The first COVID-19 vaccine will soon be on its way to hospitals and health care facilities in Northeast Ohio and across the state.
There are 10 sites that have been designated by Ohio Gov. Mike DeWine to receive the vaccine first, including three in Northeast Ohio - Cleveland Clinic and MetroHealth in Cuyahoga County, and Aultman Hospital in Stark County, according to the state's plan. These facilities will receive vaccine shipments directly from Pfizer.
Gov. DeWine confirmed last Friday Ohio will receive some 299,475 doses of vaccine beginning Dec. 15 with another 359,000 doses tentatively scheduled to arrive days later.
The Food and Drug Administration (FDA) will hold a special meeting on Dec.10 and is expected to grant emergency use authorization for the vaccine developed by drug companies Pfizer and BioNTech, the first COVID-19 vaccine to be considered for such approval in the US.
The vaccine, which must be administered in two doses 21 days apart, has reported more than 95 percent efficacy in preventing the infection of COVID-19, according to Pfizer.
The federal government has already paid for approximately 6.4 million doses to be sent out across the country within 24 hours of the vaccine’s approval, according to the U.S. Department of Health and Human Services.
The vaccine dose estimates from both Pfizer-BioNTech and Moderna are tentative and subject to change, DeWine said.
On Dec. 15, Pfizer is expected to send 9,750 to hospitals and 88,725 to Walgreens and CVS to go to congregate care settings for the “vulnerable” Ohioans and their caregivers. Then on Dec. 22, Pfizer is expected to ship another 123,000 vaccines to hospitals and pharmacies. Also on that date, Moderna will ship 201,000 to 98 hospitals and 108 health departments to vaccinate EMS personnel.
Still, the initial shipment will be a limited supply, so the Centers for Disease Control and Prevention (CDC) will provide its official recommendations on Dec. 10 for who should be vaccinated in the first round. CDC officials are expected to designate front line health care workers and first responders, such as police and emergency medical services, as those who should get the vaccine first.
Federal officials will coordinate the national shipping and delivery processes, but individual states will handle distribution.
Northeast Ohio Distribution
When the vaccine arrives in Ohio, state officials will determine allocation for hospitals and other providers throughout the state, and individual health departments and emergency management officials will handle local distribution, said Chris Barker, emergency preparedness supervisor at Summit County's health department.
“The vaccine will have to be allocated once it becomes available, and it’s probably going to come in short supply,” Barker said. “Once we receive word on who’s receiving that and how the distribution intends to take place, we will work with those organizations to allocate in the county jurisdiction.”
Some smaller providers and local health departments may get their doses from the Ohio Department of Health, Barker said.
Health care workers, first responders first in line
Ohio vaccinations will occur in a series of phases, with different populations and groups of people designated for the vaccine in each phase, Barker said.
The first group, Phase 1A, includes “high-risk” health care workers, first responders and residents of some congregate settings, he said.
Caregivers designated for the first phase of vaccination will likely receive their shots at the health care system they work at, Barker said.
The 10 prepositioned hospitals were selected based on their ability to store the vaccine in ultra-cold freezers, health officials said. Pfizer’s shots need to be stored at -94 degrees Fahrenheit, and will be shipped in containers with dry ice, according to the company.
Hospitals with proper freezer capacity could potentially receive their vaccine allocation before FDA approval, because they are able to store them for a longer period of time, said Chris Parrish, senior vice president of the Aultman Healthcare Delivery System.
Parrish expects Aultman will be allocated 4,000 to 5,000 doses of the vaccine in the initial shipment, he said. The hospital employs more than 8,500 people across multiple campuses, with more than half of them being nurses, he said.
“It’s a very difficult thing to kind of pick and choose exactly who gets it and who doesn’t, because almost all of our front line workers have a risk factor of being exposed,” Parrish said.
Aultman employees who qualify for the first phase of vaccines will have the option to get the shots, he said, and if they do not want the vaccine, they must sign a declination form.
“My understanding is that at least Phase 1A of the COVID vaccine is being provided at no charge for front line workers,” he added.
Other hospitals will receive their shipments after the vaccine is approved by the FDA, he said.
Officials are still figuring out how to get the vaccine to first responders, who are the other individuals designated in Ohio’s first phase, Parrish said.
“What I’d imagine is, most of that will run through the individual county health departments,” Parrish said.
Phase 1A distribution will also include high-risk people, such as older adults in nursing homes, and individuals in congregate settings such as group homes, according to Ohio’s plan.
Aultman may partner with nursing homes in the region to assist with their distribution, Parrish said.
Ohio is expected to complete Phase 1 toward the end of the year, he said.
When will the general public be able to receive it?
Phase 2 will include more of the general public - including essential workers in the health care and human services industries, teachers and school staff, people of any age with underlying conditions and older adults not included in Phase 1, and individuals in congregate settings such as homeless shelters, jails, and detention centers, according to the state’s tentative plan.
There are a few different options still being considered for this large-scale distribution, Barker in Summit County said.
“One will be very similar to H1N1, where we have community-centered distribution site where the vaccine will be administered,” he said. “The best comparison I could probably give to that is what you see in the COVID testing drive-thru clinics.”
Another option is for indoor vaccination at community centers, he added, which would require additional safety protocols and social distancing.
“The reason for looking at the internal platforms is the weather we have here in Northeast Ohio,” Barker said. “Drive-thrus are pretty good when it’s warm outside, but as it gets extremely cold, we not only want to make it convenient for the public that are receiving their shots … but that also takes a toll on the staff that’s providing the vaccine, so we may look at some indoor options.”
Phase 2 of Ohio’s vaccine distribution is also when officials will begin planning vaccine outreach efforts to marginalized communities, according to the state’s plan.
Minority populations, specifically the Black community, may be hesitant to get the vaccine due to ongoing distrust of the medical industry, said Ronnie Dunn, chief diversity and inclusion officer at Cleveland State University.
“We know that there’s going to have to be a targeted, specific focus when the vaccine is available in those communities, in the black community, to get people to trust it,” Dunn said.
Previous statewide outreach for COVID-19 testing did not do enough to target pop-up sites and drug stores in inner city and low-income areas, Dunn said. He expects planning outreach to marginalized groups will take time, he said.
“They should be developing that now, because they know that by, maybe March, for example, maybe there will be a Phase 2, where they need to start vaccinating the Black and minority communities,” he said. “If not now, then when?”
Dunn recommends officials come up with a targeted public service campaign with information about the vaccine, and ask well-known and trusted community leaders to implore citizens to take it, he said.
Ohio’s Phase 3 will include young adults and children, as well as essential workers at high risk of exposure in other industries.
By Phase 4, all Ohioans will qualify to be vaccinated, according to the state’s plan.
The federal government is set to pay for some of the vaccines, but there could be administrative fees, so it is not yet clear whether the general public will have to pay.
The FDA is meeting to consider Moderna’s vaccine candidate on Dec. 17. If approved, shipments could arrive in Ohio around Dec. 22, DeWine said.
It is unlikely that people will be able to pick which vaccine they get, and health officials have said people will probably get whichever vaccine their provider has access to.
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