Nursing home residents and health care workers will be the priority for initial doses of a soon-expected and long-awaited COVID-19 vaccine.
And Virginia is hoping both populations will be covered by the state’s initial allocation of vaccines from the pharmaceutical companies Pfizer and Moderna, expected to arrive by the end of December. In a Friday news release, the Virginia Department of Health announced the state is now expecting 480,000 doses — nearly seven times the number originally anticipated — by the end of the month.
The amount will be enough to deliver a first dose to the majority of Virginia’s roughly 500,000 health workers and long-term care facility residents, including those at nursing homes and assisted living facilities.
“Vaccine will be provided to Virginians in a way that is fair, ethical, and transparent,” state Health Commissioner Dr. Norman Oliver said in a statement. “We will focus initially on the groups that have been most at risk for severe illness from COVID-19 infections and those whose work puts them at greatest risk of contracting COVID-19 infections. Over time, as more vaccine supply becomes available, more Virginians will be able to get vaccinated, and we can look forward to a time when this pandemic will end.”
The state’s draft vaccination plan, first submitted to the federal Centers for Disease Control and Prevention in early October, anticipated that health care workers and long-term care residents would be prioritized for the vaccine based on their risk of exposure and outsized vulnerability to the virus. Nearly half of Virginia’s 4,160 COVID-19 deaths, as of Friday, were people in long-term care facilities and 14,543 total health care workers have contracted the virus, according to VDH data.
That plan was solidified on Tuesday when the CDC’s Advisory Committee on Immunization Practices met and voted to prioritize the two groups in the initial distribution of vaccine. But even a few days ago, state officials were planning for the possibility of a scarce first-round allotment, which could possibly require health officials to choose which of the two groups would receive the very first doses.
Based on the updated information — provided Thursday by the federal government’s vaccine development partnership, Operation Warp Speed, according to the release — that prioritization likely won’t be necessary.
VDH announced that the first shipment of vaccine, expected to arrive by the middle of the month, will come from Pfizer, which requires its doses to be stored at ultra-cold temperatures of about -94 degrees Fahrenheit. All 72,150 of those initial doses will be distributed to 16 hospitals across the state with ultra-cold storage facilities and distributed to hospital workers, with an emphasis on those who care directly for COVID-19 patients.
But “subsequent weekly shipments” are expected to begin after the first and will be divided between health workers and long-term care facility residents, according to the release. For long-term care residents, most doses will be received and administered through a federal partnership with major pharmacy chains, including CVS and Walgreens. State health officials said the partnership was designed to lessen the strain on nursing homes and care facilities, which aren’t generally designed with cold storage or the capability to immunize their residents in mass.
“This would be to decrease the burden on the long-term care facilities that’s involved with receiving, storing, handling, administering and reporting COVID-19 vaccine doses,” Christy Gray, the director of VDH’s division of immunization, said in a meeting for the state’s Vaccine Advisory Workgroup earlier this week. “It is an intense process that most facilities are not equipped to do.”
Distribution to long-term care facilities through the pharmacy partnership will begin Dec. 21 and include doses for facility employees, according to Dana Parsons, the vice president of LeadingAge Virginia, an association of nonprofit senior service providers. The group is also pushing the state to include adult day centers and independent senior living facilities — the latter sometimes housed on the same campuses as nursing homes — in early distributions of the vaccine.
“I’m very pleased with the amount of vaccine that’s going to be available,” Parsons added. “This is a very positive outcome for long-term care communities, since the pharmacies will be administering and storing the vaccine.”
Both the Pfizer and Moderna immunizations require two doses spaced three to four weeks apart for full protection. The initial allotment will be enough to cover the first dose for 480,000 health workers and long-term care residents, but a “reserve will be held at the federal level” to ensure all of those recipients can receive a second dose, according to the state’s plan.
Much is still unclear about how vaccines will be prioritized and distributed after the initial allotment. The state’s vaccine plan defines other priority groups as medically vulnerable adults and elderly residents outside long-term care facilities, along with those who are at higher risk of contracting and spreading the virus, including Black and Hispanic Virginians. But distribution will likely depend on multiple factors, including the level of spread in a community, and how quickly the state receives new shipments of the vaccine, according to the plan.
Children are not currently included in the state’s planning. In a Tuesday presentation for state legislators, Dr. Lilian Peake, Virginia’s state epidemiologist, said early trials have not examined the safety and efficacy of either vaccine in children or pregnant women.
“The vaccines that are coming out now — and this is typical — are going to be approved for adults,” Peake said, adding that “those studies would still have to be done before the vaccine is recommended for children, and that’s one reason why we haven’t started that planning yet.”
Overall, Virginia is expecting to spend nearly $121 million on its vaccination campaign. In late October, Gov. Ralph Northam dedicated $22 million in federal CARES Act funding to the effort, which will support the plan through the end of the year. The administration “will identify additional sources of funding to continue to support the vaccination program in 2021,” according to state planning documents.
Public health experts are urging Virginians to trust the safety and efficacy of available COVID-19 vaccines, which are reviewed by federal agencies as well as an independent subcommittee within the state’s Vaccine Advisory Workgroup. They’re also asking for patience as doses gradually become more available.
The months-long process will require even vaccinated residents to continue safety precautions, including mask-wearing, social distancing, and staying home whenever possible to reduce the spread of the virus. Virginia is currently experiencing its worst surge of COVID-19 since the pandemic began, with hospitalizations at an all-time high and cases continue to climb in all five geographic regions.
“It’s going to take some sacrifice,” said Bryan Lewis, a computational epidemiologist at the University of Virginia’s Biocomplexity Institute, which partners with the state health department to model the potential spread of COVID-19 across the state. “But the cost of not doing anything is also a sacrifice.”