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Northern California Hospitals Preparing for COVID-19 Vaccine

The UC Davis Medical Center is administering an experimental vaccine or a placebo to about 230 local volunteers as part of the national Pfizer trial, one of a handful of tests underway internationally.

by Tony Bizjak and Hannah Wiley, The Sacramento Bee / November 11, 2020
Nov. 11—News this week from Pfizer pharmaceuticals of a coronavirus vaccine breakthrough is prompting Sacramento and Northern California healthcare providers to step up preparations for mass distribution.
That includes the UC Davis Medical Center in Sacramento, which is in talks with state officials about serving as a vaccine storage and distribution site for Northern California. The vaccine requires specialized low-temperature freezers for storage, and UC Davis has some and is buying more.
Dr. David Lubarsky, chief executive for UC Davis Health, said a limited number of vaccine doses could be available as early as December in California for first responders and healthcare workers. The general public, he said, probably won't have access until after the middle of next year.
The UC Davis Medical Center is administering an experimental vaccine or a placebo to about 230 local volunteers as part of the national Pfizer trial, one of a handful of tests underway internationally. Pfizer reported on Monday the tests nationally have shown an initial 90% success rate.
"The news is tremendously good," Lubarsky said. "If it holds up, the possibility to achieve herd immunity is within reach for the U.S. within a year."
It's a race against time as the U.S. struggles to contain an autumn surge of potentially lethal COVID-19 cases. The virus has been connected with 240,000 deaths in the United States since the pandemic hit in February. Worldwide, it has killed 1,270,000, according to the World Health Organization.
Amid a regional surge in infections, Sacramento, Placer and El Dorado counties were demoted to more restrictive tiers of business activity on Tuesday. The six county Sacramento region has combined for more than 660 deaths and 42,000 confirmed infections since the pandemic began. Nearly 1 million people in California have been sickened by the coronavirus and more than 18,000 have died.
California Health and Human Services Secretary Dr. Mark Ghaly declined this week to offer a timeline for vaccine distribution in California, but said, "we anticipate that we are getting near approvals of some vaccines. We aren't done yet. Nothing is complete. We eagerly wait for more information."
Pfizer still must monitor its clinical test subjects to observe the vaccine effects, then win emergency authorization from the U.S. Food and Drug Administration.
Several of Sacramento's major healthcare providers — UC Davis, Kaiser Permanente, Sutter Health and Dignity Health — told The Sacramento Bee this week they are in active preparation to get vaccines to their members once it becomes available.
Sacramento County public health officials also said this week they are in talks with the state about obtaining doses that they plan to administer to people who are not otherwise able to get the vaccine from a health provider, including small community health clinics and congregate care facilities.
But health officials say they are still in the dark about timing and details of vaccine distribution. "We don't know how much (doses) we are getting," Sacramento County Health Officer Dr. Olivia Kasirye said.
Newsom and health equity
Gov. Gavin Newsom on Monday reiterated that the first general public vaccine injections will go to essential healthcare workers and first responders. "A vaccine is on the way. That's good news," he said. "But the availability to you and me and others outside our first responders, outside our health care professionals is many, many months off."
The California Department of Public Health's draft COVID-19 vaccination planning report includes the general public in the last stages of its outline.
In the second part of California's first vaccine phase, as outlined in the state health department's report, Californians who face the worst of COVID-19 would be prioritized. These individuals might have underlying medical conditions, like cancer, heart conditions, immunocompromised systems, type 2 diabetes or Sickle cell disease, according to the Centers for Disease Control and Prevention's list of qualifying conditions.
When a larger supply reaches California, Newsom said certain populations would be next in line, including those in nursing homes, with disabilities or in under-served Latino, Black and rural communities.
"Improving health equity will also occur by examining the demographic and social factors that contribute to the overall health disparities in California," the department's report notes, "such as racism, income, ageism, English proficiency, lack of access to healthcare, crowded housing, precarious employment, and discrimination related to disabilities, sexual orientation, gender identity, ethnicity, and immigration status."
Newsom's administration is also preparing a list of storage, safety and transportation requirements for when the vaccine does become available, including dry ice and personal protective equipment for health workers administering the shots.
UC Davis executive on herd immunity
Lubarsky said he is concerned that some members of the public might not be willing get vaccinated, which would make it harder to achieve herd immunity.
Some are opposed to vaccinations in general, and others may worry about the safety of the vaccine, given the political push from the Trump Administration to get a vaccine to market.
"There has been way too much talk of politics involved with science," Lubarsky said. Technology and pharmaceutical companies have been working quickly, but with a public health focus, not a political one, he said.
Sutter Health prepares
At Sutter Health, which operates 200-plus clinics in Northern California, officials say they have acquired about 15 freezers, "both large and smaller, portable options — that can each store about 12,000 to 30,000 doses depending on their size. The smaller portable freezers can be used to transport doses from one location to another or as mobile 'pop-up' vaccination units."
The healthcare provider said it plans to be judicious in the name of safety. Sutter's medical director of infectious disease is serving on the state's COVID-19 Vaccine Drafting Guidelines Workgroup.
"We are committed to following established standards despite the significant urgency and rapid operationalization of vaccine development and deployment," Sutter said in an email to The Bee. "Like other health systems, we are taking an informed and carefully considered approach to vaccine prioritization."
Kaiser Permanente in COVID vaccine trial
Kaiser Permanente, a national healthcare provider based in Oakland, is participating in clinical trials for both the NIH/ Moderna and Pfizer/ BioNTech vaccines.
Officials with Kaiser Permanente said limited initial supplies of the vaccine will require government officials and others "to balance equity considerations and the need to maximize the benefits of an initially limited supply."
"We will work with our partners at the Centers for Disease Control and U.S. Department of Health and Human Services, as well as health officials in each state where we operate, to comply with local and regional allocation and distribution procedures when those plans are approved by the CDC," Kaiser said in a statement to The Bee.
"While the CDC has yet to announce its criteria for prioritizing which populations should receive the vaccine first, when it is announced we will leverage the extensive data and advantages of our integrated system to identify, reach out and vaccinate members and employees who meet that criteria. We expect to use many different venues for administering the vaccine, with an emphasis on patient safety, convenience, and the most efficient use of resources."
Kaiser officials said they also plan to work to educate their members on the value of the vaccine and of continued safety steps.
"We also are committed to educating our members, workforce, and the communities we serve about the safety and effectiveness of the vaccine and to promote understanding of how a vaccine — coupled with continued public health measures like the wearing of masks, appropriate physical distancing, and frequent hand washing — can help control and ultimately bring about the end of the COVID-19 pandemic."
Dignity Health
Officials with San Francisco-based Dignity Health, which operates in three states, said they too are encouraged about this week's Pfizer announcement.
" Dignity Health is closely monitoring the development of a vaccine for COVID-19 and are encouraged by initial results from Pfizer's vaccine trial," the healthcare company said in an email to The Bee. "While we anticipate federal, state and local health agencies will take the lead on determining distribution plans and recommending who should receive the vaccine first, we expect priority may initially be given to health care workers involved directly in patient care and those who are most vulnerable in our community and at an increased risk for the virus.
" Dignity Health has well-established protocols in place to receive, store, and administer vaccinations and stand ready to partner with our health agencies to help safely distribute any COVID-19 vaccines that are approved for distribution. The care and safety of our employees and the patients we serve is always our top priority, and we look forward to sharing more with our community when we learn more."
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