HOUSTON — We fantasize a lot about how life will be better when a COVID-19 vaccine is available. KHOU 11 has learned health officials are now working to build on existing immunization infrastructure, including expanding it, to make it work for COVID-19 vaccine distribution.
In Houston, the Department of Health said it was in the beginning stages of planning, working with the Centers for Disease Control and Prevention, as well as DSHS on what the coronavirus inoculation process will look like.
There is a lot to consider, KHOU 11 learned, including who will administer the vaccine and how they will order and receive it, where the inoculation will take place, who will pay for it and how many individuals in every age group, at high risk or not will need doses.
Vaccines will also have to be properly stored and accounted for, part of the training that will be needed for some providers.
“Once the vaccine is available, we're gonna need all hands on deck,” the chief of the immunization program for the Houston Health Department Omar Salgado told KHOU 11. “It's going to be available to private providers, pubic providers, it's going to be available to hospitals, pharmacies and federally qualified health centers.”
In a Zoom interview, Salgado told KHOU 11, the department has to first do a survey of the health care providers that already work with them to administer the Texas Vaccines for Children program, an effort to provide low-cost vaccines to eligible kids from birth to 18 years of age, and the providers who are a part of the Adult Safety Net Program, created by DSHS to increase vaccine access for uninsured adults.
Salgado said the survey will count the existing clients who’ll need the COVID-19 vaccine. Health officials will also have to figure out how many total vaccines are needed to inoculate the entire population of Houston and Harris county, including those who don’t see a doctor regularly.
Salgado said the list of the providers already “in the system,” familiar with the vaccine ordering process that first goes through the state and then the CDC system, will have to be expanded. Providers will have to be trained, Salgado said, to make sure as many Texans as possible have access to the coronavirus vaccine.
“There are different manufacturers, some of the manufacturers will have a vaccine that is going to take one dose to get immunity. Others are going to need two doses, which means they'll come in for the first dose and come back probably four weeks later to get that booster to build that immunity,” Salgado said.
Salgado told KHOU 11 people can expect drive-through vaccination clinics, similar to COVID testing sites.
“What we're doing right now, we are creating maps, maps of our community to determine which areas are high in COVID cases, so we can start to target those areas,” he said. “When the COVID vaccine comes out, we're gonna have to prioritize. It's going to first target first responders and those are the elderly population.”
When the vaccine does come out, the Houston Health Department is up to the task.
“We’ll definitely be ready,” Salgado said.
In an emailed statement, the Texas Department of State Health Services said it’s currently working with the CDC, planning for COVID-19 vaccine distribution.
“Final plans will depend on the formulation of the vaccine and the distribution schedule once one or more vaccines are approved,” wrote Chris Van Deusen, Director of Media Relations. “Health care providers interested in administering the COVID-19 immunization should register with ImmTrac2, the Texas immunization registry."
Texas is one of the few states that has an existing adult vaccine program, according to Claire Hannan, Executive Director of the Association of Immunization Managers. Both the adult vaccine and children’s vaccine programs are established immunization framework health officials could lean on to distribute the COVID-19 vaccine.
The Association is a Maryland-based non-profit that includes vaccine experts and leaders from all 50 states, plus large cities, including Houston, and U.S. territories, working to control vaccine-preventable diseases.
“Each state has received supplemental funding from CDC to raise flu vaccination rates and will be receiving flu vaccine doses as well,” Hannan said. “Texas is using these funds to reach out and enroll additional sites to their Adult Safety Net program, including pharmacies, nursing homes, long-term care facilities, etc. And they will be providing the flu doses form CDC to adults through these newly enrolled and existing sites, and then building relationships with these sites in preparation for COVID-19 vaccination.”
Hannan said the Texas Adult Safety Net program has 570 clinics enrolled, including 300 Federally Qualified Health Centers and Rural Health Clinics that inoculate uninsured adults.
“We have about 40,000 providers across the country enrolled in this children’s program,” Hannan said. “We probably need to triple or quadruple that with providers that serve adults. We need to get them enrolled. We need to get them trained. We need to make sure they understand how to store the vaccine. We need to get them to agree to give it to the right people to manage their inventory, report the doses administered into immunization registries. So, you know, that system we have in place for children, we just need to expand that for adults.”
Hannan said the system in place to administer the flu vaccine is a good one to build on, as well as the experience the country had in 2009 with the H1N1 pandemic.
“I guess I'd say we're probably almost halfway there,” Hannan said. “We just need to put those all those pieces together to make it work.”
“This is an unprecedented time,” she added. “Getting all of America vaccinated with a brand-new vaccine, we've never done anything like that before. In this case, it's a massively larger campaign. We're looking at getting more Americans vaccinated and potentially with two doses. So, it's a little bit bigger than the flu.”
Hannan said she anticipated the COVID-19 vaccine to be free of charge. How this will work is clearer if you have a private provider.
“We think that enrolling private providers will allow the providers to have an incentive to give the vaccine because they will be able to charge insurers for an admin fee,” Hannan said. “So, the vaccine will be free. The insurance will cover the admin fee. You know, this is what we anticipate happening. This is the way that it happened in 2009. And this is the way it also works with the Vaccines for Children program.”
The details of how this will work for the uninsured are being worked out, she said.
“[What] we're really working through now is working with pharmacies, community health centers and figuring out how we're going to make that work,” Hannan said. “It's unknown exactly who's going to pay for the admin fee. We want to make sure the vaccine is accessible and is available and is affordable, as widespread as possible in as many communities as we can get.”
Hannan said the Federal Government’s COVID-19 vaccine effort, dubbed Operation Warp Speed, is taking a “deep dive” at certain areas in the United States to see what challenges the nation-wide coronavirus vaccine distribution could encounter, and how to solve those before the vaccine is available.
According to the Department of Health and Human Services (HHS) website, Operation Warp Speed is supposed to produce and deliver 300 million doses of safe and effective vaccine, with the initial doses available in January of 2021.
Operation Warp Speed is a partnership between HHS, the CDC, the FDA, the National Institutes of Health, the Department of Defense and the Biomedical Advanced Research and Development Authority.
“They're going to North Dakota, California, Philadelphia, Florida and Minnesota,” Hannan said. “And they're going to be focusing on different challenges in those areas
and working through a number of the issues and then putting out some guidance and a model plan following these visits.”
Hannan is hopeful the COVID testing issues that have been widely reported across the country won’t be repeated with vaccine distribution.
“With the time period we have to prepare, we can really work out some of these kinks and work out a way to get the vaccine seamlessly out to the public,” she said.