Crossroads health care workers prepare for logistical challenge of COVID-19 vaccine rollout

Pfizer’s COVID-19 vaccine is expected to be one of the first available in the U.S., but it presents logistical challenges for local health care providers as it must be stored at extremely cold temperatures.

Dozens of Crossroads hospitals, clinics, and health care providers have signed up to distribute COVID-19 vaccines as they become available, and some could be distributing them before the end of the year.

There are at least 19 providers in Victoria County who have signed up to receive and distribute vaccines, according to an email from Lara Anton, a spokesperson for the Texas Department of State Health Services.

But even as hospitals and health care workers prepare for the massive logistical challenges of vaccinating Texans, there are still major unknowns in the state and federal government’s rollout plan for who will be prioritized for the initial vaccines and how many doses will be distributed.

“It’s frustrating, but it’s understandable because of how quick everything is going, so they are really just trying to figure things out,” said David Gonzales, the director of the Victoria County Public Health Department. “All we can really do is prepare to receive and vaccinate as quickly and as safely as possible.”

There are dozens of vaccines currently being researched and tested in clinical trials. Two vaccines — one from Pfizer, the other from Moderna — are furthest along in the research, testing, and review process, and both vaccines could become available to health care workers and Americans at highest risk of serious illness before the end of this year. On Friday, Pfizer submitted data to the FDA for an emergency use authorization. The FDA’s review process could take several weeks, but if Pfizer’s vaccine is approved, it could be distributed within weeks. Moderna has said it also plans to apply for emergency use authorization soon.

As drug makers get closer to having a vaccine ready, health workers in the Crossroads are preparing to distribute vaccines as soon as they receive them.

Both Pfizer’s and Moderna’s vaccines require two injections to be effective, meaning that vaccine providers will have to make sure residents remember to show up for the crucial second injection needed to make the vaccine effective. And further complicating distribution, Pfizer’s vaccine has to be stored at minus 94 degrees Fahrenheit, and can only briefly be kept at room temperature before it is injected.

Gonzales said he didn’t know of any facility in Victoria County that is equipped with the ultra-cold freezers that would be best suited to store Pfizer’s vaccine. Both Citizens Medical Center and DeTar Healthcare Systems have ordered such freezers, representatives for the hospitals said, and expect to receive the freezers soon.

Absent the high-strength freezers, Pfizer’s vaccine can be kept stored using dry ice. Gonzales said the health department was working to find a local supply of dry ice, and Citizens hospital has contracted with a commercial gas company so it can receive a steady supply of dry ice as well, said Dr. Daniel Cano, the hospital’s chief medical officer.

Cory Wasicek, the chief nursing officer at Refugio County Memorial Hospital, said he expects the hospital and its three clinics will likely only distribute the Moderna vaccine because of how Pfizer’s vaccine must be shipped and stored. Wasicek said if the state or the local trauma service area decided to divvy up smaller shipments of Pfizer’s vaccine, “we will work around the clock to vaccinate as many people as we can to make sure it’s not wasted.”

The hospitals and clinics who have told the state health department they are ready to distribute vaccines don’t know which vaccines they’ll ultimately receive. When providers signed up to be a part of the distribution process, they were required to include information about the storage capabilities, including what types of freezers and refrigerators they had, when that equipment was last certified, and more, Wasicek said.

Cano, the chief medical officer at Citizens, said the hospital is still waiting to learn how the state will distribute vaccines as they become available.

“I think it will really be up to (the Texas Department of State Health Services) to decide who gets what type, or if they preferentially give one facility one type because they have capacity for that one or vice versa,” Cano said. “But that part still remains to be seen.”

Despite the questions posed by the immense challenge of making vaccines available to every Texan and American who wants one, the information we have so far makes a few things clear, said Maria Elena Bottazzi, the associate dean of Baylor’s National School of Tropical medicine. The data released by Pfizer and Moderna so far show that their vaccines can produce a good immune response, that they are safe, and that they can prevent or reduce serious illness, Bottazzi said.

But a major remaining question is how long immunity will last, Bottazzi said. Some vaccines, like the measles, mumps, and rubella vaccine, provide lifelong protection, whereas others, like the flu shot, only provide protection for shorter periods of time.

“One thing we definitely do not know is how long the immunity will last,” said Bottazzi, who is also the co-director of the Texas Children’s Hospital Center for Vaccine Development. “If we see that the immunity wanes we’re going to probably have to recommend a booster.”

With numerous different groups and researchers working to develop different vaccines, Bottazzi said she could foresee a future where people would get a certain vaccine based on their age and other factors, geographic location, and availability. So, for example, some vaccines might be better suited for adults over the age of 65, while a different COVID vaccine might be better for children.

Bottazzi and her colleagues are developing what’s known as a recombinant vaccine, the same technology behind the Hepatitis B vaccine. Because the procedure to make this type of vaccine has already been used in the past, the vaccine Bottazzi and her colleagues are developing will be cheaper and easier to manufacture, she said.

More vaccines, and more doses from Pfizer and Moderna, are expected to become available in the coming months. But the general public is unlikely to have access to a vaccine until the middle of 2021, or even later, according to the state’s distribution plan. The current version of the state’s plan says that health care workers, first responders, people over the age of 65 and people with pre-existing conditions will be prioritized for the first vaccines, but it remains to be seen exactly what groups will have access to how much vaccine at what time.

Ciara McCarthy covers public health and health care for the Victoria Advocate as a Report for America corps member. You can reach her at cmccarthy@vicad.com or at 580-6597. To support local journalism at the Advocate through Report for America, go to VictoriaAdvocate.com/report.

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Health Reporter

Ciara McCarthy covers public health and health care for the Advocate as a Report for America corps member. Questions, tips, or ideas? Please get in touch: cmccarthy@vicad.com or call 361-580-6597.

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