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Five weeks after the arrival of the first vaccines against COVID-19 in Puerto Rico, the amount of doses sent has failed to satisfy the high demand for this product on the island.
Since the arrival of the first shipment last December 14, it was anticipated that this disparity could occur, as the 350,000 vaccines from Pfizer (205,725) and Moderna (147,400) that were expected to arrive in the country in this one were not received. then.
The director of the COVID-19 vaccination program of the Department of HealthIris Cardona has insisted that the root of the problem – and what remains a major challenge – is the low supply of vaccines that has reached the country.
“I am super happy and calm that people want to be vaccinated. The limiting factor is the amount (of doses available). The biggest challenge has been the configuration (which have had to be done) in the distribution (of the vaccines “The 300,000 doses allocated to Puerto Rico were reduced. We have received a third (of what was expected). We knew this (the dilemmas they would have with the supply and demand of the product) since December.” expressed Cardona.
In an interview with The New Day, The pediatric infectologist acknowledged that they have had to juggle the distribution of the vaccine, for which they have the support of the National Guard.
“Although there are fewer doses (than expected), a regular cadence of 40,000 doses per week is guaranteed,” he stressed.
However, he explained that 11,300 of them reach directly to Walgreens and CVS, pharmacy chains that have a contract with the federal government for the vaccination of elderly adults living in long-term care institutions.
Vaccination of older adults congregated in these facilities, which is part of phase 1-A delineated by the government to prioritize populations at high risk of infection or virus-related complications, began on January 4 and s ‘should be extended until mid-February, the official said, noting that this also includes staff at these centers who are interested in getting vaccinated.
According to Cardona, as of January 12, 4,000 people had been vaccinated in 127 of these institutions.
Meanwhile, of the nearly 40,000 vaccines that arrive in the country weekly, the National Guard stores 10,000 to administer at its regional vaccination centers and for other initiatives. The remaining 20,000 are distributed among health care providers authorized to administer them. As of Friday, there were about 300 certified suppliers to administer the vaccine in Puerto Rico, although only 175 had received the product, according to data from the Department of Health.
Phase 1-A, Cardona recalled, also covers about 150,000 health professionals and employees. The expectation, he said, is that vaccination in this population, which began on December 15, will be extended until the end of the month or beginning of February, with the two doses required.
Huge challenge phase 1-B
The current challenge, he stressed, is phase 1-B for the clamp that is, as it includes about 600,000 people over 65, in addition to about 60,000 first responder workers, which includes police, firefighters and staff of medical emergencies. These began vaccinating last week in a process of gradual integration that was to give priority to adults over the age of 75, but which, due to the high demand for the product, was chosen to implant people from the 65.
And, within the challenge of vaccinating such a large population with limited quantities of the product, it is added that this week begins the vaccination of teaching and non-teaching staff of education, both public and private. According to Cardona, this sector should be vaccinated in about four to five weeks, while the expectation is that everything comprising phase 1-B will take between eight and 12 weeks. He anticipated that between week 8 and 10 of phase 1-B, he could begin to integrate it 1-C.
The designated Secretary of Education, Elba Aponte, has reported that on Tuesday the operation of the first three vaccination centers for public system staff and private schools across the island will begin. The first three centers will open in Bayamón (Coliseum Rubén Rodríguez), Mayagüez (Palace of Recreation and Sports) and San Juan (Pre-technical School Federico Asenjo). The goal is to open more vaccination centers to immunize some 55,000 people in this sector.
“The education sector is an interest group (in vaccination), but vaccination (continuity of) should also be allowed for first responders and older adults. The question is, how do I do it with 30,000 doses (per week)? “, Questioned Cardona, who noted that this week also begin to vaccinate about 63,000 residents and employees of households of people with intellectual disabilities.
Care for the bedridden population
The challenge of continuing and ensuring vaccination of a growing population also includes coordination to immunize older bedridden adults. To do this, the official said, they have the support of staff from the College of Surgeons and the College of Practical Nursing of Puerto Rico.
Julio Irson, spokesman for the College of Practical Nursing, reported that vaccination in this population will involve the Key Masters Corporation and the Hospice and Home Care Association.
Victor Ramos, president of the College of Physicians, said the process began last week, and includes vaccination of the primary caregiver. Those interested in vaccinating a bedridden person, it was reported, write to [email protected].
During the interview, Cardona insisted that, given the limited number of vaccines that have arrived, they are distributed using concepts of “science, logistics and equity” to ensure there is coverage at all points on the island. He acknowledged, however, that there are complaints about the lack of vaccines in certain places and geographical areas, such as the mountains and the west of the country.
“The number of vaccines that arrive weekly is finite, and they don’t all arrive on the same day. For example, we were told that on Monday which is a holiday (today, Martin Luther King’s day) nothing (vaccines) will be delivered,” he said. said, by pointing out that this causes delays in distribution, as happened during the Christmas holidays.
He warned that if limited amounts continue to arrive, vaccination could spread more than expected. “If it’s still finite (the arrival of vaccines), I’ll be with these groups (1-A and 1-B) until May. Now, if more arrive, the process is accelerated,” he said.
The hope, he added, is that in February dose production will increase and more will arrive, in addition to other COVID-19 vaccines being approved by the federal government and more available. Among the next to be approved, he mentioned that of Johnson & Johnson, which, he said, only requires one dose, which would increase coverage in less time.
“If more arrive (dose), the priority will be older adults,” he stressed.
Meanwhile, he commented that certified facilities and suppliers to store and administer the vaccine must have the capacity to manage the required rigorous cold chain. And, despite the dose limitation, he has opined that the process is flowing in an orderly fashion, especially with more vaccinating sites.
He reported, however, that in one of the facilities, which he did not identify, 40 vials of the vaccine were stored in a freezer, instead of in a refrigerator, which resulted in the loss of 200 doses of the vaccine. This, because after consulting with the manufacturer, he indicated that these doses should not be used. He did not specify what measures, if any, were taken in relation to this provider.
Regarding complaints that, in some clinics, people not included in the current vaccination phase have been immunized, Cardona stressed that this action “is not bad” if the doses are in danger of being damaged, considering that once prepared they last only six hours.
Of the 68 adverse reactions to the vaccine reported as of Jan. 1, he reported that one was an anaphylaxis or severe allergic reaction that required the person to be hospitalized for two days. All of these reactions, he said, were reported after the first dose, and 25 required visits to emergency rooms.