With both Moderna and Pfizer reporting that their vaccine candidates are close to 95 percent effective, and Pfizer planning to submit an application for emergency authorization for its vaccine in the next few days, health systems across the country are finalizing plans to distribute a COVID-19 vaccine.
Four executives recently spoke with Becker's Hospital Review about the steps their systems are taking to prepare for vaccine distribution, as well as to combat vaccine misinformation:
Editor's note: Responses have been lightly edited for length and clarity.
Stephanie Jackson, MD, senior vice president and chief quality and clinical value officer at HonorHealth (Phoenix): A few months ago, we started a COVID-19 vaccine preparedness steering committee, which is divided into four subgroups. One is looking at the clinical data, efficacy and safety and determining who to prioritize for vaccinations. One is looking at the logistics of refrigeration that the mRNA vaccines, such as Pfizer's, require. A third team is planning the mass vaccination process, and a fourth is figuring out the registration process and how to make all of the information flow into the right databases. This vaccine has to be very closely monitored, and every adverse event has to go to a data-reporting system and a state database.
We are working with a digital solution company called Twistle. We will send every employee an email with a link to enroll, and Twistle will ask them questions about their role as a provider and if they want to be vaccinated. Once we have a vaccine, we can use the app to let our employees know when they can receive a vaccination. We can also use the app to report any side effects as well as to remind people to come in for their second dose of the shot.
We'll use existing staff, as well as city, fire, EMS and police personnel, to help staff COVID-19 vaccination sites. Each major health system in Phoenix has been assigned an area to cover when it comes to vaccinations, and we've been coordinating with all chief clinical and medical officers statewide to figure out the vaccination process.
One of the things we're worried about is that, because of skepticism of the government's response, some people have lost some faith in vaccinations. We're going to be working with the county and the Arizona Department of Health to promote vaccines in general, as the last thing we want is for measles or other old enemies to come back with a vengeance because people are afraid of vaccines. Given the efficacy data Pfizer just released, which is better than a lot of us expected, I think we may be surprised that we may have more demand for the vaccine than we thought.
Katie Passaretti, MD, medical director of infection prevention at Atrium Health (Charlotte, N.C.): A couple months ago we put together a multidisciplinary group that includes pharmacy, physician and administrative leaders to start planning our approach. We're trying to take a broad approach in coming up with a plan for all eventualities. We know whatever initial supply we get isn't going to be enough to vaccinate everyone, so we're figuring out how to make the best use of that vaccine. We're sticking close to the CDC guidance to prioritize healthcare workers that are on the front line, especially those with high numbers of COVID-19 patients. From there, we will prioritize high-risk patients, essential workers and other populations where the vaccine will make the biggest impact. We bought ultra-cold freezers to be able to store the vaccines and help with distribution if we get the Pfizer vaccine. There are a lot of unknowns, but we do know we're going to have to figure out how to give people two doses 28 days apart, and we're planning for what's going to be the most challenging situation to set up. We're initially taking a centralized distribution approach, which involves having the vaccine at select areas to make sure we're accessing the right populations but not having to get the vaccine to 500 clinics immediately.
I think the biggest challenge to distribution will be the vaccine hesitancy. Vaccines, like masks, have become very political, so we're trying to get ahead on the messaging on vaccines to depoliticize it and talk about the science. There's a lot to be said for physicians having discussions directly with patients about vaccines, so we're making sure our physicians are armed with the information to have those discussions. Beyond that, we're working across healthcare systems and public health entities in our area to make sure we're messaging about the benefits of the vaccine and why it's important. Especially in underserved areas, having key leaders to educate and be a resource helps improve uptake. You have to meet people where they're at and use people trusted by the community so it's more of a conversation between people that are comfortable with each other.
Brian Swift, PharmD, chief pharmacy officer, Jefferson Health (Philadelphia): Our standard policies and procedures have prepared us well to be ready for distribution of the COVID-19 vaccine when it does become available. We are working with enterprise leadership to register with the required regulatory entities to enable us to receive the vaccine when it is available. We have conducted a thorough inventory of available refrigerators and freezers across our enterprise and feel that we are prepared to receive the products. We may be acquiring a few ultra-low temperature freezers to supplement what we currently have.
We communicate on a daily basis with leadership across our enterprise regarding safety issues and COVID-19 pandemic-related issues as well. We have regular updates from our infectious disease leadership regarding the progress of the vaccine development and thoroughly discuss the science behind that.
David Woods, PharmD, chief pharmacy officer, San Francisco Department of Public Health: San Francisco is forming a COVID-19 vaccine workgroup to plan for the review, distribution and administration of vaccines throughout the city. We have a pharmacist on the team to help with the planning and decision-making.
Right now, combating COVID-19 vaccine mistrust is being accomplished at the community level. Washington, Oregon, Nevada and California have joined to independently review any coronavirus vaccine before distributing it to the public. San Francisco has a medical officer participating in the scientific review committee. The addition of a local, trusted resource on the panel of experts will hopefully go a long way to develop community trust by making sure that decisions regarding vaccines are not just expeditious, but also safe. San Francisco also formed a vaccination workgroup to engage community organizations in the workflow and plan for flu vaccinations. Hopefully, this will provide a model and/or insight when it comes time to distribute and administer the COVID-19 vaccine.
With both Moderna and Pfizer reporting that their vaccine candidates are close to 95 percent effective, and Pfizer planning to submit an application for emergency authorization for its vaccine in the next few days, health systems across the country are finalizing plans to distribute a COVID-19 vaccine.
Four executives recently spoke with Becker's Hospital Review about the steps their systems are taking to prepare for vaccine distribution, as well as to combat vaccine misinformation:
Editor's note: Responses have been lightly edited for length and clarity.
Stephanie Jackson, MD, senior vice president and chief quality and clinical value officer at HonorHealth (Phoenix): A few months ago, we started a COVID-19 vaccine preparedness steering committee, which is divided into four subgroups. One is looking at the clinical data, efficacy and safety and determining who to prioritize for vaccinations. One is looking at the logistics of refrigeration that the mRNA vaccines, such as Pfizer's, require. A third team is planning the mass vaccination process, and a fourth is figuring out the registration process and how to make all of the information flow into the right databases. This vaccine has to be very closely monitored, and every adverse event has to go to a data-reporting system and a state database.
We are partnering with a digital solution company called Twistle. We will send every employee an email with a link to enroll, and Twistle will ask them questions about their role as a provider and if they want to be vaccinated. Once we have a vaccine, we can use the app to let our employees know when they can receive a vaccination. We can also use the app to report any side effects as well as to remind people to come in for their second dose of the shot.
We'll use existing staff, as well as city, fire, EMS and police personnel, to help staff COVID-19 vaccination sites. Each major health system in Phoenix has been assigned an area to cover when it comes to vaccinations, and we've been coordinating with all chief clinical and medical officers statewide to figure out the vaccination process.
One of the things we're worried about is that, because of skepticism of the government's response, some people have lost some faith in vaccinations. We're going to be working with the county and the Arizona Department of Health to promote vaccines in general, as the last thing we want is for measles or other old enemies to come back with a vengeance because people are afraid of vaccines. Given the efficacy data Pfizer just released, which is better than a lot of us expected, I think we may be surprised that we may have more demand for the vaccine than we thought.
Katie Passaretti, MD, medical director of infection prevention at Atrium Health (Charlotte, N.C.): A couple months ago we put together a multidisciplinary group that includes pharmacy, physician and administrative leaders to start planning our approach. We're trying to take a broad approach in coming up with a plan for all eventualities. We know whatever initial supply we get isn't going to be enough to vaccinate everyone, so we're figuring out how to make the best use of that vaccine. We're sticking close to the CDC guidance to prioritize healthcare workers that are on the front line, especially those with high numbers of COVID-19 patients. From there, we will prioritize high-risk patients, essential workers and other populations where the vaccine will make the biggest impact. We bought ultra-cold freezers to be able to store the vaccines and help with distribution if we get the Pfizer vaccine. There are a lot of unknowns, but we do know we're going to have to figure out how to give people two doses 28 days apart, and we're planning for what's going to be the most challenging situation to set up. We're initially taking a centralized distribution approach, which involves having the vaccine at select areas to make sure we're accessing the right populations but not having to get the vaccine to 500 clinics immediately.
I think the biggest challenge to distribution will be the vaccine hesitancy. Vaccines, like masks, have become very political, so we're trying to get ahead on the messaging on vaccines to depoliticize it and talk about the science. There's a lot to be said for physicians having discussions directly with patients about vaccines, so we're making sure our physicians are armed with the information to have those discussions. Beyond that, we're working across healthcare systems and public health entities in our area to make sure we're messaging about the benefits of the vaccine and why it's important. Especially in underserved areas, having key leaders to educate and be a resource helps improve uptake. You have to meet people where they're at and use people trusted by the community so it's more of a conversation between people that are comfortable with each other.
Brian Swift, chief pharmacy officer, Jefferson Health (Philadelphia): Our standard policies and procedures have prepared us well to be ready for distribution of the COVID-19 vaccine when it does become available. We are working with enterprise leadership to register with the required regulatory entities to enable us to receive the vaccine when it is available. We have conducted a thorough inventory of available refrigerators and freezers across our enterprise and feel that we are prepared to receive the products. We may be acquiring a few ultra-low temperature freezers to supplement what we currently have.
We communicate on a daily basis with leadership across our enterprise regarding safety issues and COVID-19 pandemic-related issues as well. We have regular updates from our infectious disease leadership regarding the progress of the vaccine development and thoroughly discuss the science behind that.
David Woods, chief pharmacy officer, San Francisco Department of Public Health: San Francisco is forming a COVID-19 vaccine workgroup to plan for the review, distribution and administration of vaccines throughout the city. We have a pharmacist on the team to help with the planning and decision-making.
Right now, combating COVID-19 vaccine mistrust is being accomplished at the community level. Washington, Oregon, Nevada and California have joined to independently review any coronavirus vaccine before distributing it to the public. San Francisco has a medical officer participating in the scientific review committee. The addition of a local, trusted resource on the panel of experts will hopefully go a long way to develop community trust by making sure that decisions regarding vaccines are not just expeditious, but also safe. San Francisco also formed a vaccination workgroup to engage community organizations in the workflow and plan for flu vaccinations. Hopefully, this will provide a model and/or insight when it comes time to distribute and administer the COVID-19 vaccine.