During a week when Louisiana coronavirus hospitalizations shot up 22% and some intensive care units approached capacity, hospitals and state health officials are fervently planning for the first shipment of the vaccines aimed at ending the pandemic.
They said Thursday they were preparing to receive the first shipments of vaccine and get it to individual hospitals as soon as next week, pending federal approval. But as they proceed on a highly compressed time frame, health officials, hospitals and others tasked with distributing the drugs are still collecting information on distribution sites and finalizing plans.
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The first vaccine, developed by Pfizer and BioNTech, will be reviewed for emergency use authorization by the Food and Drug Administration on Dec. 10. It is expected to be shipped within 24 hours of approval, meaning it could come anytime between Dec. 11 and Dec. 15, depending on how long the FDA takes to review and approve it.
According to federal guidance and state officials, the first doses will go to frontline health care workers at hospitals, followed by residents of long-term care centers such as nursing homes. But specific plans are still very much in flux, even at the federal level, where after FDA authorization, the Advisory Committee on Immunization Practices will meet to make more granular recommendations about how the vaccine should be used.
“What we are used to seeing from ACIP is very finite guidance, like this medicine performs this way in patients below 50, this way in patients above 65, better or worse for people with these conditions,” Dr. Joe Kanter, Louisiana’s top coronavirus official, said on Thursday. “We don’t expect any bombshells in that, but we can’t be certain.”
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If the committee recommendations change, Gov. John Bel Edwards has indicated he will closely follow them.
And while the state estimates it will receive about 40,000 doses in the first shipment and another shipment with the same amount shortly after, that number is not set in stone.
Kanter said the state is planning to distribute the first shipments to 121 Tier 1 hospitals based on the size of the hospital’s staff, so long as the shipment size comes in as expected.
At this point, Kanter said the definition of frontline workers — the people set to receive the first shots — would be left up to hospitals.
“What we’ve tried to communicate is it’s not just health care professionals on the front lines,” he said. “It’s all types of support staff that have interactions with patients and their infectious materials.”
Ochsner Health System, which employs about 26,000 people across the state, will be giving the first vaccines to workers in its COVID-19 units, along with emergency department and urgent care workers, said Dr. Sandra Kemmerly, Ochsner’s medical director of hospital quality.
Ochsner will receive the vaccine at three different hubs in New Orleans, Lafayette and Shreveport, where it has positioned ultra-cold freezers. It will then transport it to individual hospitals.
Employees will receive a text asking them to fill out paperwork, and the hospital will also send people into the units to provide vaccinations. There will be multiple drive-thru sites that were piloted during flu shot vaccinations.
Hospital system executives at LCMC Health, which operates six hospitals in New Orleans, said they would be looking to the Louisiana Department of Health for further guidance over the next week but would dole out the first shots to people in direct contact with patients most likely to carry infections.
“The priority will be frontline workers, both clinical and non-clinical, who have been identified as actively working in high-risk settings such as ERs, ICUs, and COVID units,” said Dr. John Heaton, chief medical officer of LCMC.
At the Southeastern Louisiana Veterans Health Care System, decisions on who will receive shots first will reflect several risk factors: exposure, likelihood of severe illness and death, the chance of transmission to others and the importance of a person’s job in a functioning society.
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As hospitals work to nail down specifics on the first test of how efficiently vaccines can be administered, the state Health Department is also looking ahead to the next groups that might be vaccinated. It has created a questionnaire to solicit information from businesses that employ high-risk or critical workers, such as daycares, first responders, food processing facilities, post offices, other medical facilities, jails and grocery stores.
The questions gauge how well these places can store a vaccine that might require ultra-cold temperatures. Included in the document, for example, are questions related to how the facility plans to secure dry ice.
The state has also requested information from all potential providers of the vaccine, due Friday.
Meanwhile, the state is working to align its vaccine tracking system, called LINKS, with the federal government’s Tiberius tracking system.
And although vaccines represent a light at the end of a long, dark tunnel, health care providers warned Thursday that more infections and deaths lie ahead no matter how quickly the vaccine is distributed.
“Unfortunately, the number of cases is going up again,” said Dr. John Schieffelin, an infectious disease expert at Tulane University. “The number of hospitalizations is going up again. Hospitals I’m involved with are getting a little nervous and starting to look at PPE stock. We’re all worried that we could be heading back to where we were in March and April. It’s gonna be a nervous couple of weeks.”
And the vaccines might not provide protection for several weeks after the initial dose, he said.
“Based on data I’ve seen, it really looks like you get protection two weeks after the second dose — five to six weeks after that first dose of vaccine,” Schieffelin said.
Still, the idea of vaccines on trucks and planes to Louisiana has buoyed spirits in the medical community, even as they brace for several more months of social distancing, mask wearing and rising infections.
“This is how the pandemic ends,” Kanter said. “The end is in sight. The challenge is we still have to keep our eyes on the road. We’re working hard to get vaccine out and it’s nice to envision what it looks like on the other side, but we still have time on the clock.”