Health officer discusses vaccine prioritization

Widespread vaccinations hoped to start in spring

Jefferson County Health Officer Dr. Tom Locke

Jefferson County Health Officer Dr. Tom Locke

PORT TOWNSEND — During the first week of vaccinations against COVID-19 with Pfizer’s vaccine, Jefferson County Health Officer Dr. Tom Locke outlined to the county board of health how vaccination priorities were set.

During Thursday’s meeting with the board, the Food and Drug Administration’s advisory committee approved a recommendation to the FDA to grant Emergency Use Authorization (EUA) to Moderna’s vaccine.

The FDA approved Moderna’s vaccine’s EUA Friday and shipments will start to be sent out this week.

Although there are now two vaccines available for use, the quantities of them are too limited to allow for widespread vaccinations, so they must be used strategically, Locke said.

“Prioritization is the key when we have something like this: a remarkably effective vaccine that appears to be very safe,” Locke said. ““The supply of vaccine and the rate at which the manufacturers can produce it is far less than the demand for the vaccine.”

As of Wednesday, Washington state had received 62,400 doses of the Pfizer vaccine, with Jefferson and Clallam counties each receiving one unit of 975 doses. Next week’s shipment is to be cut by 40 percent, according to Gov. Jay Inslee. That won’t affect the North Olympic Peninsula.

Locke said he didn’t know if cuts would continue or how they would affect the Peninsula in the long term.

The Centers for Disease Control and Prevention (CDC) made guidelines for who should be vaccinated first, and each state set their own priorities based ujpon them, Locke said.

All public health jurisdictions must then implement the prioritizations that the state decides, Locke said.

Currently, the state is in Phase 1a of the vaccination priorities, which includes health care workers and first responders who do direct patient care and long-term care facility residents and staff.

Vaccinating health care workers is a priority because they’re at the highest risk of exposure to COVID-19 as they treat patients, and hospital staff is limited, Locke said.

“We don’t have enough health care workers on the front line as it is now. We can’t afford to have any less,” he said.

Long-term care facilities have been devastated by the pandemic, Locke said.

“The startling statistic that I’m always quoting is that long-term care residents represent about 1 percent of the U.S. population, but they have had 6 percent of the confirmed Covid cases and they’ve had 40 percent of the mortality,” he said.

“Over 100,000 long-term care residents have died so far. It’s just a very high-risk situation and a population that has a lot of risk factors for complications.”

Phase 1b includes people with underlying health conditions that increases the risk of severe complications if they’re infected with COVID-19. Such underlying conditions include cancer, chronic kidney disease or chronic lung disease and older adults who live in congregate or overcrowded housing facilities.

Phase 2 includes essential workers such as teachers and law enforcement, people with other at-risk health conditions, inmates in prisons, correctional facilities and people who are aged 65 and older, Locke said.

Phase 3 includes healthy adults without risk factors and children, he continued.

Phase 4 would include everyone else not included in the prior phases. However the Phases 1-3 cover the majority of the U.S. population.

A turning point for the pandemic will be when the vaccines are able to be widely distributed and available without prioritization, which is not expected until between April and June, based on current manufacturing projections, Locke said.

The “wild card” in that planning is three other vaccines still in trials conducted by Johnson & Johnson, Oxford and the University of Washington, and whenever those are granted EUA and are distributed, he added.

All three are still in clinical trials and it could be several months before the companies apply for an EUA.

“Probably by the end of 2021 we’ll have a confusing variety of vaccines,” Locke said. “We could theoretically have a dozen different Covid vaccines by the end of the next calendar year, but right now we would welcome that abundance.”

“We would like to be vaccinating hundreds of millions of people right now and we can’t. We’re just going to have to do the best we can.”

Jefferson County is organizing mass vaccination campaigns, possibly beginning in March, that would have health care workers use a high school gymnasium and have several stations set up to vaccinate many people at once.

Port Townsend, Chimacum and Quilcene high schools have already have offered their gymnasiums to host those events, said Locke.

Vaccinating health care workers during Phase 1 will be critical to be able to host those events, since there will still be potential for virus spread at them; vaccines do not provide instant immunity, Locke said.

“That’s the challenge before us but I’m enormously impressed with the seriousness and the level of organization among the various partners in Jefferson County and at Jefferson Healthcare,” he said.

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Jefferson County reporter Zach Jablonski can be reached at 360-385-2335, ext. 5, or at [email protected].

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