ELLSWORTH — Certain health-care workers and emergency responders could be given the first doses of a COVID-19 vaccine sometime in December as long as the authorization process goes smoothly, said Dr. James Jarvis, medical specialist for Northern Light Health’s incident command, in a press conference on Nov. 25.
“There are two vaccines that have asked the federal government for emergency use authorization,” said Jarvis. Drug maker Pfizer applied for emergency use authorization from the Food and Drug Administration on Nov. 20; Moderna said on Nov. 30 it would apply for authorization that day.
“We expect that those will go to a committee on the 10th of December and that shortly thereafter, if approval is granted, that we will have some vaccine available in the state of Maine.”
But Jarvis cautioned that the initial supply of vaccine would be “extremely limited” and its distribution, at least initially, would be directed by the federal government.
“The federal government is going to dictate who is eligible for the vaccine first,” said Jarvis. “We expect that to be, because of the limited supply, health-care workers and emergency responders who are dealing directly with COVID-positive patients. So that will not even be all of the health-care workers that serve our needs either in our system or in the other hospitals in other systems across the state. It’ll be a targeted thing.”
Frontline health-care workers first
State officials are reviewing plans put forward by the National Academies of Sciences, Engineering, and Medicine (NASEM) that suggest a four-phased approach. Frontline health-care workers and those who play “a critical role in maintaining health care system functionality” would be first, followed by people over 65 living in congregate care settings and those with underlying conditions that put them at a higher risk for death or severe COVID-19 disease.
Phase two would include K-12 teachers and school staff and workers who are at a high risk of exposure, such as those working in public transit or in the food supply system. By phase three roughly 40 to 45 percent of the population would have access to a vaccine, including “workers in industries such as colleges and universities, hotels, banks, exercise facilities and factories that are both important to the functioning of society and pose moderately high risk of exposure,” according to the document. Young adults between 18 and 30 are also included in phase three — while they’re less likely to become severely ill with the disease, they have “broader social networks than older adults, increasing their risks of infection and transmission.” Children could be vaccinated in phase three as well, depending on whether they’ve been tested “adequately for safety and efficacy.”
Widespread availability possible by summer
So, when can most Americans expect to be vaccinated?
Moncef Slaoui, chief scientific adviser of the government’s Operation Warp Speed vaccine development and distribution program, told CNN’s “State of the Union” politics show last week that if all goes well, enough Americans should be vaccinated by “May or something like that” to allow somewhat of a return to pre-pandemic life.
Draft plans released by the Maine Department of Health and Human Services in mid-October identify just shy of 20,000 hospital staff statewide at high-risk for exposure to COVID-19, including 178 at Mount Desert Island Hospital, 116 at Northern Light Blue Hill Hospital and 215 at Northern Light Maine Coast, as well as 240 staff at Birch Bay Retirement Village and an additional 189 working “off-campus” for Northern Light Maine Coast and Blue Hill hospitals.
MDI Hospital said it could handle vaccinating 200 people each day, while Northern Light Blue Hill could handle 100 and Maine Coast could handle another 100.
But state officials also are preparing to eventually have the vaccine available in pharmacies, school parking lots, fire departments, social clubs and health clinics, Maine Center for Disease Control and Prevention Director Dr. Nirav Shah told the Portland Press Herald in a recent interview. Some or all of the 27 “swab-and-send” sites set up by the Maine Department of Health and Human Services for COVID-19 testing in the coming months will likely become vaccination sites, Shah said.
The goals are “velocity and equity,” he said, to make sure that minority populations and rural areas have access.
The goal is to distribute the vaccine to all parts of the state when the doses come in, so rural areas will get the vaccine around the same time as cities, Shah said.
“We are going to take an ‘all approaches on the table’ strategy,’” Shah said. “We want to bring the vaccine as close to people as possible. We are creating large-scale infrastructure, large-scale clinics that can handle a lot of traffic. We don’t want 200 people packed into a Walgreens in the middle of February waiting for their shot while the pandemic is still going on.”
Sharon Daley, a nurse and Island Health Services director at Maine Seacoast Mission, said she recently finished doing flu shot clinics on six islands and is waiting to hear from the state about plans for COVID-19 vaccines.
“I don’t know how far down on the list the islands will be,” said Daley. “I just want to make sure they are on the list.”
Daley said there are more winter residents than usual on the islands, many staying later than usual at their seasonal residence. “People think going to an island is safe. In a way it is, but once it’s in that small community…It can spread really quickly on an island.”
She said she has not yet been reached out to specifically about the COVID-19 vaccine. “I just feel like there’s so much going on for the CDC; they’re working so hard, you have to just let them sort a few of those things out. I’m just sitting back, I’m going to be ready, but the question is when and how?”
Even the best laid plans get waylaid by the weather, however.
“I make a plan always for going and like doing flu shot clinics and then the wind blows or the boat can’t run,” said Daley. “We just went to Mohegan and it was really, really rough, so we couldn’t dock. We went in, anchored and I went in by skiff and somebody picked me up on a golf cart.”
Mask wearing likely necessary through 2021
Both the Moderna and Pfizer vaccines require two doses several weeks apart, although single-dose vaccines are also in the pipeline. The Moderna and Pfizer vaccines are not interchangeable, and making sure people get both doses in a timely fashion is vital.
“That second dose is really a booster,” said Dr. Jarvis. “There will be some immunity for the first one, but it will not be immunity that would protect the overall population enough, so it’s critically important people get that second vaccine.”
He added that getting a single dose of the vaccine, or even both, does not mean you can take off your mask and abandon all precautions.
“No vaccine gives you 100 percent protection and frankly we know that not 100 percent of people are going to get vaccinated,” said Jarvis. “I do not expect that in the rest of 2020 or all of 2021 we will be going without masks, regardless of what the vaccine supply is…We’re also not 100 percent sure as to how quickly the vaccine shows immunity and grants immunity.”
He continued, “It’ll be awhile before we see that the overall level of virus around our communities goes to a level low enough that we can stop wearing masks.”
Dr. Jarvis sought to reassure residents that any vaccine would be safe.
“Before we administer any vaccine, it will not only go through the federal process…but also the national certification for immunization and then we will do our own internal look at the data,” said Jarvis. “We will make sure that it is safe because we want to make sure it is safe for our health-care workers.”