Commentary: Public Health, hospitals partner on COVID vaccine availability

Editor’s note: This commentary was written in concert with Bayhealth, Beebe Healthcare, Nanticoke Health, and TidalHealth Nanticoke.

By Dr. Karyl T. Rattay

One or more coronavirus vaccines may be available in the coming weeks, maybe even by early to mid-December, though initially in limited quantities. To ensure our readiness, the hospitals serving residents of Kent and Sussex counties are closely coordinating with the Delaware Division of Public Health on the receipt, distribution and administration of the COVID-19 vaccine.

Dr. Karyl Rattay

The U.S. Centers for Disease Control and Prevention (CDC) expects the vaccine to reduce COVID-19-related illnesses, hospitalizations and deaths and help our nation return closer to the normalcy we knew before the pandemic.

There is a five-step process for vaccine approval in the U.S.: 1) clinical trials; 2) Food and Drug Administration review and approval of emergency use authorization (EAU); 3) manufacturing; 4) distribution; and 5) post-vaccine safety monitoring.

Vaccine development has been coordinated under Operation Warp Speed, a public-private partnership led by the U.S. government. The partnership’s support helped accelerate the vaccine’s development, manufacturing and distribution, while still following the same processes for safety and effectiveness used for any other vaccine. It is important to understand that fast does not mean unsafe.

On Nov. 20, Pfizer and its partner, BioNTech, submitted their EUA request to the FDA after completing Phase 3 clinical trials, where promising vaccines are extensively tested on large numbers of volunteers. Another manufacturer, Moderna, just completed its Phase 3 trials and also plans to submit an EUA request very soon. Two more manufacturers, Johnson & Johnson and AstraZeneca, are finalizing their trials. The Pfizer and Moderna trials combined involved more than 70,000 volunteers, including people of different ages, races, ethnicities and medical conditions. The public can be reassured that the vaccines are being tested extensively, and early reports from both Pfizer and Moderna show more than 90% efficacy.

The FDA, as well as the CDC’s Advisory Committee on Immunization Practices (ACIP), review all safety data from the clinical trials and authorize emergency vaccine use only when the expected benefits outweigh potential risks. As soon as an EUA has been issued, doses of the vaccine will be distributed to the states based on their population.

The state of Delaware is ready to receive and begin administering a vaccine. Vaccine distribution will occur in three phases. In Phase 1 (December-January), a limited supply of vaccine doses may be shipped directly to health care providers to vaccinate high-risk workers who provide direct patient care in acute settings or who have routine exposure to infected materials; to emergency medical services agencies to vaccinate first responders; and to long-term care staff and residents. In Phase 2 (early 2021), more doses will be available for high-risk workers who provide primary care and non-direct patient care, for individuals with co-morbid or underlying health conditions and for those in certain congregate settings, such as prisons and schools. Phase 3 (spring 2021) will offer the vaccine to the general population through primary care providers, federally qualified health centers, pharmacies and drive-thru clinics. The FDA and CDC will continue to monitor the safety and effectiveness of the vaccines.

Most public and private insurance companies will cover any fees charged by vaccine providers for administering the shots. The uninsured will be able to be vaccinated at no cost. The vaccine must be administered regardless of an individual’s ability to pay.

The state will follow the CDC-recommended priority groups for vaccination, in consultation with the state ethics committee. DPH’s Ethics Advisory Group and Health Equity Bureau are ensuring that the vaccine will be distributed fairly, ethically and transparently.

DPH submitted its operational vaccination framework to the CDC in early October and has closely communicated with both the CDC and the Department of Health and Human Services as recently as Nov. 20, when the federal partners expressed their confidence in Delaware’s progress and readiness. DPH is coordinating a Statewide COVID Vaccine Task Force with more than 80 stakeholders and partners representing health care, first responder, long-term care and community organizations. The division’s Immunization Program has been recruiting and surveying medical providers to gauge interest in administering the vaccine once available to the general public. Communications planning ensures consistent messaging.

DPH’s health system partners have been busy, as well. Bayhealth is working diligently to inform its team members internally and within the surrounding community about the importance of the COVID-19 vaccine. Bayhealth developed a formal vaccination plan in collaboration with state and federal guidance and has strategically selected a variety of targeted communications to reach its audiences, including the Bayhealth website, a video series including live messages, social media, emails, letters and publications in concert with DPH to share important details about the vaccine, as well as distribution plans once more information becomes available.

Beebe Healthcare continues to communicate to the community and its team members through virtual town halls. One example of a topic is that approved vaccines will be safe, as vaccines are reviewed through clinical trials involving tens of thousands of participants, after multiple safety reviews. Beebe Healthcare is prepared to work alongside state partners and DPH for seamless vaccine distribution.

TidalHealth is partnering with health providers and Wicomico, Worcester and Somerset counties’ public health divisions, as well as DPH, to keep the community informed through traditional media awareness, a social media campaign, podcasts and videos. Local providers are working with Latino and Haitian media to inform those communities. TidalHealth’s website, tidalhealth.org/covid-19, contains resources and links to the CDC and other experts.

The future vaccine’s swift and efficient allocation and administration plays a vital role in reducing COVID-19 effects on Delaware’s health, society and economy. To stay safe as we await widespread availability of the vaccine, we must continue key prevention practices: wearing a mask, practicing social distancing and regularly washing or sanitizing hands. We encourage you to get the COVID-19 vaccine — in two doses, weeks apart — when it becomes available. Even after vaccination, we will still have to wear our masks and be cautious until we reach widespread immunity.

Information and resources including the COVID-19 Vaccination Playbook are available at coronavirus.delaware.gov/vaccine.

Dr. Karyl T. Rattay is the director of the Division of Public Health within the Delaware Department of Health and Social Services. She is board-certified in pediatrics and completed her pediatric residency at Georgetown University and a preventive medicine and public health residency training program at the University of Maryland. She earned a medical doctorate from the Medical University of Ohio and a Master of Science in epidemiology from the University of Maryland.