Today, Nevada Governor Steve Sisolak unveiled a plan to distribute and administer novel coronavirus vaccines when they become available.
At the end of October, the US Centers for Disease Control and Prevention published the COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations. The publication is intended to help subsidiary forms of government, both large and small plan and operationalize a vaccination response to COVID-19 within their jurisdictions.
Within their vaccination plans, vaccine awardees must address all requirements outlined in the playbook and clearly describe their responsibility for ensuring activities are implemented. The State of Nevada has been planning a tiered distribution of vaccines.
But questions remain. It is not yet known which vaccines will be available, in what volumes, at what time, with what efficacy, and with what storage and handling requirements.
There are currently two vaccines that are offering promising results, one from Pfizer and the other from Moderna. Both have filed for emergency use authorization with the FDA and both are showing an early efficacy of about 95 percent.
During today’s virtual press conference, Candice McDaniel, Health Bureau Chief, Bureau of Child, Family, and Community Wellness, Division of Public and Behavioral Health said vaccines with 95 percent level of effectiveness would slow the spread of COVID-19.
“A 95 percent efficacy indicates a 95 percent reduction in disease occurrence among the vaccinated group or a 95 percent reduction in the number of cases you would expect if the group had not been vaccinated,” McDaniel explained.
Even with the promising efficacy percentages, a vaccine will not be released for use until the FDA deems them both safe and effective. The FDA Vaccines and Related Biological Products Advisory Committee is set to meet on December 10.
“And from that point we anticipate things will move quickly,” McDaniel said. “Staff for the Nevada State Immunization Program are prepared and we’ll be on standby to accept initial shipments and for the redistribution when a vaccine is received.”
The state has been planning and preparing for scenarios they may encounter during the vaccine rollout. From these exercises, according to McDaniel, the state has developed a more comprehensive process for distribution.
The Nevada State Immunization Program is receiving regular updates on both vaccines and how they must be shipped, handled, stored and administered. The Pfizer and Moderna vaccines each have very specific challenges and parameters.
“The Pfizer vaccine will require ultra cold storage, but the Moderna vaccine will not,” McDaniel said. “Both vaccines require two doses to be administered with a set timeframe in between. We continue to work with our partners statewide to share this information, ensure vaccinators are enrolled and initial orders are submitted.
“Allocations of the COVID-19 vaccine will be made based on population. And we will use the tiered approach in alignment with the Advisory Committee on Immunization Practices guidance to ensure our frontline medical providers receive the first doses.”
To be effective, the Pfizer vaccine needs a second dose within a 21 day interval. The Moderna vaccine requires a maximum of 28 days between the first and second shot.
Shannon Bennett, Immunization Program Manager, Division of Public and Behavioral Health talked about the tiered approach to vaccine distribution.
“Nevada’s playbook outlines the tiered populations that will receive the first doses of COVID-19 vaccine,” Bennett said. “It is important to remember that when a vaccine is approved for use and allocated to individual states, the tiers we developed will outline who is eligible to receive the vaccine.
“Our framework of priority populations begins with those at the highest risk for contracting COVID-19 and those we are all depending on to take care of us, our critical infrastructure workforce in hospitals and medical facilities. Tier One also includes other medical provider types, correctional facility, staff, and law enforcement.
“Of this first vaccine allocation, a portion will also be set aside for CVS and Walgreens, our pharmacy partners, who will work to vaccinate members of our vulnerable population who work and reside in long term care facilities. We are working with all Nevada counties to finalize their plans to vaccinate their Tier One population.”
The state has taken pains to detail their vaccine distribution plans. Bennett said they would account for potential side effects on medical staff when rolling out the doses.
“An important consideration when vaccinating medical facility staff is the potential for anticipated side effects. As with other vaccines, a low grade fever and a sore arm are indications the vaccine is doing its job, but it may impact our medical workforce’s ability to do theirs, for a short amount of time.
“We are planning with our medical facilities to ensure only a portion of the staff received the vaccine at one time in order to not create a potential staffing shortage. The COVID-19 vaccines will not be released until they are deemed safe and effective. But these common side effects are an important consideration while we all work to protect the health of our communities,” Bennett said.
Once a vaccine is approved, the state anticipates weekly allocations. Each county will be able to submit their request for the vaccine. These requests and the monitoring of vaccination and distribution will run through Nevada’s immunization Information System, Nevada Web ID.
“This is a system that the immunization program uses every day for influenza vaccine in the Vaccines for Children Program,” Bennett said. “We are able to track how much vaccine has been used and how much is still left on hand. The program is working hard to be prepared to get the vaccine to our immunizing providers once it has been approved. And we are updating that as vaccine playbook with additional details thoughtfully planned to support this response.”
Bennett said she expects the need for roughly 170,000 Tier One vaccinations, which could be distributed as soon as the end of this month. Bennett said she anticipates the vaccine will be available to the general public by mid-to-late spring of next year.
In the meanwhile Governor Sisolak asked all Nevadans to wear a mask in public and to restrict travel over the holidays.
Brian Bahouth is the editor of the Sierra Nevada Ally. Support his work before the end of the year, and NewsMatch will double your one-time or ongoing contribution.