Large hospital systems develop plans for which health care workers will first receive the COVID-19 vaccine

How large hospital systems make the best decision about which health care workers will be vaccinated for the first Covid-19 is a difficult task when it is unclear what shots they will receive, how many and when to arrive.

The first COVID-19 vaccine could be cleared for use in the U.S. next month, Pfizer Inc. And the candidate for Bionettech SE is already under review and the shots of Modern Inc. are not far behind. Federal officials, meanwhile, have indicated that health care workers and at-risk older Americans should be vaccinated as part of months of decision-making with other major priority groups.

But following those initial guidelines can be difficult. U.S. With 21 million health care workers, there certainly won’t be enough doses to reach them all at once. It forces hospitals to categorize their workers based on estimates of optimal distribution, a task that is further complicated by state-by-state patchwork for some systems.

Minnesota’s Elena Health System, which employs 15,600 workers who have direct contact with patients in Minnesota and Wisconsin, estimates that she may initially receive 3,000 to 4,000 doses. Plan: Prioritize people who have direct contact with coronavirus patients by listing each worker by their job type and the units in which they operate.

“We’re looking at all the employees, where they work, what their roles are and what the risks of coming into contact with them are,” said Ryan Els, who monitors coronavirus responses at Alina Health’s hospitals.

Health systems that operate in line with the state face an even greater challenge. While states are signaling federal guidelines, they are developing their own priority lists, creating a situation where some employees in one state are vaccinated against their peers in other friends.

“How reasonable does it seem to people in the same system?” Amy Kampton-Phillips, a doctor and chief clinical officer at Providence, said it operates 511 hospitals in seven states, as well as clinics and medical offices.

Like Elena, Providence also plans to vaccinate based on workers ’roles in the fairness effort. The health system will notify workers when it is time to get vaccinated. If people think the groups were mis-classified, it also creates an appeals process. “You have to make really tough decisions when there is a shortage of supplies. They don’t feel good, “said Compton-Phillips.

Federal officials plan to send an initial 6.4 million doses across the country, according to Gus Parna, chief operating officer of Federal Operations Speed. More doses will then be sent on a weekly basis, with a target of distributing 40 million doses by the end of the year, Parna said in a call with reporters on Tuesday.

Alex Azar, secretary of the U.S. Department of Health and Human Services, said shipments would be divided into states based on the size of the adult population, and not in response to an additional virus.

“We wanted to keep this simple, as we are seeing a nationwide spread and disease susceptibility,” Azar said. “But, once we go through these early branches where we are more in a state of scarcity, eventually we reach the stage where it should be needed per capita. So instead of having multiple methods, we thought it best to keep it simple. “

Some health systems are taking a more grainy approach in preparing for the use of shots.

Advocate ur Rora Health Inc., with 26 hospitals and even more clinics and doctors in Illinois and Wisconsin, is identifying workers at greatest risk of serious illness, expecting it will not receive enough doses to cover employees equally. That means factoring in details such as how prevalent the coronavirus is in a particular community, as well as employee risk factors, said Robert Citronberg, a doctor and executive medical director of infectious disease and prevention.

“We aim to target as many people as possible who are seriously ill with covid, and we know that they are older people, people with underlying medical conditions,” Citronberg said.

New York’s Northwell Health, along with 23 hospitals, has prepared a spreadsheet of its 74,000 workers, classifying them at risk of catching the novel coronavirus on the job, according to Mark Jarrett, a doctor and chief quality officer at the system.

The weight of Northwell’s calculations is how much staff interacts with infected patients and how prevalent the virus is in a community like Advocate ur Rora. It may change at other data point times, resulting in people working in more widespread areas being vaccinated first.

And Jarrett brings another issue to the table. People are claiming for the vaccine and workers are less worried about not wanting it, officials at other hospitals across the country were appalled.

Providence Compton-Phillips said those concerned about the rapid pace of COVID-19 vaccine development were already facing an anti-vaccination movement in the health system.

Alison Shuttle, a doctor at Sanford Health in South Dakota and chief medical officer at Sioux Falls, hopes the clinical trial data will reassure workers. An internal survey found that more people said they would take the COVID-19 vaccine after Faviser and Moderna announced preliminary results, showing that their candidates were 95% effective.

Cautiously optimistic

“I’m optimistic, cautiously optimistic, and proud of our health care workers that they jump, stick to their shoulders and get vaccinated,” Shuttle said.

If and when the Food and Drug Administration authorizes vaccine candidates, the Centers for Disease Control and Prevention will make final recommendations on who should be vaccinated. Members of the CDC’s immunization committee will review data for clues as to whether formulas work better in some groups than in others.

In the meantime, health systems will continue to prepare as much as they can. When asked if Northwell knew how many doses he would get, Jarrett laughed.

“No,” he replied. Any estimates are likely to change, Jarrett said, and even the smallest fluctuations can make a big difference.