"We expect to receive at UI Health Care, relatively imminently, doses of the Pfizer vaccine, assuming there is emergency use authorization," UI Hospitals and Clinics CEO Suresh Gunasekaran told reporters Wednesday. "We have been planning for over months to be ready to distribute this in a fast and efficient way for our employees."
In that health care workers are among the Americans prioritized to receive the first COVID vaccine doses, but supplies are limited, UIHC has broken its 18,000-some employees into four different groups for vaccine prioritization, according to Gunasekaran.
The first group of about 1,500 to 2,000 employees includes physicians, midlevel providers, nurses, therapists, housekeepers and others who are most directly involved in patient care. The second group covers those supporting patient care on the main campus, while the third group involves workers supporting patient care at off-site locations and clinics.
The fourth group includes all other UIHC staff involved in supporting health care delivery — but who are not on the front lines.
UIHC leadership doesn't yet know exactly how many doses the campus will get in its first shipment — although Gunasekaran is estimating about 1,000.
"We are going to finalize the numbers probably over the next couple of days with (the Iowa Department of Public Health)," he said. "Right now, we're being told we will only be told one week at a time how many doses that we're getting."
"So we think, for next week, the number will probably be close to 1,000 doses."
Gunasekaran said logistics around administering this specific vaccine are endless — considering it must be stored at ultracold temperatures requiring specialized freezers, which UIHC proactively ordered months ago.
"You have to figure out how to get everyone into a central location, and how we dose it is very different," Gunasekaran said. "Once you thaw it and start using it, you have very little time — just a few hours if you will — to get all of that vial used. So when we're looking at the logistics, there's been a lot of planning that has gone into this."
Should vaccine doses become more available, he said, UIHC storage space shouldn't be a problem.
"We could store a lot," he said. "We could store more than 50,000 doses easily."
Even with other vaccine candidates coming down the pike — and a Moderna version close behind Pfizer's — UIHC Vaccine Treatment and Evaluation Unit Director Patricia Winokur on Wednesday told reporters, "storage capacity is not going to be the limitation."
"The limitation is going to be how much vaccine we get."
The U.S. Food and Drug Administration on Thursday will livestream its final review needed to authorize Pfizer's COVID vaccine for emergency use. The United Kingdom took that step earlier this week, as did Canada on Wednesday.
But even after Americans begin receiving vaccine — including Iowans and UIHC employees — Winokur warned two doses spaced weeks apart are required for 95 percent efficacy. That means everyone should continue masking, social distancing, and taking other precautions for some time.
"After the first dose, the efficacy is only about 52 percent between the first and second dose," she said. "So there is still going to be a need for the people who have been vaccinated to continue to maintain social distance and masking."
Researchers also don't know yet whether the vaccine reduces shedding of the virus.
"We know that it reduces the number of cases of symptomatic COVID-19," she said. "What we need to learn more about is whether it truncates transmission from person to person."
UIHC isn't at this time requiring employees get vaccinated, although Gunasekaran said they'll be strongly encouraged.
"They will be required to give us their vaccination status, i.e. whether they have received the vaccine or they declined," he said. "But, at this time, we will not be making them, which is our usual practice — even for flu."
Still, Gunasekaran said, getting UIHC employees vaccinated serves multiple purposes — including modeling to the broader community and ensuring its capacity to continue serving it.
"We have to manage the message to our staff and hope that our staff will be role models to broader community that this is a vaccine that we think we should take," he said. "We think that it will create stability within UI Health Care so we can know that we will have the clinical teams that are necessary to take care of Iowans through the rest of this pandemic."
UIHC last month saw its highest COVID hospitalizations to date — nearing 100 mid-November. Those numbers have ebbed back down to around 50 this week. But Gunasekaran and Winokur noted that leveling off is a plateau — not a decline. And a high plateau at that, meaning the general public also shouldn't expect to be free of the advisement to wear a mask and socially distance any time soon.
"It's encouraging to have seen the plateau," Winokur said. "But I think the global picture is that the plateau is still way too high ... And we're not going to have enough vaccine available quickly to start releasing the usual recommendations of face masks, hand washing, and social distancing."
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