With few answers on how and when a COVID-19 vaccine will actually be available, Connecticut has submitted a draft plan to the federal government on how it will execute statewide mass vaccination.
The 77-page document, submitted to the U.S. Centers for Disease Control and Prevention by the Oct. 16 deadline, outlines potential groups of people who would receive priority status for getting doses early on and how the state will coordinate vaccine administration by medical providers.
Gov. Ned Lamont’s COVID-19 vaccine advisory group met Thursday night for the first time, virtually. Dr. Reginald Eadie, president and CEO of Trinity Health of New England, serves as co-chair.
“I think we all would agree that an equitable immunization program with a safe and effective COVID-19 vaccine is a critical component to our state’s strategy to reduce COVID-19 illnesses, hospitalizations, of course, deaths, and to restore societal functioning,” he said.
More than 62,000 positive COVID-19 cases have been recorded in Connecticut since the spring, and 4,540 people have died as of Thursday.
There are nearly a dozen SARS-CoV-2 coronavirus vaccine candidates worldwide in Phase 3 large-scale human clinical trials. Johnson & Johnson, a front-runner, recently paused its trial to investigate an “unexplained illness” in a study participant.
Last month, British-Swedish company AstraZeneca halted its global trials to investigate a case of transverse myelitis in a volunteer.
AstraZeneca’s trials quickly resumed in sites around the world, but they remain paused in the United States pending a U.S. Food and Drug Administration investigation, according to the New York Times.
Deidre Gifford, acting commissioner of the state Department of Public Health, said Connecticut’s final vaccination plan will likely change given so many unknowns right now.
“We are doing our best to prepare,” she said, “but also knowing that we need to remain flexible and adapt as we get further information.”
Gifford said federal officials remain cautious about a COVID-19 vaccine timeline, but they’ve suggested in meetings with state leaders that there may be an answer on the effectiveness and safety of at least one of the Phase 3 vaccines by the end of the year.
Lamont’s main vaccine advisory group includes 20 members from Connecticut’s hospitals, health centers, business associations, legislature, advocacy groups, health equity organizations, labor unions, houses of worship, aging services and state departments.
Even more experts, residents, state officials, legislators, advocates and others make up three subcommittees focused on vaccine allocation, vaccine science, and communication.
The state’s draft plan outlines a phased approach to COVID-19 vaccination. Eadie said the ultimate goal is to have enough vaccines available for everyone, but it’s likely that there will be a limited number of doses in the beginning.
“We’ve got to prioritize, at least initially, who gets the vaccine,” he said.
Priority groups that would be eligible for vaccines in Phase 1 of the plan may include essential workers, both medical and non-medical, and people at high risk of severe COVID-19 illness, like those with underlying medical conditions and people over 65 years old.
The state is actively surveying all licensed medical providers to determine who or what organizations are interested in administering the vaccine to people. The survey collects information on storage capacity for vaccine doses and an estimate of how many people that health location or office could vaccinate each day.
Local health departments, pharmacies and other health clinics will also be involved, according to the state plan. Local health departments should prepare to vaccinate their municipal workers.
DPH is also working with the Connecticut Hospital Association to recruit hospitals to administer the vaccine. Hospitals would be ideal if the minimum order for vaccine in Phase 1 is a large quantity of 1,000 doses.
Kathy Kudish, DPH immunization program manager, said the COVID-19 plan will also require some policy and structural changes. Education for health providers on enrolling and using the state’s existing vaccine program will be necessary.
She said many pediatricians and other health providers who administer childhood vaccines are already accustomed to these systems.
“COVID-19 vaccine planning and distribution will necessitate an entirely new group of health care providers signing on,” Kudish said.
Connecticut law requires health care providers who administer childhood vaccines to report those doses to a state tracking system, but that does not extend to vaccines given to adults. In order to track COVID-19 doses, Kudish said an executive order currently being drafted will create a reporting component.
“Patient-level information is important should it be necessary to trace back down to the precise lot number of COVID vaccine what was administered to a patient to help ensure patient safety and to monitor adverse events,” Kudish said.
Many COVID-19 vaccines in development require two doses given several weeks apart. Kudish said reporting and monitoring systems will be critical to ensure people come back for their second dose and that they get the same type of vaccine as they did the first time.
Jason Schwartz, assistant professor of public health at the Yale School of Public Health, specializes in vaccine policy in the United States. He said Connecticut and other states don’t have to start from scratch when it comes to planning for COVID-19 vaccines.
“Even though there’s so much that’s unprecedented about this vaccination program that lies ahead and so much that’s unknown,” Schwartz said, “I think hopefully it will be reassuring to individuals who are just learning about vaccination and vaccine policy … to learn what a strong foundation we have here in Connecticut.”
The main vaccine advisory group will meet once a month for the rest of this year. The subcommittees will begin meeting next week.