Most Massachusetts residents will not receive a coronavirus vaccine until at least April, after two doses are given to health care workers and residents who face a greater risk of infection. But in all cases, the vaccine will be free for everyone, meaning no co-pays or fees, according to Gov. Charlie Baker.
Speaking during a press conference Wednesday, Baker unveiled these and more details from the state’s plan to distribute more than two million doses by the end of March. The timing and the number of doses will depend on federal authorizations for the vaccines, the first of which could come as early as this week. That would be a welcome development as the state and the country see record numbers of new coronavirus cases and hospitalizations.
Under the state plan, frontline health care workers in 75 hospitals across Massachusetts will be the first recipients of a coronavirus vaccine, likely next week. The state expects Pfizer to deliver 59,475 doses on or close to Dec. 15, pending approval from the Food and Drug Administration. The FDA’s advisory group meets Thursday to review Pfizer’s trial results and is expected to discuss Moderna’s emergency use authorization a week later.
Baker said the doctors, nurses, respiratory therapists and hospital cleaning staff who have direct contact with COVID-19 patients are at the highest risk for the coronavirus.
“Providing this group with the vaccine first will protect them from exposure and ensure that they can continue to provide health care to others safely,” Baker said.
The second expected delivery of 40,000 Pfizer doses will go to nursing home and assisted living residents and staff, to be administered by employees of CVS and Walgreens.
Massachusetts expects to receive enough doses for 300,000 people by the end of December, assuming a second vaccine, produced by Moderna, is approved this month. Community health center staff, police officers, firefighters, EMTs and home health care workers may be more likely to get the Moderna vaccine, which does not require ultra cold storage, and which comes in small shipping containers: 100 doses per box, compared to 975 for Pfizer.
Both vaccines require two doses per person, roughly three and four weeks apart, respectively. The trials show immunity takes effect roughly six weeks after the first dose. It’s not clear how long immunity lasts.
Roughly 668,000 Massachusetts residents could be vaccinated by the end of February, according to the Baker administration.
Unlike most states, Massachusetts will include staff and residents of prisons and homeless shelters in phase one of vaccine distribution. As more vaccines become available, the state will also include undocumented immigrants. And it will make sure 20% of doses go to communities with the highest infection rates, based on the CDC’s Social Vulnerability Index.
The steps, recommended by the state’s vaccine advisory group, are aimed at making sure residents in communities hit hardest by COVID-19 receive a proportionate share of the vaccine
“This group that I belong to worked hard to affirm the value of life, of every life,” said Rev. Liz Walker, a member of the advisory group.
Walker acknowledged that persuading some people, many Black and Latino residents in particular, that the vaccine is safe and works will be a challenge. Hospitals, health centers and the state are all working on or rolling out campaigns to address safety concerns. Dr. Paul Biddinger, who chairs the state’s vaccine advisory group, said there has been and will continue to be close scrutiny of every step of coronavirus vaccine development and results.
“We all share the same goal of preventing harm, saving lives and conquering this pandemic,” he said. “We feel we’re in a very good position to have confidence in the safety and efficacy of the vaccine.”
Phase two of the rollout, set to begin in February, will first focus on people who have two more conditions –such as asthma and diabetes — that complicate COVID-19 and then extend to essential workers in day care centers, schools, transportation, grocery stores and public health. Adults over the age of 65 and people with one complicating medical condition will follow. This could total 1.5 million people.
While vaccines may be available in pharmacies, health centers or special vaccination clinics as soon as this spring, it will take several months, depending on the supply, to vaccinate all Massachusetts residents who are willing to get the shots. And even then, life won’t return to normal.
Biddinger said it could be six to nine months before enough Americans have been vaccinated so that community transmission is no longer a risk. Until then, masks and social distancing will still be necessary.
“What we know about vaccines is that they dramatically lower your risk of needing hospitalization or dying. They protect you,” he said. “What we don’t know is whether they completely prevent you from getting a low-level infection or transmitting the illness.”
At hospitals and nursing homes across the state, the rush is underway to make sure staff priority lists are up to date. Many hospitals will start with all of the staff assigned to critical care units, emergency rooms and clinics where patients in the early stages of infection have their first visit. Others will start in their dedicated outpatient clinics for patients with COVID-19 symptoms.
“They are seeing COVID-positive patients, face to face, early on, when we know patients tend to be more infectious,” said Dr. Lou Ann Bruno-Murtha, medical director of infection prevention at Cambridge Health Alliance.
Unlike most hospitals, which plan to bring employees to a centralized vaccination clinic, CHA plans to take vaccine vials to each unit and inject staffers where they normally work so there’s less disruption in the work day.
Hospitals will stagger vaccination schedules within each unit to accommodate those who have a mild reaction to the vaccine, such as fatigue, muscle aches or a fever, and may need a day out of work. The expectation is that about 50% of people will experience a reaction and that about 10% will need to take a day or two off work if they have a fever, for example.
Some hospitals aren’t telling staff where exactly they fall on the priority list until a delivery date of the vaccines is certain, and each facility knows how many doses it will receive. Many hospitals will begin with a small number of staff and ramp up as they establish how quickly each vaccine can be delivered. Unlike with the flu, for example, the registration process will take a bit longer, and each person will be monitored for 15 minutes to make sure there are no immediate side effects.
While they review final preparations, some hospital leaders say the excitement is building.
“It’s all becoming very real now,” said David Twitchell, chief pharmacy officer for Boston Medical Center. “We’re excited to be able to start fighting back.”
The Massachusetts Senior Care Association said its grateful staff and residents will be a top priority for vaccination.
“The Baker Administration’s planned rollout is great news and supports our collective hard work to further protect our vulnerable residents and their dedicated caregivers,” Tara Gregorio, president of the Massachusetts Senior Care Association, said in a statement.
It’s not clear who will deliver vaccines to staff and residents of homeless shelters and prisons, but some advocates say they are pleased that prisoners will be early recipients.
“Making vaccines available to incarcerated people is an important step toward containing COVID-19 inside and outside of these facilities and providing constitutionally mandated medical care,” Carol Rose, executive director at the ACLU of Massachusetts, said in a statement.
Rose said Baker must also increase testing in prisons and jails and reduce crowding to prevention infections, illness and more deaths.
This article was originally published on WBUR.org.
Copyright 2020 WBUR
