State medical head answers FAQs on COVID vaccinations

Delaware State Medical Director Rick Hong addresses COVID-19 vaccine questions and concerns:

Q: Why isn’t the state administering vaccines at a faster pace? What is causing the lag between receiving doses and administering them?

A: While we always want to do more, we are doing well compared to other states. However, all states are undergoing this new process, which we’ve never encountered before. And we have to realize that this is not just your traditional influenza vaccine. There are many nuances in this vaccine that we have to encounter so that we provide vaccines in a safe manner and also reduce waste.

There are other processes in place for this vaccine that do not exist for other vaccines. There’s an enrollment process for providers to be a part of the vaccination process. There’s also reporting requirements that do not exist for other vaccines and there is a learning curve to get these processes in place to be able to successfully roll out this vaccine.

Timing was also an issue. This vaccine was rolled out around the holidays and we have come to find out that many people did not want to get the vaccine around the holidays due to concerns of mild side effects. Also, with vacations staffing shortages, it was more difficult to be able to roll out this vaccine in a quick manner.

However, we are very appreciative for all of our partners. Even though we have some vaccine in our warehouse, we are really relying on our partners to be able to get vaccine out to their staff and other members within the community that belong to Phase 1a. So, we really appreciate the health systems, ambulatory offices, pharmacies, urgent cares and EMS agencies to really help us get this vaccine out to as many people as possible, even during the holidays.

Q: Why didn’t the state have details and plans finalized for vaccine rollout sooner or use the same processes in place for flu vaccinations?

A: It’s important to understand that just about every state is having the same challenges that we saw in Delaware. And in fact, many states, including Delaware, used our experiences during H1N1 as well as our seasonal flu vaccination plans to kind of start off on figuring out how we’re going to address the COVID vaccine.

However, we could not finalize our plans until we got additional information. One key information is when the vaccine was going
to be delivered. And until that information was available, it was hard to determine how to allocate vaccine to some of our partners as well as to the medical community as our initial rollout.

Also, we did not really know what groups to target initially and we were waiting on the CDC Advisory Committee on Immunization Practices to give us guidance on who should be targeted first in initial rollout and then subsequent allocations afterwards.

Many folks believe that this is very similar to the flu vaccine. But there are a lot of intricacies involved that really makes it very much more difficult to handle this vaccine versus your traditional influenza vaccine. Not only storage was a challenge, but also we had to consider how we were going to get the second dose administered in a timely fashion to make sure that we are making effective use of this vaccine.

Q: How is the state working to get vaccines to health care providers in the Phase 1a that are not part of a health care system or long-term care facility, such as independent practices?

A: There are many options for providers to get access to vaccine. One of the best ways to do so is to be enrolled as a vaccine provider. This is required for providers to receive vaccine whether it is to vaccinate staff and or patients. We have an enrollment process in place that’s available on our website. We also have a helpline through email address to help providers through the process.

If this is not a good option, you can always partner with other practices or other providers that are already enrolled in the process. And we’re very appreciative for these partnerships with these vaccine providers to not only vaccinate internal staff, but also to vaccinate other members within the phase 1a group. If neither of these options are available, there will be mass vaccination sites targeting Phase 1a groups as well as traditional vaccine delivery channels such as urgent cares, as well as pharmacies.

Q: If someone falls into the Phase 1b/65-plus distribution category, how and when do they get the vaccine?

A: Currently Phase 1b includes two major categories. You have frontline essential workers, and you have those greater than or equal to 65 years of age. We are looking at many ways to get vaccine to this particular group. We are looking at traditional vaccine delivery channels such as pharmacies and urgent cares and primary care offices or other entry offices to be able to provide vaccine for this group.

However, we also want to take advantage of infrastructures in place and currently, we are working with large employers to provide vaccine on-site so that they can vaccinate employees on-site, which is one of the more efficient ways of doing this.

Many employers are already working with partners such as pharmacies to be able to distribute vaccines, such as influenza, every year. We would like to use those channels as well for COVID-19. So, there will be a lot of messaging available once we transition to Phase 1b.

So please look out in social media, press briefings, press releases, news, etc., to be able to know when we’re going to officially start 1b. Once we do so, we will provide information on how you can access the vaccine.

Q: How will distribution for the Moderna vaccine differ from Pfizer?

A: We are very excited to have the Moderna vaccine as part of our vaccine supply. The Moderna vaccine needs to be stored at -20 degrees Celsius (-4 degrees Fahrenheit), which is the temperature of a regular freezer, making it more accessible for smaller facilities and local communities. It can be kept in this medical-grade freezer for up to six months. Once placed in a medical-grade refrigerator at warmer temperatures, it must be used within 30 days.

Pfizer needs to be stored at -70 degrees Celsius (-94 degrees Fahrenheit), which requires ultra-cold storage. It can be stored that way for up to 30 days. Once removed from ultra-cold storage, it can be stored in a medical-grade refrigerator for up to five days before it expires.

Q: Two workers at an Alaska hospital suffered serious allergic reactions after receiving Pfizer’s COVID-19 vaccine in December. Should other health care workers and Phase 1 recipients of the Pfizer vaccine be concerned? Did this happen to anyone in Delaware?

A: Even though the reaction required hospital attention, it is still considered a rare side effect at this time. State and federal officials continue to be on the lookout for side effects not previously identified during clinical trials, and if the side effects become more widespread, Pfizer will update its patient information sheet stating that providers can give that information to the public.

The CDC recently announced that out of 1.9 million doses of the vaccine administered nationwide, only 29 instances of severe allergic reactions have been confirmed to date. While more mild side effects can be expected to occur, particularly after the second dose of some vaccines, CDC is classifying instances of severe allergic reactions as extremely rare, and DPH continues to encourage health care providers and staff, and residents and staff of long-term care facilities to be vaccinated.

• No recipients of the Pfizer vaccine have had any serious allergic reactions here in Delaware at this time.

• The potential side effects from the vaccine are very similar to those experienced by people who receive the flu shot, such as soreness at the injection site, fever, headaches, and body aches. All of which usually go away within 24 hours. Unless symptoms worsen or linger, there really is no need to seek medical care.

• It is recommended that those with a history of severe allergic reactions, especially from injectable medications and other vaccines, discuss with their provider before receiving the vaccine, as it may be best for them not to receive the vaccine at this time.

Q: How will the general public receive the vaccine? Do they need to sign up or register somewhere?

A: The public does not need to sign up or register to receive the vaccine at this time as it is not widely available to the public just yet. We are hoping that as we expand the supply and the vaccine becomes available for the general public, we will increase the number of access points including normal vaccine delivery centers, such as primary care offices, pharmacies – including those located in grocery stores- and health centers.

Q: Why are people who have already had COVID receiving the vaccine? Don’t they already have the antibodies?

A: There is not enough information currently available to say if or for how long after infection someone is protected from getting COVID-19 again; this is called natural immunity.

Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. Until the CDC’s advisory committee on immunization practices makes more specific recommendations, they have not specifically said that people who had COVID-19 should not get the vaccine.

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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