Among national calls for speeding up COVID vaccine administration, the Assembly Health Committee this week held a hearing to learn more about the distribution in Wisconsin.
In the one month since a COVID vaccine first became available, Wisconsin has administered more than 195,000 doses according to Wisconsin Department of Health Services (DHS) Deputy Secretary Lisa Olson. That’s just about one-third of the total allocation to the state thus far.
The challenges associated with the rollout of a vaccine such as this during a pandemic discussed in the hearing include logistical challenges for the state and vaccinators, including registration of vaccinating entities, transportation, storage and handling, coordination across multiple levels of government, shifting guidelines, and managing dosing and scheduling.
Hospitals and health systems have stepped up to the challenge knowing that they are making their communities safer and helping Wisconsin get back to work and school and allowing residents to gather again with family and friends. In testimony provided to the Assembly Health Committee on Thursday, Jan. 14, Wisconsin Hospital Association President and CEO Eric Borgerding encouraged continuing to move ahead as quickly and safely as possible.
“Depending on various assumptions, we calculate that Wisconsin will need to administer between 28,000 and 38,000 doses per day
to successfully vaccinate 2.5 million people with two doses of vaccine by June 30,” said Borgerding. “This is an immense, but achievable, challenge if we move forward in a pragmatic, coordinated and adequately resourced manner.”
Differing Messages on Prioritization
As supply has been limited thus far, the federal and state governments have recommended prioritizing who may receive the vaccine. However, the guidelines have often been unclear across federal and state officials.
On Dec. 1, 2020, the federal Centers for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) recommended that health care personnel and long-term care facility residents be offered COVID-19 vaccination first in what they term, “Phase 1a.” Nearly three weeks later, on Dec. 20, ACIP updated these recommendations
, stating that in Phase 1b, COVID-19 vaccine should be offered to persons aged 75 years or older and to non–health care frontline essential workers, while Phase 1c vaccines should go to persons aged 65–74 years of age, persons aged 16–64 years of age with high-risk medical conditions, and essential workers not included in Phase 1b.
Each state is moving forward in a different manner. In Wisconsin, a subcommittee of the State Disaster Medical Advisory Committee (SDMAC) this week released its Phase 1b proposal
for public comment, which is due Monday, Jan. 18. The SDMAC subcommittee recommendations differ in some significant ways from ACIP. Based on these recommendations, which are not final, Phase 1b in Wisconsin would include individuals who are:
- Age 70 years and above
- First responders
- Non front-line health care personnel
- Education and child-care workers
- Living in congregate settings, including incarcerated
- Enrolled in Family Care or IRIS programs
- In the business of mink husbandry
However, even while the state is working on this guidance, U.S. Department of Health and Human Services Secretary Alex Azar this week encouraged states to speed up vaccine administration and to start vaccinating people aged 65 and above. Olson indicated in her testimony that the state will consider this as they finalize their recommendations.
The state’s SDMAC subcommittee expects to finalize its work on defining Phase 1b next week. Olson indicated the state expects to roll out the vaccine to various groups within Phase 1b week-by-week from January into February as more vaccine comes into the state. As an example, this week DHS announced that police and fire department personnel will be eligible beginning January 18
Borgerding commended all entities that have stepped up to assist, including hospitals, pharmacies, clinics, federally qualified health centers and local public health departments. He noted the need for the state to continue quickly implementing a vaccine strategy and recognized the critical role public health is and will continue playing as the state moves forward with broader community-wide vaccination. Borgerding recommended that the state move forward with a strategy that includes the following guiding principles:
- Has as its primary goal vaccinating as many people as quickly and safely possible;
- Is not hindered by overly prescriptive processes or planning;
- That is flexible and acknowledges the prudence of variation and phase overlap;
- Develops and leverages all vaccinator assets to the fullest extent; and
- Is driven by the principle that each day additional people in a community are vaccinated, that community is safer than the day before.