Financing, supply chain logistics, and tracking who’s got the shot are just a few of the challenges facing health administrators in the coming months as the first round of COVID-19 vaccines makes its way to Connecticut.
Acting state Public Health Commissioner Deidre Gifford said Tuesday that Connecticut will be ready to give out COVID-19 vaccines no matter what. But she’s concerned about how much money the federal government is allocating to states spearheading the effort.
“I think all states are in agreement that additional federal support would be valuable,” Gifford said.
In its first round of COVID-19 vaccine funding, the Centers for Disease Control and Prevention allocated $2.4 million to Connecticut. Gifford said an additional $1.5 million is still anticipated.
But in a letter to Congress last month, the Association of State and Territorial Health Officials, a national nonprofit organization representing public health agencies in the United States, said at least $8 billion would be needed nationwide for the effort.
President-elect Joe Biden said he would like to invest $25 billion “in a vaccine manufacturing and distribution plan that will guarantee it gets to every American, cost-free.”
As Kaiser Health News notes, such spending would likely require congressional action.
“We have not been led to believe there would be additional funding,” Gifford said. “The vaccine itself, obviously, is being provided to the states. We’re not being asked to fund that. And some of the logistical pieces of the system are being funded by the federal government.”
“I think additional federal dollars would be welcomed, Gifford said. “It’s obviously a massive undertaking to vaccinate … three and a half million people in Connecticut.”
Connecticut’s Initial Vaccine Allocations Take Shape
Kathy Kudish, immunization program manager at the Department of Public Health, told Gov. Ned Lamont’s COVID-19 Vaccine Advisory Group last week that the state expects Pfizer’s vaccine to be the first available in Connecticut.
Distribution of the vaccine will be tied to state population, Kudish said, “which will mean approximately 220,000 to 330,000 doses” will be available by the end of December.
Another vaccine, from Moderna, is expected to be available in the coming months. “About 15 to 20 million doses are expected to be available in the U.S. by the end of December, which will mean about 165,000 to 220,000 doses for Connecticut,” Kudish said.
This week, U.K.-based pharmaceutical company AstraZeneca also released results from its own COVID-19 vaccine trials.
Gifford said initial allocations of vaccines will be targeted to health care workers.
“All of our hospitals have agreed to vaccinate their own employees. And many of them will also be vaccinating those that work within their broader network,” Gifford said. “Between those two categories alone, that’s going to take care of a very large number of health care workers.”
Still, challenges remain. One example is how to quickly vaccinate home health care workers, who may lack an affiliation with a larger health care network.
“We have a large number of home care workers,” Gifford said. “They take care of many of our HUSKY members and they may provide home care for others. Many of them are affiliated with hospital systems, but many of them aren’t. So we would want to make sure … [they] know where to receive their vaccine.”
Gifford said those workers would be matched up with vaccinators at a local health department or a hospital system.
Getting Vaccines To Nursing Homes
State public health officials are optimistic the challenge of delivering vaccines to more than 200 nursing homes will be partially addressed by a federal partnership with CVS and Walgreens that promises to deliver those vaccines directly to residents.
Gifford said it’s her latest understanding from the federal government that those doses will come from the state’s overall vaccine allotment.
“They will send vaccinators out to our nursing homes who have signed up. To vaccinate all of their residents. That’s definitely a support,” Gifford said.
Nursing home staff members will also be prioritized for vaccination, but state officials said they are unsure if that will happen at the same time as residents because they are still awaiting guidance from the federal government.
“While this may change, it is likely that if staff are vaccinated in the same wave as residents, they will be vaccinated through the federal program. If staff are vaccinated before residents, the state will utilize other providers to vaccinate staff,” said Lora Rae Anderson, a spokesperson for the state's chief operating officer, Josh Geballe.
In addition to hospital workers, other initial vaccination priorities will include dentists, dental hygienists, active EMS, urgent care workers, community health center staff, and staff performing COVID testing.
Got A Shot, Now What?
Gifford said there’s also the challenge of keeping track of who got the vaccine. And since both Pfizer’s and Moderna’s vaccines require two doses, officials will need to record who got what type of shot and when so they can avoid mixing vaccine types and coordinate any subsequent doses.
Gifford said the first line of defense will be old-fashioned: give people a piece of paper.
“That says when they should get their follow-up, but we understand all of us being human, those can sometimes get misplaced,” Gifford said.
The more high-tech solution is a vaccination clinic mobile application called VAMS, which the CDC is making available to states, but Gifford said it’s unclear exactly how that database will notify people and how it will integrate with electronic health records and the state’s own vaccine registry.
It’s one more problem to solve, and one more spot where she said more federal aid could make a difference.
“It’s definitely a challenge. We want to make sure that people are educated. They know when to come back for their dose. They know which vaccine they got for the first dose,” Gifford said. “That is a place where federal support would be [an] additional help.”