Two years after McLean County health officials led a full-scale disaster drill for a mass vaccination, the real thing will soon be here.
In a three-part series on McLean County's COVID-19 vaccine distribution, WGLT spoke with McLean County Health Department Administrator Jessica McKnight, the department's emergency services coordinator, David Hopper, and county administrator Camille Rodriguez about how the county plans to oversee distribution of tens of thousands of COVID vaccines once they arrive.
Rodriguez was head of the county health department at the time the agency simulated the drill for an anthrax vaccination at Redbird Arena in the fall of 2018.
Interview has been edited for clarity.
Rodriguez: We did that to ensure that we were coordinated and that we can provide an effective response in an actual crisis. Here we are on the verge of doing a mass vaccination. It's exactly why we practice, we plan, and we test our procedures. So that exercise where we were supported by places like the McLean County Disaster Council, the American Red Cross, the Normal Fire Department, and so on, and all of the volunteers that really helped us prepare and practice at that central point of dispensing, or a pod as we call it, at the Redbird Arena at that time.
WGLT: One key difference from what was done in the drill a couple of years ago, is that since we're talking about something contagious, like the coronavirus, will this distribution be more decentralized than that kind of scenario that was done during the drill?
McKnight: Social distancing has been a key preventive measure that we've been focused on with COVID-19. In our planning for mass vaccination, it's something that we've kept in our mind--of how do we do this in a way that we can keep all of our workers safe, all of our public safe. We did do some drive-thru testing sites earlier this year, very successfully, and I think that's obviously, what we're looking at, is to be able to run a mass vaccination clinic, and a larger nature, but run that similarly.
WGLT: Do we know at this point, who all will be involved in the distribution of the vaccine? To what extent will it be McLean County Health Department staff, volunteers from the (county’s) Medical Reserve Corps (MRC) that the county has bolstered? How much will it be on private health care providers to do this.
McKnight: It's going to be multi-tiered. It's going to be a marathon, not a sprint, whenever we were doing this, and so, it's going to be on the health department to do some of the distribution. But we're also, you know, our pharmacy partners, our local health care partners when this becomes more widely available.
We've talked a little bit about the phases that we'll go through. Initially, we will work with the hospitals (and other) health care partners. Then, as we get broader, and the vaccine is more widely available, we'll be looking at our other partners that are in the community. So, it won't just be the health department that will be doing this, but we've definitely been coordinating the effort, which I know David can talk a lot about.
WGLT: So David, in discussing the plans for the distribution, as Jessica said, this is going to be a marathon. Certainly not a one-time event or anything like that. Do you feel the county has the staff and volunteers to help manage this over an extended period of time, weeks and months?
Hopper: Certainly. Yes, I definitely think that we do. Camille referencd what we do ongoing for public health emergency preparedness. It goes way back, prior to 2018, (when) we did the full-scale exercise. Now, our public health staff is ready to do this.
We have just a little over 100 MRC volunteers, and this is why they became MRC volunteers is to assist their communities to address public health emergencies. Over the last two to three months, as we've been preparing for COVID vaccine, we've had countless meetings, working with community partners. I want to remember all the partners that have stepped up (and) said that they will support the health’s department response.
It will still be some time before COVID vaccines will be available at doctor's office and pharmacies. The first vaccines shipments will go to front-line health care workers and then likely to residents of long-term care facilities.
Hopper: In these initial weeks and months, we have a very strong support system in the county, a lot of really great partners. It'll be really targeted vaccine clinics, not necessarily open to the general population. And then when we went transition to phase two and so on, it will be more widely available. We still have to operate pods (points of dispensing) to get to communities, to get to populations who aren't going to access it at CVS, Walgreens, Walmart or wherever it is.
WGLT: There has been reporting recently that the federal government initially balked at taking a second order of a Pfizer vaccine that would have taken it to perhaps 200 million (doses), as opposed to 100 that are due to come to the U.S. now. That's 50 million people. So, there's a possibility that there could be a potential gap in time between that first distribution that goes to those most at risk, but then the general public may be maybe left waiting for a while. Do you think that's a possibility?
McKnight: The Pfizer vaccine, it doesn't flip a switch automatically. It's going to be a marathon and we have multiple pharmaceutical companies that are working toward developing additional COVID-19 vaccines. What we know is it's going to be a slow process to have the vaccine widely available. We're probably going to be still using all of those mitigation measures of wearing your face covering, watching social distance for quite some time, even after that vaccine initially becomes available.
Not everyone will have easy access to a COVID vaccine, even when it becomes widely available. And not everyone wants a shot. Hopper said vaccine equity is a major focus as health officials work to achieve herd immunity.
He added the county's IT department will use vaccine data to track where the gaps are. He said MCHD also will work with social service agencies to determine those who may not be able to get to a vaccination site.
Hopper: That's an emphasis for our public information staff party, we have a couple of staff members whose sole purpose through this vaccine campaign is to work on vaccine equity. So what they're doing ahead of time is looking at lessons learned from the past; the 2009 H1N1 response, how disproportionate COVID affected certain populations and historical data related to reasons that barriers exist for certain populations.
They’ve been researching and they've conducted surveys. Vaccine hesitancy is a very real thing for a variety of reasons. There's not a really simple answer, but we have (been) trying to uncover as many of those reasons as possible, and then craft messaging specific to those populations just to do whatever we can to, to break through that.
WGLT: What kind of targeted communication might that be?
Hopper: I've worked with the team that is doing it, and it's going to be dependent on the population. Social media can work with some populations, but it's not very effective for others, utilizing community leaders for populations, where that makes sense, case managers. There are definitely populations where social media is going to be the way that you reach them. It can vary by what population that they're targeting.
WGLT: How will the county be able to track who all has had the vaccine, who still needs a second dose and, how will you know when you get to herd immunity?
Hopper: First and second-dose management. I-CARE (Illinois Comprehensive Automated Immunization Registry) takes care of that. Any provider in the county--the health department, a physician's office, a pharmacy--is required to report administration of all doses within 24 hours in that I-CARE system. We're going to give them a COVID vaccine administration card that will show what day they got a vaccine, what vaccine they received. That would indicate when they would be eligible to get their second dose. Not everyone will bring that back, so we will have access to I-CARE. We can pull records for people at the point of dispensing to make sure that they're eligible for a second dose and to make sure they get the right manufacturer for their second dose.
WGLT: What questions or concerns do you have? There's still probably a lot that hasn't fallen into place yet, but once the vaccines are here, everything's got to 0 to 60 pretty fast.
Hopper: It's optimism more than concern, but I'm just hoping for flexibility in understanding from our community. At least initially, we won't know when the vaccine is coming, We won't know how much we're going to get. We will have a very limited time to receive vaccine and get it administered to as many people as we have doses.
There will be very short turnarounds. We may not be able to advertise a point of dispensing a vaccine clinic until two days before the clinics is going to run. So, people have to be flexible and they have to respond when they need to and then understand that we have a mission that's been given to us by the federal government--reinforced through the state that only certain people are going to be eligible for the vaccine initially. If it's summer, if it's beginning (of) fall, no one knows, but eventually there will be enough vaccine for everyone.
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