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The first 2.9 million batches of Pfizer’s new two-dose coronavirus vaccine were shipped from the company’s Kalamazoo, Michigan factory on Sunday, kicking off a massive national project that health officials hope will end. to the pandemic sometime in late 2021.
But some states are better prepared to end the coronavirus than others.
The US Centers for Disease Control and Prevention is dividing the doses weekly as they leave the Pfizer factory and ship via UPS and FedEx. Then it is up to the authorities in each US state and territory to decide exactly where those doses go and who is first in line to get them.
It is a complicated process. States, in essence, are deciding who gets protection first and who should continue to be at risk of contracting COVID-19 and potentially dying from it.
“This is emergency triage,” Irwin Redlener, founding director of the National Center for Disaster Preparedness at Columbia University, told The Daily Beast. “There are so many people at risk now and so many sectors that legitimately need attention with the early availability of the vaccine.”
“There will be people and populations that will be left out,” Redlener said.
Perhaps no state better illustrates that dilemma than Florida. The state is especially vulnerable to the coronavirus due to its combination of a huge elderly population, nearly 400,000 of whom live in nursing homes and other assisted living facilities, and a Republican governor and legislature who have downplayed the severity of the pandemic while actively resisting. Efforts by local authorities to control transmission through social distancing measures and masking mandates.
Florida urgently needs the vaccine to contain a growing wave of infections (about 9,000 new cases a day in recent weeks) and prevent a nightmare-like surge in deaths. The state has already lost nearly 20,000 people. How many more die depends in part on who state authorities allow to be vaccinated first as the vaccine supply slowly increases.
But Florida is already getting it wrong, according to experts polled by The Daily Beast, and the results could be disastrous.
As states loosely align their own vaccine distribution policies with broad guidance from the CDC, four highly vulnerable groups compete for the first batches of vaccine: frontline healthcare workers, nursing home residents, nursing home workers, essential industries and people of color.
The problem: Florida health officials under the leadership of Gov. Ron DeSantis are putting them in the wrong order, experts said.
Neither the Florida Department of Health nor the DeSantis office responded to requests for comment for this report.
Florida’s strategy, the draft of which is available here, is to rush 55 percent of its initial supply of 180,000 doses of Pfizer’s genetically engineered “messenger RNA” vaccine, enough to vaccinate 90,000 people, assuming it doesn’t spoil. to the big hospitals to vaccinate their own. personal.
The state is reserving the remaining 45 percent of the doses for people in nursing homes. That ratio seems likely to apply to the rest of the roughly 1 million doses that Florida expects to receive from Pfizer before the end of the month.
But, as is the case in most states, none of Florida’s first doses go to essential workers such as grocery store personnel, transit workers, pharmacy clerks, and teachers. What makes Florida’s plan so controversial is that, unlike many other large states, Florida authorities have refused to restrict businesses and schools or require the use of masks. Those policies have left essential Florida workers no choice but to work among a particularly ineffective and at-risk audience.
Similarly, DeSantis has not detailed a plan to rush vaccines to communities of color who, due to structural disadvantages that go back generations, are especially vulnerable to the virus. In Florida, as in many other states, there is significant overlap between essential workers and communities of color, further underscoring the importance of vaccinating these groups as quickly as possible.
“The need for strong equity strategies in Florida is extraordinary,” Lawrence Gostin, a public health expert at Georgetown University, told The Daily Beast.
In its current form, Florida’s hundreds of thousands of essential workers must wait, probably months, until Pfizer can produce and ship much more vaccine.
DeSantis and his health officials should change the order and bring essential workers to the front of the line, experts told The Daily Beast. “The moral claim essential workers have to be at the forefront of the vaccine line is overwhelming,” Gostin said.
“Once again, we cannot let the poor and low-wealth essential workers last,” said the Rev. William Barber II, co-chair of the Poor People’s Campaign. The New York Times.
It might make sense for Florida for essential workers to wait for their shots if the state was making other efforts to protect these workers. But is not. In September, DeSantis issued an executive order preventing Florida cities from penalizing people for failing to follow local mask mandates.
The same order made it difficult for cities and counties to close restaurants. “I am opposed to the mandates, period,” said DeSantis, a close ally of President Donald Trump. “I don’t think they will work.”
DeSantis has repeatedly demonstrated a poor understanding of the basic science of a viral pandemic and vaccines. He even appeared to support a fringe proposal that people skip the second dose of Pfizer’s two-dose vaccine. Data from Pfizer’s large-scale phase 3 trials made it very clear that without that second dose, the vaccine doesn’t work.
With a science denier in charge, Florida is more or less forcing essential workers to interact with an unmasked public, then refusing to help those same workers get vaccinated early.
Of course, experts recognized that uploading essential workers in line for the vaccine means hitting other vulnerable people. It’s not that hospital staff and nursing home residents don’t deserve protection. They do. And it’s not that vaccinating these populations early won’t save lives. Will.
But these groups have ways of protecting themselves that many essential workers don’t.
“Healthcare workers in most facilities will be fully clothed in the most advanced personal protective equipment available,” explained Redlener, using the acronym for personal protective equipment such as gloves, goggles, masks and face shields. “That is not true for an employee in a grocery store or pharmacy or a bus driver.”
Also, because nursing homes are highly controlled environments, staff can wear additional PPE and limit visits to protect residents and reduce the urgency to vaccinate them. “Nursing homes are doing a lot of testing for residents and staff,” Jeffrey Klausner, a UCLA professor of medicine and public health who previously worked at the CDC, told The Daily Beast.
And since nursing home staff are a major vector of outbreaks in the facility, vaccination staff offer protection to residents, potentially releasing doses that would go residents to essential workers.
“If you can vaccinate your staff and you can secure protective masks, PPE, etc., then you should be able to control infection and deaths in these settings and use early vaccine supplies to vaccinate the other minority and prime groups. line, ”Edwin Michael, an epidemiologist at the University of South Florida Center for Global Health Infectious Diseases Research, told The Daily Beast.
Florida’s nearly 22 million people could get more and more equal overall protection from initial batches of the state’s vaccine if authorities divert a portion of the first few doses to essential workers. But even that strategy won’t prevent the hardships all experts said looming, nor will it reverse the damage DeSantis has already inflicted on his state.
“The next vaccines are too late and too low in terms of supply to avoid the next third waves in most US counties, even if the planned gradual rollout begins in earnest beginning in January 2021,” Michael said. “Our simulations show that the only way to contain the coming waves is to increase the measures of social distancing, with an even moderate increase in the people who comply with these measures able to suppress and even flatten these waves in many areas.”
