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Pfizer’s COVID vaccine proves effective, but how to distribute it?

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When it was announced last week that a COVID-19 vaccine produced by Pfizer was shown to be more than 90% effective, public health departments in Wisconsin had a framework in place to distribute it. With guidance from the Centers of Disease Control, state health departments like Wisconsin’s have created vaccination plan templates for what will be the most massive immunization program ever undertaken.

The plan creates priority groups, with the first vaccines to be distributed to healthcare workers who work directly or indirectly with COVID patients as early as December, according to Doug Voegeli, a member of Madison and Dane County Public Health’s mass vaccination team. He said that includes those who clean rooms in hospitals where the virus has been present.

Voegeli described the next priority group in the plan as all health care workers, public safety workers and essential workers, noting that the term “essential” had not yet been defined.

The next tier would be all high-risk individuals, and eventually, the rest of the population.

Asked when a vaccine could be widely available, Voegeli could only offer a “total guess,” but estimated “April-Ish.”

“That’s kind of a guess because you just have to think about manufacturing the number of doses you would need to properly vaccinate a country of over 300 million people. So that’s quite a bit of vaccine and quite a bit of manufacturing to get that supply out there,” Voegeli said.

The Pfizer vaccine, which Bloomberg news has reported was funded by the German government, requires two doses and must be stored at -80 degrees Celsius. It is awaiting FDA approval.

Voegeli said four vaccines are in clinical trials, and he expects all will be used eventually to keep up with the massive scale.

In Dane County, storing the vaccine at the extreme sub-zero temperatures should not be a problem, Voegeli said.

“First, many healthcare systems have ultra-cold freezers that they can use for this purpose,” Voegeli said.

He added that the vaccines are shipped in dry-ice containers, which can store the vaccine for up to 15 days if they are re-iced daily. Vaccines can also be stored at a refrigerated temperature for up to five days.

To ensure individuals receive both doses of the vaccine, health care workers will record the first vaccine in the Wisconsin Immunization Register, Voegeli said. The system will track the first dose and schedule a second dose, perhaps sending a reminder. Voegeli said those details are still being worked out.

One Waunakee resident who works in immunology raised concerns about ensuring the vaccine is available to all in the community, including the most disadvantaged.

Ann Lewandowski, a program manager with Southern Wisconsin Immunization Consortium and founder of Wisconsin Immunization Neighborhood, said bringing vaccination clinics to the community would be the most effective means. At a recent Waunakee Village Board meeting, she pressed the board to set funding aside for a vaccination program.

“My general point is that we are on the verge of the largest public health vaccination campaign this country has ever seen,” Lewandowski said. “We will need to be adaptable and take responsibility for the health of our community and not simply expect Dane County Public Health to do it all.”

Lewandowski recently helped plan a community-wide drive-through influenza vaccine clinic at Waunakee High School, where health care providers administered shots to those with or without health insurance.

Right now, the plan calls for healthcare systems to be the primary vaccinators, Voegeli said, but pharmacies will also be able to deliver the vaccine and are partnering with the state of Wisconsin to vaccinate nursing home staff and residents.

For those who are uninsured, Madison and Dane County Public Health will provide the vaccine, he added.

Asked if communities like Waunakee should consider planning their own clinics, he said that may be premature at this point.

“Your local pharmacies may be applying to provide vaccines. Your local EMS may or may not apply to become vaccinators,” Voegeli said.

Lewandowki called Dane County’s health department “nothing short of heroic,” but said a community-wide effort may be needed as well.

“The reality is, we are an upper-income community who might be expected to fend for ourselves while they focus on the broader needs of our county,” Lewandowski said.

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