More than nine months into the pandemic, the first doses of a COVID-19 vaccine arrived in Colorado this week — and within hours hospitals began injecting doses into the arms of staffers who work most closely with virus-stricken patients.
The arrival of the vaccine, developed by Pfizer, ushered in a new phase in public health officials’ fight against the novel coronavirus. However, vaccine supply is severely limited and distribution across Colorado and the rest of the nation is expected to take months.
Colorado’s health department has detailed the broad outlines of a three-phased approach to prioritizing who gets vaccinated and in what order, and while the state released a draft vaccination-distribution plan in October, there’s not yet a finalized document.
Many questions still remain about who will get the next doses, and in what order, once this winter’s Phase 1 is finished, and how members of the general public will be able to get their shots once enough vaccine is available.
Here are answers to questions about the vaccine and how Colorado’s distribution will work:
How many doses will Colorado get?
COVID-19 vaccine supply is expected to be severely limited when it first becomes available. The state health department received 46,800 doses of Pfizer’s vaccine in the first batch early this week.
Colorado’s second order of the Pfizer vaccine, due to arrive this week, had been expected to total 56,550 doses, but was reduced 30% by the federal Operation Warp Speed distribution program. Now, the state is expecting 39,780 doses in that second Pfizer shipment.
But the impact of that reduction is blunted somewhat because it’s been discovered many of the Pfizer vials contain six doses of the vaccine, rather than the five states were told to expect. If each vial only contained five doses, Colorado’s next shipment would only be enough for 33,150 people, meaning at least 6,000 fewer people could receive their first of two shots that week.
If Colorado had received the full original allotment of 11,310 vials in the second shipment and got six doses out of each, rather than five, it would have had enough for 67,860 people.
The Department of Public Health and Environment has also ordered 95,600 doses of Moderna’s vaccine — which received emergency use authorization from the U.S. Food and Drug Administration on Friday — to arrive this week.
Colorado is slated to receive 1.69% — a percentage that is based on population — of available vaccine in weekly batches, and the state said Friday that it’s been informed by Operation Warp Speed that it will receive the same size allocation each week.
Both Pfizer’s and Moderna’s vaccines require two doses taken several weeks apart.
Who will get the first shots?
The state health department is distributing COVID-19 vaccines in three phases because of constrained supply of the shots.
Under revised framework released by the agency this month, health care workers in closest contact with coronavirus patients and people who live and work in long-term care facilities, such as nursing homes, will receive the first doses.
Hospitals across the state began administering the shots to employees this week.
While supplies are limited, the state is prioritizing protecting medical workers most at risk of exposure and people more likely to develop severe symptoms or die for the disease.
In making recommendations on who should receive vaccine first, the goal is to save the most lives, end the pandemic and maintain critical societal functions, said Dr. Anuj Mehta, a pulmonary and critical care physician at Denver Health and National Jewish Health.
A critical societal function ranges from maintaining health care services — which can both save lives and end the pandemic — to protecting the food supply chain, he said.
“The recommendations that we made were made on some really strong ethical principles,” said Mehta, who advised the state on its draft vaccination plan. “Obviously we want to save as many lives as possible.”
The next group of people to receive the vaccine in the first phase, which is expected to last through winter, are: other health care workers; people that work in home health, hospice and dental practices; and first responders, such as paramedics, correctional workers, police and funeral service workers, according to the framework.
The Department of Public Health and Environment does not know how many people will be covered in each phase of the vaccination plan. In Colorado, there are 114,000 residents and staff at long-term care facilities. There are also about 331,000 health care workers that will be covered in the first two phases.
Who’s next?
The second phase of distribution — which the state expects to enter into by spring — is more vague than the first phase when it comes to prioritization and covers a very large segment of the population.
The people expected to receive the vaccine in Phase 2 are:
- Anyone 65 and older
- Individuals with underlying heath conditions, such as obesity, diabetes, chronic lung disease, heart disease, chronic kidney disease or cancer, or are immunocompromised
- People who interact directly with the public, such as school staff and grocery store workers
- People who work in high-density settings, such as farms and meatpacking plants, or serve people living in high-density settings
- Any health care workers not covered in Phase 1
- Adults who received a placebo during a COVID-19 vaccine trial
The state health department has not announced how the groups of people in the second phase will be prioritized. Previously, the agency prioritized those living in congregate settings, such as jails and shelters, with essential workers and before those with underlying health conditions. Notably, those in congregate settings — including prisoners — are no longer specifically mentioned in the framework.
Jill Hunsaker Ryan, executive director of the state health department, has said that the agency is waiting for guidance from the national Advisory Committee on Immunization Practices before prioritizing any of the groups within Phase 2. The panel makes recommendations to the Centers for Disease Control and Prevention.
When the state health department revised its framework, it altered it to more closely align with the panel’s recommendation that health care workers and nursing home residents should be the first to receive doses of the COVID-19 vaccine.
The second phase is expected to cover such a large portion of the population that by the point it’s underway vaccine supply will be more readily available.
While the health department doesn’t have estimates on how many people will be included in this phase under the revised plan, the state’s initial draft plan estimated that Phase 2 would include more than 3 million residents.
Hyoung Chang, The Denver Post
Ganesh Chandran, manager of pharmacy, holds a bottle of COVID-19 vaccine at UCHealth University of Colorado Hospital in Aurora, Colorado on Thursday, Dec. 17, 2020.Does the state prioritize any other group?
No. The state health department’s plan does not say whether other key populations, including pregnant women, children and military personnel, will receive a higher prioritization before the vaccine is made available to the general public in the summer.
While Colorado’s draft plan acknowledges that people of color have become sick and died from COVID-19 at a disproportionately high rate, it does not say how it will ensure that they are vaccinated except that they will be covered when the state prioritizes essential workers and those at high-risk of severe disease.
This is because people of color are more likely to work public-facing jobs or have underlying health conditions.
Members of the Southern Ute Tribe and the Ute Mountain Ute Tribe also are not prioritized in the health department’s draft vaccination plan nor its revised framework.
Adrianne Maddux, executive director of the Denver Indian Health and Family Services, said the Denver clinic was asked to choose between getting the COVID-19 vaccine through the state or through Indian Health Services and decided on Indian Health Services.
Under the Indian Health Services umbrella, the Denver clinic falls under the Albuquerque area to pick up the vaccine.
“We can’t just go down the road to pick it up,” Maddux said. “As we speak, we are waiting to hear when we can go pick it up from our providers, and we have two staff on alert. The minute they get the call, they’re going to be headed down to Albuquerque to pick it up.”
When does the general public get the vaccine?
There won’t be much vaccine supply initially so the state health department estimates it will be at least until summer before anyone between the ages of 18 and 64 who doesn’t have high-risk health conditions or an essential job can get the vaccine.
This could change if vaccine supplies becomes more widely available earlier or it could take longer if there are distribution issues.
Can children get the COVID-19 vaccine?
Pfizer’s vaccine is only authorized for people as young as 16. And if approved, Moderna’s vaccine will only be available to those 18 years and older.
Studies for both of these vaccines are starting to look at how effective and safe they are in children, but it will take several more months before researchers know more about how they perform in people as young as 12, said Dr. Jessica Cataldi, a pediatrician at Children’s Hospital Colorado who specializes in infectious diseases.
“We want to make sure that the vaccines are safe for kids because kids do have different immune systems,” she said.
Helen H. Richardson, The Denver Post
Gina Harper, clinical coordinator with pharmacy, measures out the exact amount of the COVID-19 vaccine for a dose before it is administered to the first patients in Colorado at UC Health Poudre Valley Hospital on Dec. 14, 2020 in Fort Collins.Does the arrival of COVID-19 vaccines mean I can finally throw away my mask and stop social distancing?
No. Initially, public health officials expect there to be a very limited supply of COVID-19 vaccines and it is expected to take months to distribute them across the U.S.
Even those who get the initial doses of vaccine should keep wearing masks and social distancing. This is because it’s still not known whether the shots can prevent a person from spreading the disease while not having symptoms themselves, Mehta, the physician with Denver Health and National Jewish, said.
“Vaccines are not going to be the smoking gun we all want them to be,” he said.
How do I know the COVID-19 vaccines are safe?
When a Denver Post reporter asked Dr. Anthony Fauci about why people can trust that any COVID-19 vaccine is safe, he said that the clinical trials were done in tens of thousands of people.
And the results of the vaccine trials were monitored by group of scientists, clinicians, immunologists, virologists, statistician and ethicists — not the federal government nor the pharmaceutical company, said Fauci, the director of the National Institute of Allergy and Infectious Diseases.
“I think if every health care worker realizes how transparent and independent the process is they will feel much more comfortable about getting vaccinated,” Fauci said.
Next, a company developing a vaccine presents the results to the FDA, which has more scientists examine the data before issuing an emergency use authorization, Fauci said.
“So even though it seems fast, all of those regular steps have been followed,” added Cataldi. “It really shows the power of having so many scientists around the world working on the same thing.”
What about side effects and allergies?
For Pfizer’s vaccine, the most common side effect includes pain at the injection site. Other people may have body aches, fatigue, headaches and fever, Cataldi said.
The side effects often show up in the first couple of days, but are most common after the second dose. The reason why there are side effects is because it’s part of the body creating an immune response.
It is not possible for someone to get COVID-19 from the vaccine, Cataldi said.
A small number of people in the United Kingdom and at least one person in the U.S. had severe allergic reactions to the vaccine.
“We’re working to get more information about which part of the vaccine folks are responding to,” Cataldi said.
People who have a severe allergy to or have had an anaphylaxis reaction to a vaccine or another injected medicine should be cautious and talk to their doctor to make sure they can get the vaccine, she said.
“People have allergic reactions to other vaccines from time to time,” Cataldi said. “It’s very rare”
The vaccine should not be a problem for people with allergies to food, animals, the environment, oral medicines or seasonal allergies, she said.
Pfizer’s vaccine uses messenger RNA, or mRNA, technology. What does that mean?
This means that the vaccine uses a piece of genetic code that goes into cells and gives them a message to produce a protein that will spark an immune response to the novel coronavirus’ spike protein, Cataldi said.
mRNA does not interact with a person’s DNA, she said.
This technology is also unlike other vaccines that use a weak or dead strain of a virus.
What is the threshold for “herd immunity” for COVID-19?
Herd immunity occurs when enough people are protected from a disease that a community is no longer susceptible to an outbreak.
The Colorado School of Public Health estimates that to reach this threshold for COVID-19, 70% of people in the state need immunity through vaccines, since there’s no guarantee that having COVID-19 once means you won’t get it again.
“Because this virus is new, we don’t know how long natural immunity might last,” said a spokesperson for the Department of Public Health and Environment in an email. “Some early evidence — based on a small sample size of people — seems to suggest that natural immunity may not last very long and is estimated at around 90 days.”
David Zalubowski, The Associated Press
Colorado Governor Jared Polis opens the state’s first shipment of COVID-19 vaccine in the laboratory of the Colorado Department of Public Health and Environment, early Monday, Dec. 14, 2020, in east Denver.How will Colorado ship and store Pfizer’s COVID-19 vaccine?
Pfizer’s shots present a unique challenge because they have to be stored at an ultra-cold temperatures.
The vaccine supply that recently arrived came in thermal containers packed with dry ice. The boxes can be replenished but they can only be opened twice a day.
The boxes will be shipped directly to hospitals and local public health agencies via FedEx in doses ranging from 975 to 4,875.
The providers that received the first shipment of vaccine are locations that have ultra-cold freezers that can store the shots at -103 degrees Fahrenheit.
The vaccine can also be stored in a refrigerator at temperatures between 35.6 and 46.4 degrees Fahrenheit, but it will only last for five days. Before the shot is administered it is diluted with saline, making at least five doses of vaccine per vial.
There are nine hubs in Colorado will break down the orders into fewer quantities for smaller hospitals that don’t have an ultra-cold freezer. The smaller boxes will be delivered by couriers and the Colorado National Guard.
For example, Vail Health, one of the hubs, received 975 doses of Pfizer’s vaccine on Dec. 15. Only 365 doses are for the hospital. The rest will go to Eagle County Public Health and Aspen Valley Hospital, according to a news release.
How will I get the vaccine?
In the first phase, most people will receive the vaccine through their employer or a local public health agency.
Those living and working in long-term care facilities, such as nursing homes, will receive their vaccines via Walgreens and CVS. The companies have an agreement with the CDC and will receive a portion of the state’s vaccine allocation.
It is not yet clear how the vaccine will be administered to those in the second and third phases.
How much will it cost to get a COVID-19 vaccine?
Both private and government insurers — such as Medicare and Medicaid — will cover the cost of getting the shots to protect against the novel coronavirus.
And people without insurance will get the shots for free, according to the state health department’s website.
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