Local health officials doubt federal pivot on Covid-19 vaccines will help in time

HHS Secretary Alex Azar presented the changes, which fit the approach previously announced by the new Biden administration, as something that had been part of the plan from the start. A senior administration official told CNN on Tuesday that the change followed two Operation Warp Speed ​​meetings hosted by Azar in the past 48 hours on how to speed up the overdue deployment process.

Opening vaccines to people 65 years of age and older could help in areas where there were more doses than people eligible or willing to receive them – in some cases additional doses would no longer be used, expire and be piers. And the release of second, reserved doses could benefit areas where there has not been enough vaccine for all who are eligible and willing.

Local health officials are working to put health workers in place for a flood of extra doses of the Covid-19 vaccine – but many of those departments are understaffed and under-resourced, NACCHO’s Freeman said.

“Releasing every second dose and eliminating that holdback isn’t necessarily seen as a solution to getting the vaccine out faster. We still have issues – logistical issues – as to how to plan and manage. this mass vaccination effort, “she said.

‘There is a necessary balance’

At both the state and county level, supply and demand do not always match the Covid-19 vaccine.

The two vaccines that have been licensed for emergency use in the United States – Pfizer / BioNTech and Moderna – are given in two doses, 21 and 28 days apart, respectively.

With the Trump administration’s new deployment guidelines, Freeman said, there are concerns about mixed messages to the public about the importance of receiving a second dose of the Covid-19 vaccine and when.

“What message is this going to send around the original advice we were given that you have 21-28 days to get your second dose? What if that doesn’t happen?” Freeman said. “There has to be a balance between wanting to get as many people vaccinated as possible and making sure that we are able to pass the second doses of vaccine and have a sufficient supply.”

Another local concern is who received their first and second Covid-19 vaccines.

At Tuesday’s press conference, Azar said the second doses would still be available for those who need them.

“We are still in the middle of the pandemic”

At the local level, some health services may decide not to change their plans.

The city and county of Denver, for example, administered Covid-19 vaccines as part of Colorado’s Phase 1a and 1b priorities, meaning healthcare workers, first responders, and people aged 70 years and older are the only groups currently eligible to receive the vaccine.

To make changes to this phased approach, such as lowering the eligibility age to 65, “I think that would be a state-level decision,” Associate Director Dr Judith Shlay told CNN on Tuesday. of Denver Public Health.

“Our governor should make that decision. I’m not sure we will at this time, because we really have a lot to do with what we’re trying to do at the moment,” Shlay said.

Some states have decided to open up vaccination to more people.

Idaho will open up Covid-19 vaccines to all residents aged 65 and over starting February 1, Governor Brad Little announced Tuesday afternoon. “We don’t want to create a bubble or a backlog,” Little said. “Once we get a feel for the capacity, we’ll be able to reach the population 65 and over.”

Meanwhile, in Mississippi, Gov. Tate Reeves announced that Mississippians aged 65 and older, or those with pre-existing health conditions, can book Covid-19 vaccinations.

But Shlay said the business is huge.

“What we need to build is the infrastructure that can then be consistently available for months at a time. It will probably take nine months or a year for all of this to be deployed,” she said. .

The American Hospital Association said that simplifying the process and releasing more vaccines can help speed up vaccination.

However, “for this initiative to succeed at the speed at which we need it, a solid infrastructure must be in place in every state and jurisdiction capable of accommodating large numbers of people receiving both their first and second photo. in a timely manner, “said Rick Pollack, president and CEO of AHA, in an emailed statement to CNN on Tuesday.

“ Our local health services have not always been at the forefront ”

Speaking to CNN on Tuesday morning, Freeman said she was heading to a meeting with President-elect Joe Biden’s transition team to discuss the deployment of the Covid-19 vaccine.

She said local health services have been excluded from federal decision-making.

“Throughout this pandemic, our local health services have not always been at the forefront,” she said.

“It is disheartening for us that this kind of decision is made without fully integrating the public health system’s response to such a decision, especially because our health services are under-resourced and understaffed and are doing a truly exceptional job despite that, ”she added.

“With each level of complexity that presents itself, the weight on the shoulders of our health services becomes simply unbearable. They want to do a good job – they want to protect and immunize their communities and do it effectively and efficiently – but that doesn’t necessarily help them do it. ”