Challenges for States Managing the COVID-19 Vaccination Process

What we’re talking about

As the first vaccines start rolling out, each state will be required to manage the vaccine distribution process to ensure targeted populations, health care workers, nursing home patients, etc. are able to receive the initial doses. 

In today’s episode of Disaster Recovery Roundtable Podcast, Tidal Basin CEO Daniel Craig says the biggest challenge for states will be managing the vaccine program.  

Topics Covered:

  • The FDA Vaccines and Related Biological Products Advisory Committee is meeting to consider approving the first COVID-19 vaccine use in the U.S. The committee will consider emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine with final FDA approval coming as early as this week (12/10/20).
  • The Pfizer-BioNTech group is requesting an “emergency use authorization,” shy of a full approval. The vaccine is desperately needed as public health experts warn virus cases will continue to climb. As of December 10th, there have been more than 15.3 million cases and 289,000 deaths have been reported, according to Johns Hopkins University data
  • As the first vaccines start rolling out, each state will be required to manage the vaccine distribution process to ensure targeted populations, health care workers, nursing home patients, etc. are able to receive the initial doses.

Additional Information:

Transcript

(0:03 – 1:37)

This is Disaster Recovery Roundtable’s special coverage of the COVID-19 pandemic. Join us as we share the latest news and lessons learned from the ongoing response and recovery efforts to the pandemic. Now, here’s your host, Greg Padgett.

The COVID-19 pandemic has consumed the U.S. and the world for most of 2020. As the vaccine distribution begins, we’ll provide special coverage on the latest COVID-19 related news, including updates on how states are managing the response to the pandemic. In this episode, we welcome Tidal Basin CEO, Daniel Craig.

But first, here are the latest COVID-19 headlines as of December 10th, 2020. The United Kingdom and Canada have authorized Pfizer’s COVID-19 vaccine, administering the first doses to elderly high-risk patients and health care workers on the front line. Within the next few days, the first three million doses of the vaccine are expected to reach patients in the U.S. from Pfizer, while states are in the process of developing their vaccine distribution plans.

Pfizer says an additional three million vaccines, 2.9 million to be exact, will be shipped out two weeks later for the required second dosage for those who receive the initial vaccine. Other companies, including Moderna, are expecting emergency FDA approval in the coming days for their COVID-19 vaccines. Meanwhile, COVID infection rates continue climbing around the U.S. as public health experts attribute the higher numbers to the post-Thanksgiving holiday surge.

This week, California recorded 30,000 new infections for a single day, a record for that state since the pandemic began. Stay with us. Up next, our conversation with Tidal Basin’s CEO, Daniel Craig.

(1:39 – 3:26)

You’re listening to our special coverage of COVID-19. Now, back to the host of Disaster Recovery Roundtable, Greg Paget. Our first guest in this special coverage of COVID-19 is Tidal Basin’s own Chief Executive Officer, Daniel Craig.

Dan, welcome to Disaster Recovery Roundtable. Thank you. How are you doing? Doing well.

Thank you so much for being here today. We wanted to talk a little bit more about this big picture when we look at the vaccine distribution process now with COVID. What are going to be some of the big challenges that we’re going to see as a country in this whole vaccination distribution process? First of all, Greg, I think it’s, one, great news that we have potentially approved vaccinations in such a short period of time from really when COVID really hit the shores of the United States.

With that, the number one issue to me is getting the right person at the right time to get their vaccination. What I mean by that is we have manufacturers who are creating the vaccines, the pharmaceutical companies, whether that’s Pfizer, Moderna, or one of the other pharmaceutical companies. They’re going to have to deliver it to a site, and we need to make sure those folks getting the vaccine, first responders, frontline healthcare, seniors, citizens, teachers, people that may be working at a grocery store are, based on the priority of the governor’s, based on the priority of CDC and whatever the data ultimately shows, are there to receive their shot at the right time.

We don’t want to create a COVID outbreak by having everybody come at once. We also need to make sure those folks that are truly a priority, first responders, those that are helping others, are the first to get the shots. So making sure they’re at the right location at the right time to receive that shot so that, one, we don’t have any waste, and we can do this as quickly as possible.

(3:26 – 4:30)

I understand you’ve been meeting with several governors around the country. What are some of their concerns as they start to look at how this whole process is going to work in their own states? They have a couple concerns. Number one is, when will they receive it? And what quantities will they receive it? First of all, we know that’s going to go to first responders and frontline healthcare.

Two, when are they going to receive it? In what quantity? And then ultimately, how are they going to pay for it? Is it going to be run through their hospital system, CVS, Walmart? Who’s paying for the doctors and nurses and other folks that may be giving the vaccine itself? And who is making sure those right citizens are showing up at the right time? So who is ultimately paying for this? Is it the federal government? Are they paying for the whole thing? Is the money being run through FEMA or HHS or some other entity? And that ultimately is a Because of the situation we’ve been in since February, a lot of tax rolls are down. A lot of states are in a deficit situation. And paying for something that is a nationwide vaccine, a worldwide vaccine, is going to be very expensive.

(4:31 – 5:17)

I know we’re in unprecedented times. Every single state in the United States is really dealing with this major disaster. What role do you think FEMA will continue to play as we transition into 2021 with all this? Well, I think with the new administration, FEMA’s role may change.

But ultimately, I think it’s important for FEMA to play a frontline role in ensuring that states with emergency operations plans, their vaccination annexes, they have in those plans, are continuing to work with the states, one, to make sure they work. Two, to help through the Disaster Relief Fund, potentially, in a Category B disaster. This is a nationwide disaster declared in all 50 states and the territories to ensure that funds are available to states to pay for vaccines, whatever out-of-pocket expenses the states may have.

(5:18 – 5:44)

One of the most recent clinical trial results came from AstraZeneca, and they’re saying that their vaccine does not have the same cold storage requirements that Pfizer and Moderna’s has. Is that going to change the whole scope of how this could potentially work as the vaccine starts to transition over to the general population? One, it’s great news. Obviously, it takes out one of the variables needed in the logistics and supply chain of getting a vaccine into somebody’s arm.

(5:45 – 6:07)

You know, deep cold storage, which is needed in the Pfizer vaccine, is very difficult to find. But when it gets down to it, we’re inoculating three, four billion people around the world that ultimately need two shots. So we are going to need every manufacturer’s capabilities, whether that’s Pfizer, Moderna, AstraZeneca, to be able to produce that many vaccines worldwide.

(6:07 – 12:21)

And the other known factor is you need to get your second shot three to four weeks later from the same pharmaceutical company, Pfizer, for instance, that you got your first shot from. So while AstraZeneca is ultimately going to be producing some kind of vaccine at some time frame, if Pfizer is the first one to be on the streets to give their vaccines, which they’ve already started piloting in four different states, your second shot is still going to have to come from them. So we’re going to need every pharmaceutical company to help produce the vaccines around the world.

And, you know, the AstraZeneca’s and Moderna make it easier. It does. I won’t say it changes ultimately the problems, but it does take out one variable.

It sounds complicated, though. I can see people getting confused. Did I have a Pfizer one the first time or it’s easier for me to go down now to CBS and get this other vaccine for my second dosage? Is that what’s gonna require a lot of case management for this whole process? To me, that’s the critical middle part of the vaccination process.

I don’t think enough people worrying about it’s two things. It’s case management and scheduling. I think every state needs to be looking at the process, like I said earlier, of getting the right person in the right location at the right time.

And that is making sure you may have your paperwork done before you show up for your shot, because they’re gonna want to know who you are, what your medical background and history is, first of all, and then what shot you received from which manufacturer, what lot it may have been, because we know there’s going to be issues in the manufacturing process. There always is. There may be a bad shot.

It may not be effective. So you may get called back for a second first shot. We want to know where you received it from, what manufacturer.

So case management in this whole process is critical. And part of that is following up. Did you have any adverse effects from the shot? Is it interacting with any other pharmaceuticals you may be taking at this time? You know, many people are taking different things for different medical reasons.

We want to make sure that data is brought back to the manufacturers. And then ultimately, after your second shot, following up with you over the next six months to check the efficacy of the shot itself. Did you ultimately get COVID? Which shot? Which manufacturer did you get it from? So we can bring that information back.

That data could be aggregated by both CDC and your manufacturer itself to find out what is the most effective of all the shots and what percentage. And ultimately, every state is going to have to, whether you get your shot from a CBS, a Walmart, whoever it may be, that a single system for receiving that data in every state so that data can be aggregated. So that’s the purpose of one case manager’s call centers.

And then the other thing the case manager is going to do is immediately sign you up for your second shot for your second dosage and scheduling you at the right time in the right place. That makes a lot of sense. You know, we’re in the business of supporting communities after disasters and also helping them prepare before the next disaster comes.

Is this going to change the game when we look at pandemics moving forward? I don’t know if it changes the game as much as a lot smarter. You know, there’s another pandemic in a year, two years, three years. One, we learned a lot from Ebola.

We learned a lot from H1N1. We’ve continuously evolved, and I think that’s where FEMA, HHS are the most important in this whole process, is ensuring that we get smarter every time there’s a pandemic. You know, that’s the same with a disaster.

You don’t want to run into the same problems. That’s why you have an after-action report after a disaster. You want to ensure you get smarter and don’t make the same mistakes twice.

You know, you can’t fault somebody for making a mistake in a disaster. They call them disasters for a reason. So, but you don’t want to do the same thing twice that can cause you problems.

So we need to get smarter. There needs to be a nationwide and statewide after-action reports after the pandemic. So how can we, whatever the next pandemic will be, there will be another one, whether it’s worldwide or U.S.-based. We need to get smarter in how we react and deal with that.

You know, as we learned early on, you know, what were the two biggest issues, you know, when we started COVID? They were enough PPE and they were enough ventilators. You know, have we learned and what’s changed in that process? So we will get smarter as a country. I’ve heard the new, the latest slogan out there from public health officials.

It’s not vaccines that save lives. It’s vaccinations. How difficult or how big of a need is it going to be for those emergency management, public health to really stress everybody has to participate in this process in order for us to really get that herd immunity that they think is necessary for the country to survive it.

I believe everybody’s going to make their own personal choices, but I am a full believer in vaccinations. Uh, I think the United States, if we can have a significant portion of the population get vaccinated, we will have herd immunity. And it’s critical that, you know, the public information officers at every state emergency management at every public health put that message out.

It is almost our duty to work together to get vaccinations because I don’t want to give it to you. You don’t want to give it to me. And the quicker we can vaccinate this country, the quicker our Children go back to school, the quicker our economy can turn around and jobs.

The worst thing is to see restaurants shutting down or businesses shutting down small businesses because they’re affected because we just can’t go out. A lot of us can’t be with our own families because of vaccines because we don’t have it. Hopefully in a year, if everybody gets vaccinated, you know, we won’t have the same problem at July 4th or, you know, Labor Day or even next Thanksgiving.

That’s so very true. And a reminder that in 2021 the virus is not going to disappear overnight. Thank you, Daniel Craig, Tidal Basin CEO.

We’ll have more coverage on the COVID-19 pandemic in the weeks ahead. In our next episode, we’ll chat with Tidal Basin’s Director of Healthcare Services, Christopher Prickett, on the all important task of building public confidence in the COVID-19 vaccines. You’ve been listening to Tidal Basin’s special coverage of the COVID-19 pandemic on the Disaster Recovery Roundtable.

For more information on this and other episodes, visit our website at www.tidalbasingroup.com. You can download previous podcasts, learn more about the programs we discussed, and suggest a topic for future episodes. You can also find us on your favorite podcast provider. This has been a Tidal Basin production.

Thanks for listening.