The first COVID-19 vaccines could be in Vermont in just a few weeks. The state health department says an initial supply of the shots could be in its warehouse by Dec. 15.
The early supplies of the vaccine will be limited, which means the state must decide who gets the first shots. Public health officials will face an even greater task in the coming months: getting vaccines to the broader population and convincing them to get inoculated.
The FDA is currently reviewing two vaccines that appear to be more than 90% effective.
U.S. Health and Human Services Secretary Alex Azar told CBS on Monday that if the FDA signs off on them, distribution would begin immediately.
"We’ll ship within 24 hours of FDA authorization, so we could be seeing both of these vaccines out and getting into people’s arms before Christmas,” Azar said.
"We'll ship within 24 hours of FDA authorization, so we could be seeing both of these vaccines out and getting into people's arms before Christmas." - Alex Azar, U.S. Health and Human Services Secretary
But who exactly will be getting the first shots?
“We are prioritizing healthcare workers,” said Vermont Deputy Health Commissioner Kelly Dougherty. “Particularly those that have patient contact in in-patient settings … and those in high-risk settings.”
The health department says there are 17,756 workers in the initial group, which could include people who work in ICUs and emergency departments, first responders and staff at long-term care facilities.
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But who gets the vaccine, even among these high-priority groups, will depend on how much Vermont gets. Dougherty said the state is expecting to receive 5,800 doses per week for the initial three-week roll-out, but that number is still up in the air.
“It’s changing all the time … hopefully we would hear in advance of them sending it to us,” she said.
The inevitable question is: who comes after health care workers? That’s when it starts to get complicated.
The state’s draft vaccination plan breaks down distribution into four phases.
The first phase is very limited: just healthcare workers, people with serious health conditions and residents of long-term care facilities. The second phase is a longer list and includes seniors, essential workers, people in homeless shelters and correctional facilities. Phase three expands to include young adults and children and phase four is everyone else.
The state’s vaccine advisory group is set to meet on Friday, Dec. 4 to finalize that list.
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Tim Lahey, an infectious disease physician and ethicist at UVM Medical Center, said the state needs to target groups of people who are at highest risk of catching the coronavirus. That could include people who work high-contact jobs, like grocery store workers.
Lahey said that race is another factor that needs to be considered. In Vermont, like the rest of the county, people of color are more likely to be infected by the coronavirus.
“Obviously you can’t feasibly or comfortably walk down the street and say ‘you’re white, you’re Black,’ — nobody wants that kind of a system,” he said. “But what you could do is say, ‘What clinics in the state serve populations who are at higher risk of getting COVID-19?’ And so clinics that serve marginalized populations, I think, should be prioritized.”
"Clinics that serve marginalized populations, I think, should be prioritized." — Dr. Tim Lahey, UVMMC
But prioritizing access to the vaccine is only one part of the puzzle, says Maria Mercedes Avila, an associate professor of pediatrics at the Larner College of Medicine at UVM: “Accessing the vaccine is not so much the conversation, more than the distrust that exists with many communities of color.”
Some of that skepticism comes from the medical community's history of targeting communities of color as the subjects of unethical medical experiments. For example, during the Tuskegee study, hundreds of Black men known to have syphilis were misled about the nature of the research, and did not receive treatment even after it was widely available. The study, which began in 1932, was supposed to last six months. It went on for 40 years.
Locally, the UVM-led Vermont Eugenics Survey targeted Abenaki citizens and people of color, particularly women, with forced sterilization, from 1925 to 1936. French Canadians, as well as people with disabilities and those living in poverty, were also targets.
Avila says one way to rebuild trust is through programs like the health department’s culture broker initiative. The program, which got more funding during the pandemic, asks people who are trusted within immigrant and refugee communities to help disseminate public health information.
“Some of the African communities are receiving messages through social media about not trusting the vaccine,” she said. “We are trying to provide more accurate information in a way that [allows] communities [to] have enough information to make informed decisions about accessing vaccines for themselves and their families.”
"We are trying to provide more accurate information in a way that [allows] communities [to] have enough information to make informed decision about accessing vaccines." - Prof. Maria Mercedes Avila
Getting the shots distributed will be another challenge. The first round of vaccines will go to people who mostly work at hospitals where it will be easy to get people inoculated. But as the pool of eligible people expands, more places will need to be able to offer the vaccine.
The health department plans to have pop-up clinics. Primary care doctors will also help identify patients within their clinics who should get vaccinated, said Dougherty, the deputy health commissioner.
Pharmacies will also play a role. Lauren Bode, with the Vermont Pharmacists Association, said they can fill gaps throughout the state, especially in places that might not be near a large health care facility.
“Pharmacists are accessible, we’re trusted, we’re convenient,” she said. “That’s really important when you’re talking about something like immunization, because we need lots of people to get immunized very quickly.”
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Quickly vaccinating hundreds-of-thousands of Vermonters might come down to whether or not people are willing to get the shot.
A VPR-Vermont PBS Poll in September, found that only half of respondents would get a COVID-19 vaccine if one was available.
Dougherty, with the health department, says she is concerned — there are even surveys that show vaccine hesitancy among healthcare workers.
The health department has hired a marketing agency to help develop a communications plan to get vaccine information to all parts of Vermont’s population.
Dougherty says the vaccine offers a way to end the coronavirus pandemic, but for it to work, a lot of people need to get the shot.
Have questions, comments or tips? Send us a message or get in touch with reporter Liam Elder-Connors @lseconnors.
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