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COVID-19 Vaccinations Will Likely Go to At-Risk Groups First

The agency that oversees U.S. immunization practices may offer insights this week to the federal distribution plan, but for now local public health officials who will be leading the effort here say they are preparing based on assumptions.

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Oct. 29—Once a vaccine against the novel coronavirus is available, health care workers and people in long-term care facilities are likely to be the first to receive it, local public health officials say. 

Beyond that, however, much still is unknown about the upcoming vaccine against COVID-19 — including when it will arrive, how many doses will be required and when it will be available to the rest of the public.
 
The agency that oversees U.S. immunization practices may offer insights this week to the federal distribution plan, but for now local public health officials who will be leading the effort here say they are preparing based on assumptions.
 
"There's a lot we don't know," said Heather Meador, Linn County Public Health clinical services supervisor.
 
Vaccines at doctor's offices, pharmacies
 
It's hard to determine when a vaccine would be available to the public, since the timeline on when federal officials will approve it for use still is unknown. Dozens of vaccines currently are in development, including 11 that have reached the final stages of a clinical trial, according to the New York Times' vaccine tracker.
 
New vaccines undergo rigorous review to ensure safety and effectiveness, and so far, the first vaccines developed have worked as intended with no serious side effects.
 
"Limited vaccines may be available this fall, but the COVID-19 vaccine supply is expected to increase substantially in 2021 and eventually be available for everyone who wants to receive it," Meador said.
 
Once it does trickle out more broadly, residents would be able to receive the vaccine at their doctor's office or their local pharmacy, and many commercial outlets also will receive federal allocations, Meador said.
 
There may be an associated price to visit the doctor's office, but Meador said there will be no cost to patients to receive the vaccine itself. Federal officials said last month they were hoping to offer the vaccine with no out-of-pocket costs.
 
The University of Iowa Hospitals and Clinics is among the local providers signed on through the state to administer a vaccine. As officials wait for official guidance, they "have put together a team to begin developing a plan for vaccine receipt and distribution," said UIHC spokeswoman Laura Shoemaker.
 
"One of the early steps we've taken is to order freezers for the vaccines which have specific temperature storage requirements," she said.
 
Based on the vaccines currently in the later testing phases, residents would need two doses of the vaccine, taken between 21 to 28 days apart. Different COVID-19 vaccines will not be interchangeable with one another, Meador noted.
 
However, it's still unclear how long immunity from the COVID-19 vaccine will last and whether residents will need a booster shot each year.
 
Local public health officials most likely will avoid mass immunization clinics — such as those during the H1N1 flu epidemic in 2009 — because of social distancing concerns.
 
However, some local public health agencies could have the ability to plan a safe distribution to large groups. Recently, Johnson County Public Health and other local agencies were able to host a drive-through flu shot clinic.
 
"Participants were able to be contained in their vehicle and able to be vaccinated and drive off," said Sam Jarvis, community health division manager at Johnson County Public Health.
 
Awaiting guidance on priority groups
 
Priority groups to receive the first batch of vaccines will be determined by the Advisory Committee on Immunization Practices, the advisory group within the U.S. Centers for Disease Control and Prevention. The group is meeting this week and on Friday will discuss COVID-19 vaccine implementation, according to its agenda.
 
However, state and local public health agencies say it's safe to assume that health care workers, staff and residents at long-term care facilities and assisted living facilities and "other populations that would suffer severe consequences of illness without" are first on the list, Jarvis said.
 
Jarvis said national agencies, including the advisory committee meeting this week, will more than likely offer detailed guidance on these priority groups.
 
"We'll continue to coordinate with the state health department and our local partners, but I imagine that much of the response will follow the guidance produced by our state and federal partners," he said.
 
The Iowa Department of Public Health, which is onboarding providers able to administer the vaccine, will allocate the vaccine to each county "based on the estimated population of each county's priority groups," said Alex Carfrae, the department's emergency preparedness planner.
 
From there, the local agencies will coordinate allocations to providers. Already, hundreds of providers across the state have signed on to administer the vaccine, according to Carfrae.
 
"As more vaccines become available, the priority groups will broaden allowing more people to be eligible to receive the vaccine," Carfrae said.
 
UIHC officials noted that it won't be mandatory for its employees.
 
As state and local public health agencies wait for word from federal officials in the coming weeks, Carfrae said county public health departments have been tasked "to begin working with local providers to identify strategies that leverage partner capacity and resources to ensure widespread access to vaccine for the public."
 
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