What will it take to vaccinate Oregon?

This week, Kaiser Permanente launched a COVID-19 vaccination clinic at the Oregon Convention Center in partnership with three other major health systems: Providence, Legacy Health and OHSU.

It is the first mass vaccination site in the Portland area and a key step in the state’s effort to build a system that can eventually be expanded to inoculate more than 3 million adult Oregonians.

The convention center clinic will be by appointment only and will begin vaccinating approximately 2,000 people per day. As more and more doses become available, Kaiser and partners say the site should have the capacity to vaccinate up to 7,500 people per day.

“We are building this as a sustainable operation that we will run until we no longer need it,” said Wendy Watson, COO of Kaiser Permanente Northwest. “Our ultimate goal is to open it 7 days a week, extended hours.”

The new site is one example of how Oregon, after a slow start, is better at getting vaccine doses out of the freezer and into people’s arms: Last week, vaccinators repeatedly passed the Governor Kate Brown’s goal of 12,000 doses administered daily.

But the pace of vaccination needs to increase further for Oregon to achieve herd immunity and stop the spread of the virus: just over 6% of the adult population has received at least one dose of the COVID-19 vaccine until now.

Getting there is complicated and requires more than large spaces to administer our vaccines. Here’s what other experts say the state needs to be successful in expanding distribution:

More vaccines

Each week, Oregon receives approximately 100,000 vaccines in total, including the first and second doses of the Pfizer COVID-19 vaccine and the Moderna COVID-19 vaccine. If that sounds like a lot, know that there are about 3.3 million adults in Oregon, and each needs two doses.

It would take about double the current supply to fully immunize all adult Oregonians by the end of fall.

Patrick Allen, director of the Oregon Health Authority, said the lack of supply is the main obstacle the state faces.

“We are now in a place where we can administer virtually as much vaccine as the federal government can provide,” Allen said at a press conference for the launch of the convention center clinic.

Statewide, hospital systems and other partners have stepped up efforts to administer vaccines – and now they’re asking for more doses. But supply from manufacturers remains limited.

“Until we see a new vaccine approved or production increases dramatically, everyone in the state, including this operation at the convention center, will be able to immunize more people than we have vaccines.” Allen said.

In fact, approval of a new vaccine could soon help ease the supply shortage in Oregon and other states.

A third vaccine candidate, from Johnson & Johnson, is nearing the end of clinical trials. Depending on what the data shows, it could be submitted to federal regulators for emergency approval in February.

An army of volunteers

Oregon needs more trained vaccinators and more staff to support them.

Before a person can get the vaccine, they may need help knowing where to park. They must sign a consent form and be screened for factors that could complicate vaccination. After receiving the vaccine, patients should be observed for 15 to 30 minutes in a clinical setting if they have an allergic reaction.

All of this takes additional volunteers.

Health systems are calling on retired nurses and doctors to support staff at vaccination sites, so their regular clinicians can focus on treating patients with COVID-19 and anyone in need of care .

Other source of support: Oregon Air National Guard and Oregon Military National Guard.

Oregon has approximately 8,300 Army and Air Guardsmen. Several hundred are medically qualified and can administer vaccines, but the gatekeeper’s most important role will likely be to provide logistical support and non-medical volunteers for vaccination sites.

Vaccines at the pharmacy

Pharmacies currently play a key role in delivering vaccine to residents of long-term care and memory care facilities, taking them directly to facilities.

And the state and CDC have the potential to activate a much larger pharmaceutical partnership that could deliver the vaccine directly to retail pharmacies across the state – potentially allowing eligible members of the public to get vaccinated for free at their pharmacy. local.

Pharmacies participating in the federal program include many familiar names including CVS, Walgreens, Fred Meyer, and Costco.

The governor said earlier this month that the state expects drugstore shipments to arrive shortly.

Now, it is not known if this has happened or if the federal government is sending enough vaccines to Oregon to activate the pharmacy program. A week after Brown said the state was in the process of launching it, she and other governors accused outgoing Health and Human Services Secretary Alex Azar of promising more doses than the federal government could actually provide some.

The Oregon Health Authority did not respond to a request for an update on when Oregon retail pharmacies will begin receiving the vaccine.

A plan for essential workers

COVID-19 has not affected all Oregonians in the same way. Case rates are more than twice as high for blacks and Native Americans in Oregon than for whites. For Pacific Islanders and Latinos, the disparity is even greater: They are more than three times more likely to contract COVID-19 than a white Oregon.

National research has shown that one of the main reasons for these disparities is that specific racial and ethnic communities are over-represented in low-wage jobs that cannot be performed remotely, and are more likely to be exposed to the virus at work.

“I would like to bring this to the forefront of the conversation,” said Daniel Lopez-Cevallos, professor of health equity and ethnic studies at Oregon State University. “We have essential workers out there exposed, day in and day out.”

Lopez says that at a minimum, the governor should make it clear when essential workers will be prioritized for immunization. The state vaccine advisory committee has placed them in the larger group – IB – which will take priority sometime after teachers and adults 65 and older, but ahead of the general population.

Lopez-Cevallos would like to see the state plan a specific vaccination strategy for essential workers.

Melissa Unger, director of SEIU Local 530, shares Lopez-Celvallos’ concern that the state does not yet have a targeted plan to reach essential workers who have been most affected by the virus.

Unger believes essential workers risk being left behind if the state relies too much on mass vaccination sites because they won’t have time to queue or hide online looking new appointments to publish.

“They have to go to work. We need to make sure that we make this process work for the very people who have been asked to keep our economy running during this pandemic, ”Unger said.

Unger’s suggestions include a dedicated appointment line that allows essential workers to schedule their vaccinations and better outreach – by text and in people’s native languages.

More and better public health communication

Unger and Lopez both say the state needs a more aggressive public health messaging campaign to reassure people and answer their questions about the vaccine.

Unger says not all healthcare workers and hospitals currently eligible for the vaccine feel comfortable receiving it. This is a heterogeneous group that includes people with varying degrees of health literacy: certified nursing assistants, people who clean hospitals and provide catering services, and home helpers, for example.

Unger says many of them are trying to decide whether to get the vaccine and need more help answering their questions.

“What are we doing as a community and a state to make sure they have the answers they need to feel safe?” Said Unger.

Unger also thinks the state needs to do a better job of reassuring the public that there is a plan for everyone to get vaccinated – it will just take time.

“The element of scarcity in a pandemic is very dangerous,” she said. “Everyone is trying to figure out how to feel safe for their family right now, and I think the role of government is to be able to communicate that we’re going to get there, and there is hope.