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States Gear Up for Biggest Vaccination Effort in US History

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With a COVID-19 vaccine drawing closer, public health officials across the country are gearing up for the biggest vaccination effort in U.S. history — a monumental undertaking that must distribute hundreds of millions of doses, prioritize who’s first in line and ensure that people who get the initial shot return for the necessary second one.

The push could begin as early as next month, when federal officials say the first vaccine may be authorized for emergency use and immediately deployed to high-risk groups.

“The cavalry is coming,” Dr. Anthony Fauci said Thursday on ABC’s “Good Morning America.”

He said he hopes shots will be available to all Americans in April, May and June.

Pfizer also boosted hopes this week, saying early data suggests its vaccine is 90 percent effective.

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In Philadelphia, the health department is counting how many health care workers would be among the first in line.

In Louisiana, officials are planning an exercise to play out different scenarios exploring how the process might unfold.

“If you get 10,000 doses, what are you going to do, versus 100,000 doses?” Dr. Frank Welch, director of Louisiana’s immunization program, said.

Similar preparations are happening at the federal level. Welch listened in last week on a “war gaming” session at the U.S. Department of Health and Human Services.

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For the vaccination effort to get off the ground, state officials have been readying systems to track supplies and who has been vaccinated.

That information will be fed into a national network, giving federal health officials an up-to-date picture of vaccinations around the country.

Providers such as pharmacies and doctors’ offices will also need to be able to look up records.

“We not only have to bring people back for a second dose, but need to make sure that we have very good records of which vaccine they received the first time,” said Dr. Jinlene Chan of Maryland’s health department.

States already have immunization registries, which will be used for COVID-19.

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Providers will also have to report vaccination information daily, which will be an adjustment for those who typically enter data weekly or every couple of weeks, state officials said.

To help people find doses in their area, the Centers for Disease Control and Prevention wants to put information on a vaccine finder website, which will be updated each day with the latest inventory.

Supplying that inventory information might be a staffing strain for some providers, including a hospital in Utah that said it only has one person who currently enters the information, according to Jon Reid, who manages the state’s immunization registry.

“And they don’t do it every day. They do it whenever,” Reid said. State officials in Utah plan to update the inventory, rather than ask each provider to enter it, he said.

States are also working to expand the number of pharmacies, doctors’ offices and other providers that can administer COVID-19 vaccines, to ensure shots are conveniently available.

But enrollment can be time-consuming, Reid said, because providers often need help getting technical systems working and going through inspections to ensure they can meet storage requirements.

The Pfizer vaccine needs to be kept at minus 70 degrees Celsius (minus 94 F).

Given the hurdles, Reid does not expect smaller pharmacies to become COVID-19 vaccine providers.

Because of the likely need for two doses given three or four weeks apart, the CDC is considering ways to help Americans remember the second shot, including issuing cards that people would get with their first shot.

In a rural part of South Carolina, one community health center is planning multiple reminders, including text messages and calls from health workers.

Distributing doses is another issue. The Pfizer vaccine, which could be the first to get the green light, comes in shipments of nearly 1,000 doses.

“A minimum of 1,000 doses makes it very difficult to get smaller facilities vaccinated,” Rich Lakin, director of Utah’s immunization program, said.

Shipments might go to a hospital that is easily accessible to health care workers from multiple sites, Lakin said.

In North Dakota, providers receiving fewer than 1,000 doses will have them shipped to a state warehouse that can maintain the ultra-cold storage.

“We’ll break them down into the smaller quantities and then drive them to the provider,” Molly Howell, the state’s immunization director, said.

Even if distribution goes smoothly, officials worry people will not want the shots.

“If there’s going to be any real challenge, to be honest with you, it’s going to be convincing folks to get the vaccine,” said Patrick Peer, who runs the Good Neighbor Community Health Center in Columbus, Nebraska.

Public health groups estimate that an additional $8.4 billion is needed to pay for staff, data systems, outreach and supply costs.


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