The first 2.9 million doses of Pfizer’s new two-dose coronavirus vaccine sent Sunday to the company’s factory in Kalamazoo, Michigan, began a massive national project that health officials hope will end the pandemic in late 2021.
But some states are better configured to eliminate coronavirus than others.
U.S. Centers for Disease Control and Prevention distributes doses weekly as they leave the Pfizer factory and ship them via UPS and Fedex. It is then up to the authorities of each state and territory in the United States to decide exactly where these doses are going and who is the first to get them.
It is a messy process. States, in essence, decide who gets the protection first and who should continue to run the risk of capturing COVID-19 and potentially dying from it.
“This is an emergency triage,” Irwin Redlener, the founding director of Columbia University’s National Disaster Preparedness Center, told The Daily Beast. “There are so many people at risk now and so many sectors who legitimately need attention with the early availability of the vaccine.”
“There will be people and populations that will be left out,” Redlener said.
Perhaps no state illustrates this dilemma better than Florida. The state is particularly vulnerable to coronavirus due to its combination of a huge elderly population – nearly 400,000 of whom live in nursing homes and other assisted living facilities – and a governor and Republican Party legislatures that have downplayed the severity of the pandemic while actively resisting local authorities ’efforts to control transmission through social distancing measures and masking mandates.
Florida desperately needs the vaccine to curb a growing wave of infections (about 9,000 new cases a day in recent weeks) and prevent a rising death toll. The state has already lost about 20,000 people. The number of deaths further depends in part on the state authorities allowing vaccination first as the supply of the vaccine grows slowly.
But Florida is already wrong, according to experts polled by The Daily Beast, and the results could be disastrous.
As states freely align their own vaccine distribution policies with a broad CDC orientation, four highly vulnerable groups compete for the first batches of vaccines: front-line health workers, residents of nursing homes, industry workers essentials and people of color.
The problem: Florida health officials, led by Gov. Ron DeSantis, are putting them in the wrong order, experts said.
Neither the Florida Department of Health nor the DeSantis office responded to requests for comment on this story.
Florida’s strategy, a draft available here, is to rush 55 percent of the initial supply of 180,000 doses of Pfizer’s genetically engineered “messenger RNA” vaccine, enough to vaccinate 90,000 people without causing any damage to the grains. hospitals to vaccinate their own. staff.
The state sets aside the remaining 45 percent of doses for people in nursing homes. It seems likely that this proportion will also apply to the remaining approximately one million doses that Florida expects to receive from Pfizer before the end of the month.
But, as is the case in most states, none of Florida’s first doses go to essential workers, such as grocery store staff, traffic workers, pharmacy employees, and teachers. What makes the Florida plan so controversial is that, unlike many other large states, Florida authorities have declined to restrict businesses and schools or require the use of masks. These policies have left Floridian’s essential workers no choice but to work among an audience that is especially infectious and at risk.
Similarly, DeSantis has not detailed any plans to precipitate vaccines to communities of color that, due to the structural disadvantages of generations ago, are exclusively vulnerable to the virus. In Florida, as in many other states, there is a significant overlap between essential workers and communities of color, further underscoring the importance of vaccinating these groups as quickly as possible.
“The need for strong equity strategies in Florida is extraordinary,” Lawrence Gostin, a public health expert at Georgetown University, told The Daily Beast.
As it stands, hundreds of thousands of Florida essential workers have to wait, probably for months, until Pfizer can produce and ship much more vaccine.
DeSantis and its health officials should change order and bring essential workers closer to the front of the line, experts told The Daily Beast. “The moral statement that essential workers must be at the forefront of vaccines is overwhelming,” Gostin said.
“We cannot once again leave the poor and low-income essential workers,” said the Rev. William Barber II, co-chair of the Poor People’s Campaign. The New York Times.
It might make sense for Florida workers to wait for their shots if they did the state was making other efforts to protect these workers. But it is not. In September, DeSantis issued an executive order blocking Florida cities from penalizing people for failing to comply with local mask warrants.
The same order made it difficult to close restaurants for cities and counties. “I oppose the mandates, period,” said DeSantis, a close ally of President Donald Trump. “I don’t think they work.”
DeSantis has repeatedly demonstrated a poor knowledge of the basic science of a viral pandemic and vaccines. He even seemed to approve of a marginal proposal that people skip the second dose of Pfizer’s two-dose vaccine. Data from Pfizer’s large-scale phase 3 trials made it very clear that without this second dose, the vaccine would not work.
With a science denier at the helm, Florida is more or less forcing essential workers to interact with a maskless audience, and then refuses to help the workers themselves get vaccinated soon.
Of course, experts acknowledged that the rise of essential workers making line for the vaccine means hitting other vulnerable people again. It’s not that hospital staff and residents of nursing homes don’t deserve protection. They do. And it’s not that vaccinating these populations first won’t save lives. Is going to.
But these groups have ways to protect themselves that many essential workers do not have.
“Healthcare workers at most facilities will be fully equipped with the most advanced PPE available,” Redlener explained, using the acronyms for personal protective equipment such as gloves, goggles, masks and face protectors. “This is not true for an employee of a grocery store or a pharmacy or a bus driver.”
Similarly, since residences are a highly controlled environment, staff may bring additional PPE and limit visits to protect residents and reduce the urgency of vaccinating them. “Nursing homes do a lot of testing on residents and staff,” Jeffrey Klausner, a UCLA professor of medicine and public health who previously worked at the CDC, told The Daily Beast.
And given that nursing home staff is a major vector of outbreaks on the premises, staff vaccination offers protection to residents, possibly releasing doses that would go to residents to go to essential workers.
“If staff can be vaccinated and protective masks, PPE, etc. can be guaranteed, it should be possible to control infection and death in these environments and use the early supply of vaccines to vaccinate other frontline groups and of minorities, “Edwin Michael told The Daily Beast, an epidemiologist at the University of South Florida’s Center for Global Health Infectious Disease Research.
Florida’s nearly 22 million people could get more equitable and more balanced global protection against the state’s initial vaccine batches if authorities divert a portion of the first doses to essential workers. But even this strategy will not prevent the hardships that all experts say from coming, nor reverse the harm that DeSantis has already caused to his state.
“Upcoming vaccines are too late and too low in terms of supply to avoid the next third waves in most U.S. counties, even if the planned release starts in earnest starting in January 2021,” he said. Michael. “Our simulations show that the only way to contain the next waves is to increase social distancing measures, even with a moderate increase in people who comply with these measures capable of suppressing and even flattening these waves in many areas. “.