The federal government is expanding its guidelines to allow more people to receive the COVID-19 vaccine, a move that a local infectious disease expert said must happen immediately to quickly inoculate the general population.
U.S. Department of Health and Human Services Secretary Alex Azar announced Tuesday people 65 and older along with anyone with a high-risk medical condition should soon be vaccinated, scrapping the more regimented phased-in approach as the federal government prepares to release all available vaccine doses.
“This next phase reflects the sense of urgency we now face,” Azar said, adding some states have been too focused on completing the first phase that it has delayed the overall process. “Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost or one more hospital bed occupied.”
That’s a welcome change for Dr. Amesh Adalja, an infectious disease expert in Pittsburgh and senior scholar at the Johns Hopkins Center for Health Security that focuses on pandemics.
“This is a good move,” he said of moving away from priority groupings. “It really hampered how delivery was going because it added more bureaucracy and worry about how you are adhering to the priority groups.”
For the past month, Pennsylvania has been implementing the “1A phase” of the vaccination process that focused solely on health care workers, long-term living facility residents and some first responders. But focusing on priority groups has slowed the process to move into subsequent phases to vaccinate seniors and other front-line workers.
“The rollout went the way it did because of a very predictable factor. It’s a novel vaccine and (we) have to vaccinate the entire population,” he said. “States are distributing the final mile (of the vaccine) and the departments have been under-resourced and under-valued for years.”
Adalja said there are a variety of reasons for the slow rollout of the vaccine across the country and in Pennsylvania.
He noted hospitals have been tasked with administering the vaccine to their staffs and first responders while also dealing with a surge of patients infected with the coronavirus, making it more difficult logistically to complete the first phase. In addition, a delay in passage of the most recent stimulus bill in late December meant there weren’t enough resources needed to help state agencies administer the vaccine.
But most problematic has been the phased schedule that was cumbersome and led to an “irrational response” to hospitals that attempted to be more flexible by giving it to those who weren’t in one of the priority groups, Adalja said.
“The priority schedule is also causing more consternation because they have to decide if they have more doses, can they move on (to the next phase),” he said. “It was predictable, and there should be have been more planning involved.”
But it’s unclear whether Gov. Tom Wolf and his administration are prepared to move forward with that streamlined vaccination process. During a news conference Tuesday afternoon two hours after Azar announced the updated guidelines, state Health Secretary Dr. Rachel Levine said they were “still waiting to hear the exact information” from the federal government before moving to the next phase.
“We want to see the whole plan as they roll it out and study it and its impact on Pennsylvania and follow the federal guidelines,” Levine said. “We want to see the whole plan in writing and then we’ll work to implement it.”
Levine said the state has administered about 250,000 first doses, while about 30,000 people have received both the first and second doses. Another 50,000 workers and residents at long-term living facilities have also been vaccinated through the federal government’s partnership with chain pharmacies.
Adalja, who received his second dose of the COVID-19 vaccine Friday at Butler Memorial Hospital after getting his first shot Dec. 18, said the vaccination process itself is slow with registration required and a 15-minute waiting period after receiving a shot to ensure the patient does not have an allergic reaction.
He said distribution in Pennsylvania shouldn’t fall only to the state Department of Health. Instead, he suggested the Pennsylvania Emergency Management Agency and Pennsylvania National Guard mobilize to help local and county authorities set up mass vaccination sites to “give hospitals breathing room” to focus on treating patients. Local emergency management officials in Washington, Greene and Fayette counties previously said they’ve held discussion on locations for such sites that likely would be at county airports or fairgrounds.
“We have to look at this vaccine as a war effort,” Adalja said. “We need all hands on deck.”
In addition to the expanded eligibility, DHHS and the Centers for Disease Control and Prevention will distribute all available vaccines doses they have, Azar said, although the amount each state gets will depend on its population’s age and whether the current vaccines are going out quickly. The federal government through its Operation Warp Speed task force is also pushing for states to expand access points to the vaccine beyond hospitals, including pharmacies, community health centers and mass vaccination centers.
The timeline to deliver more vaccines is not clear, although Azar said they’re giving states two weeks to compile a report on how many people have already been vaccinated and to prepare for the expansion. CDC Director Dr. Robert Redfield urged governors to move as quickly as possible to expand the vaccination process.
“We clearly have enough vaccine at this point to expand and get more and more vulnerable individuals in our country vaccinated,” he said.
With the changes, Adalja is hopeful fast-tracking the vaccination process will lead to enough people being inoculated against COVID-19 so that the country can achieve herd immunity by the end of the summer.
“Things are going to accelerate nationally,” he said.