’Broadly, what we can expect’: Statewide timelines estimated for COVID-19 vaccine distribution | TheUnion.com
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’Broadly, what we can expect’: Statewide timelines estimated for COVID-19 vaccine distribution

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While timelines have been estimated for COVID-19 vaccine rollout statewide, these should be taken with “a big grain of salt” at this point, county Health and Human Services Director Ryan Gruver said.

“I think it provides a good estimate of, broadly, what we can expect based on the best info that they have at this point,” said Gruver, referring to information available through the Community Vaccine Advisory Committee, a statewide group of over 50 member organizations providing input on vaccine planning efforts.

However, he said, factors such as number of health care facilities and demographics can play into whether any particular county will complete its vaccine rollout ahead of, or behind, other counties.



Nevada County’s population, for example, is older than the state average. “We have more people who are going to fall into those earlier phases, and we’ll have more people to work through in those earlier phases,” said Gruver.

Another component affecting logistics will be which vaccine — developed by Pfizer or Moderna — is sent to a county, according to Gruver. He said the Moderna vaccine is “more practical” for places like Nevada County, where the ultra-cold storage the Pfizer vaccine requires is only available at the county’s two hospitals.




The Moderna vaccine, said Gruver, can be kept at more typical temperatures for vaccines, allowing it to be stored in other locations, and comes in boxes of 100 doses. The Pfizer vaccine, in contrast, comes in boxes of 975 doses, which he said could present more complicated logistics in using them all within the allotted time frame.

Gruver said there will likely be overlap between vaccination phases for different groups, although, “the pacing of the broad phases and tiers is going to be driven by the state.”

ESTIMATED STATEWIDE TIMELINE

Currently, Nevada County is in Phase 1A of vaccine allocation, which includes direct health care or long-term care workers and residents of long-term care settings such as skilled nursing and assisted living facilities.

As of this week, according to the county’s website, Nevada County has received 1,975 doses, and expects additional small allocations in coming weeks.

Allocation guidelines set by the California Department of Public Health recommend that, within Phase 1A, workers be prioritized by type of facility or role, location, and individual worker attributes while there are not enough doses for all.

Acute care and skilled nursing facilities, for example, would receive top priority, followed by settings such as intermediate care facilities and primary care clinics. Laboratory and dental workers are among the third and final tier of this first phase.

Within those types of facilities, should there still not be enough doses, someone would be prioritized if their facility in particular serves a greater proportion of vulnerable persons in their area. Lastly, if not all workers within a facility can be vaccinated at first, age and other personal risk factors would be considered.

This phase will be followed by Phases 1B, 1C, and 2. Definitions for these phases have been proposed, with 1B to comprise frontline workers and those over 74 years old, 1C to include other essential workers and those with high-risk medical conditions or over 64 years old.

Lastly, phase 2 is proposed to include individuals between 16 and 64 years old, without high-risk medical conditions.

Leading candidates for Tier 1 of Phase 1B — the highest-priority frontline workers aside from direct health care or long-term care — are education and childcare, emergency services, and food and agriculture.

The most recent presentation by the Community Vaccine Advisory Committee cites state officials as estimating sufficient doses for 1A would be available by the end of December, 1B and some 1C by end of February, and 1C and some 2 by spring and summer.

GENERAL DISTRIBUTION

“The state administers millions of vaccines every year, so it makes much more sense for it to be through the normal channels of vaccine delivery,” said Gruver, on whether the county plans to organize a drive-thru or “pop-up tent event” for vaccine administration.

The normal channels, he explained, would be residents’ respective health care provider networks in many cases.

Gruver said one of the most common questions he receives is whether, upon receiving a dose of a COVID-19 vaccine, an individual should immediately stop wearing a mask or following public health guidelines.

“The state has indicated it’s going to be some time before enough people are vaccinated and they have enough information about the types of protection that that affords,” he said, adding that a key factor in level of protection would also be whether the individual has received one or both doses of the two-dose Pfizer or Moderna vaccines.

VACCINE ADMINISTRATION AT HOSPITALS

Several steps had to be arranged between the arrival of Nevada County’s first vaccine shipment Dec. 17 at Tahoe Forest Hospital and the first administration of the vaccines in western Nevada County Dec. 22, according to Rob Kanyuch, director of quality and patient safety at Sierra Nevada Memorial Hospital.

Kanyuch said the vaccines arrived 24 hours before the supplies which were necessary to administer them, including diluents, needles, and syringes.

“We initially thought that we could separate the vials for western Nevada County, maintain their ’frozen’ status, and relocate to our Ultra Low Temperature freezer,” he said through a spokesperson Thursday. “Shortly before arrival of the doses, Pfizer indicated we could no longer consider doses frozen once they were removed from Tahoe Forest Hospital’s freezer.”

As a result, he said, the hospital had to re-evaluate its vaccination schedule — going from a walk-in basis to appointments — to ensure doses removed from that freezer would be used within five days, and not wasted. A 48-hour notice period for delivery to western county was also requested by both Tahoe Forest Hospital, to minimize instances of opening their freezer, and California Highway Patrol, which escorted the doses transported.

“We anticipate future allocations will primarily be the Moderna vaccine, which can be safely transported and stored in our local freezer for up to six months,” said Kanyuch.

He said that, while the hospital had initially planned to vaccinate only 20% of any department at each scheduled vaccination clinic, to allow for monitoring of side effects, it removed that limitation after learning from other Dignity Health hospitals and Tahoe Forest Hospital that side effects “had been very minor and were not impacting staffing.” Over 200 people were vaccinated in the hospital’s first vaccination clinic.

Victoria Penate is a staff writer for The Union. She can be reached at vpenate@theunion.com.


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