anything more serious than that.”
Based on updated guidance Tuesday from the federal Centers for Disease Control and Prevention, health care workers and people in long-term care facilities will likely get initial doses of the vaccine. Parry anticipates that a majority of front-line workers will volunteer.
“But I think you’ll have a sizable number of people who will not want it because of religious reasons, concerns about side effects; people feel invincible, particularly the younger you are,” he said.
However, Parry said Stamford’s health system and hospital will be encouraging workers to get vaccinated, particularly staff who work directly with patients, or who are more at risk of COVID-19 exposure or severe illness because of age or underlying medical conditions.
“I think we have a responsibility to set an example,” Parry said.
Connecticut Public's Patrick Skahill and Ali Oshinskie contributed to this report.