News that an effective COVID-19 vaccine may be available within months or even weeks is a hopeful sign that an eventual end to the pandemic is on the horizon. But there is much logistical planning ahead to ensure an effective and equitable vaccine delivery system.
Pfizer and its German partner BioNTech have asked the Food and Drug Administration (FDA) to authorize its COVID-19 vaccine for emergency use after clinical trial results showed it was safe and 95 percent effective. Pfizer hopes to produce up to 50 million doses in 2020 and up to 1.3 billion doses in 2021. Each person needs two doses. Another frontrunner, Moderna, is also expected to apply for emergency authorization. While it may be months before the vaccine is widely available for the general public, Community Health Centers stand ready to play a role in a national vaccination strategy.
To prepare, NACHC is collaborating with key partners, such as the Centers for Disease Control and Prevention (CDC) and the Association of Immunization Managers (AIM). NACHC is also coordinating the allocation of 3,697,470 doses of influenza vaccine free to health centers to prevent a potential “twindemic” of both influenza and COVID-19. The goal is to alleviate the potential burden of high rates of flu-related hospitalizations amid a dangerous surge of the virus now happening across the nation.
The Flu Vaccine Is a Dress Rehearsal for COVID-19
In a recent letter to the field, NACHC underscored to health centers and Primary Care Association partners that the flu vaccination campaign is the dress rehearsal for COVID-19 vaccine distribution when it becomes available to health centers. Administering flu vaccines can be used to check and test policies, procedures and workflows.
The CDC’s guidance for a COVID-19 Vaccination Program identifies health centers as one of the entities expected to administer the vaccine. This designation for health centers is based on the fact that their patient populations are at increased risk for the virus. Consequently, NACHC is urging centers to work with local and state health departments to be pre-screened, invited, credentialed, trained, and accepted into the COVID-19 Provider Enrollment and Ordering Management System. The CDC has also published a vaccine planning guidance for providers.
COVID-19 Vaccine Challenges Facing Community Health Centers
Our goal is to ensure efforts to fight the spread of the virus are aligned and coordinated and that health centers are sufficiently resourced for the long battle ahead. However, the COVID-19 vaccine is uncharted territory for all providers. There are many logistical hurdles that NACHC is tracking. For instance:
Staffing: Health centers have more than 50,000 nurses, medical assistants and outreach staff on the ground ready to organize once a safe and approved vaccine becomes available. At this point, we estimate that to vaccinate all current health center patients and staff, as many as 60 million doses of COVID-19 vaccine would be necessary. More doses would likely be needed to vaccinate additional community residents. Protecting health center workers on the frontlines is also a vital concern as more than 12,000 health center workers have been infected by COVID-19.
Vaccine Hesitancy: Immunizations are a very important part of primary care prevention, and health centers have a solid history of optimizing immunization coverage in at-risk populations as a trusted health care source. But we also know that many members of our patient populations have skepticism about government vaccination programs — and, certainly, a COVID-19 vaccine will be no exception. We need to prepare now and develop culturally responsible messaging for patients, providers and care teams around the following key issues for the COVID-19 vaccine that address: safety, access, quality, cost, and timeliness. The other challenge is that the COVID-19 vaccine will require two doses to be effective and require in-person visits at a time when many patients have been staying at home and avoiding preventive care services.
Storage & Logistics: There is a lot we don’t know but once the COVID-19 vaccine is ready for distribution the focus will be on storage and cold chain technology management. Human resource needs for the release of vaccines to health center sites will also be a consideration, as well as the management of supply needs (syringes, needles, documentation tools such as tablets, and protective gear for workers). NACHC is also communicating with the Bureau of Primary Health Care regarding FTCA coverage on COVID-related activities for health centers, including administering vaccines.
Community Health Centers Will Rise to the Challenge
The past few difficult months have shown that health centers are always adapting workflow models to meet the challenges of the pandemic and better meet the ongoing needs of their patients. Indeed, in a matter of weeks, they radically changed how they practice medicine in response to COVID-19.
To prepare for the COVID-19 vaccine, NACHC will work hard to ensure health centers are informed and equipped with the tools they need to stop the spread of COVID-19 in medically underserved communities.