R.I. outlines COVID-19 vaccination strategy, but some unknowns remain

RHODE ISLAND officials say the first delivery of nearly 10,000 doses of the Pfizer-BioNTech COVID-19 vaccine and approximately 19,000 doses of the Moderna vaccine could arrive in Rhode Island soon. / AP FILE PHOTO/HANS PENNINK
RHODE ISLAND officials say the first delivery of nearly 10,000 doses of the Pfizer-BioNTech COVID-19 vaccine and approximately 19,000 doses of the Moderna vaccine could arrive in Rhode Island soon. / AP FILE PHOTO/HANS PENNINK

PROVIDENCE – As Rhode Island continues to get pummeled by the COVID-19 pandemic – with cases overwhelming hospital systems and shuttering businesses – state health officials offered a sign of confidence Wednesday.

Rhode Island officials said Wednesday that batches of nearly 10,000 doses of the Pfizer-BioNTech COVID-19 vaccine and approximately 19,000 first doses of the Moderna vaccine could arrive in Rhode Island shortly after the pharmaceutical companies receive emergency use approval from the federal Food and Drug Administration.

Health care workers are set to be the first to receive the long-awaited vaccine.

However, it remains unclear when exactly the state will receive those first doses, and if Rhode Island will even receive the amount it orders from the federal government, said Alysia Mihalakos, chief to the Center for Emergency Preparedness and Response at the R.I. Department of Health. Mihalakos also co-leads RIDOH’s COVD-19 Mass Vaccination Workgroup.

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“I wish we could give you an exact date,” Washburn said during a virtual news conference, adding that the federal government still needs to approve the vaccines.

Once a vaccine is approved for emergency use by the FDA, the Advisory Committee on Immunization Practices will provide the Centers for Disease Control and Prevention with recommendations on whom to vaccinate and in what order, according to Mihalakos. The advisory committee will also provide guidance on vaccine administration storing, and handling techniques and may provide resources and tools additional to those produced by the vaccine manufacturers, Mihalakos said.

RIDOH anticipates it will received about 8,000 doses per week of both vaccines. The second dose, known as a “booster,” will start to arrive in Rhode Island roughly three weeks after the first dose, according to Mihalakos.

The size of the deliveries are subject to change, she added.

Both the Moderna and Pfizer vaccines will need people to receive an initial dose and a booster to be effective. Mihalakos said additional COVID-19 vaccines could be approved by the federal government in the future, which could increase the amount of vaccines arriving in Rhode Island.

Similarly to other states, Rhode Island will first vaccinate front-line workers and then residents and staff members in nursing homes and assisted-living facilities. The second round will vaccinate first responders, such as police, firefighters, emergency medical workers, at-home health care workers, among others, according to three RIDOH officials at Wednesday’s news conference.

In addition to Mihalakos, the panel included Dr. Philip Chan, consultant medical director of the RIDOH’s Division of Preparedness, Response, Infectious Disease and Emergency Medical Services, and Tricia Washburn, chief of the Center for Preventative Services at RIDOH and the co-lead of the COVID-19 Mass Vaccination Workgroup.

According to Rhode Island’s COVID-19 vaccination draft, a 151-page document that was last updated on Oct. 16, the distribution plan will be broken down into three phases.

Phase 1 will have limited doses of a vaccine available, said Chan. The first phase will be broken down into two parts: Phase 1A will target high-risk health care workers and first responders. Phase 1B will allow those vaccinated in Phase 1A to receive their booster dose, and vaccines will also start reaching long-term care facility residents and staffers and other older adults in overcrowded settings.

Mihalakos said hospitals will receive the vaccine and redistribute within their systems, including their own staff members. Through a pharmacy partnership, personnel from CVS Health Corp. and Walgreens will administer the vaccines to staff and residents of long-term care facilities.

First responders and home health agency workers, among other priority populations, will be able to get vaccinated at clinics.

Approximately 150,000 people need to be vaccinated in Phase 1, said Mihalakos.

In the Phase 2, there are six main groups that are expected to be vaccinated.

This includes K-12 teachers, school staff and child care providers; critical workers in high-risk settings; people with moderate comorbid conditions; people in homeless shelters or groups homes, in addition to the staff members who work at these locations; incarcerated or detailed people, in addition to the staff at these facilities; and lastly, “all older people.”

RIDOH’s vaccination plan did not identify what age bracket include “older people.”

If supply meets the demand, as laid out in RIDOH’s vaccination plan, the third phase calls for the vaccination of young adults, children and “workers in industries important to the functioning of society.”

Phase 4 will vaccinate everyone who did not have access to a vaccine in previous phases, according to Mihalakos.

The news comes as Britain’s National Health Service began delivering shots of the Pfizer vaccine on Tuesday after receiving approval on Dec. 2 – the vaccine’s first governmental authorization in the world.

Canada also approved the Pfizer vaccine on Wednesday.

Although the Pfizer has received approval in other countries, the FDA still has the vaccine under review for emergency authorization. However, the FDA is expected to discuss the Pfizer vaccine on Thursday, and the Advisory Committee on Immunization Practices will have emergency meetings on the vaccine from Dec. 11 through Dec. 13.

When asked when the Pfizer vaccine could start being administered in Rhode Island, Washburn said, “It could be this weekend, it could be the first few days of next week.”

Pfizer, and its partner, Germany-based BioNTech SE, submitted their emergency use authorization request to the FDA on Nov. 20. The drugmaker Moderna, which recently announced encouraging results on its COVID-19 vaccine, applied for FDA approval for emergency use on Nov. 30.

As RIDOH officials laid out the details to the distribution plan, the new House COVID-19 Vaccine Task Force hosted its second virtual meeting with executives from Woonsocket-based CVS. The role of the task force, which held its first meeting on Dec. 2, is designed to ensure that Rhode Island’s distribution of the vaccine is done in a timely manner while following guidelines from the CDC, and that front-line workers, the health-compromised and the elderly are given access to the vaccine first all of which has been outlined in the state’s distribution plan since earlier this fall.

Dr. Sreekanth Chaguturu, senior vice president and chief medical officer of Caremark CVS, and Christopher Cox, senior vice president for pharmacy operations, and Steven Larrabee, senior director of state government affairs for CVS, participated in the meeting.

“There’s a lot of promise ahead as we talk about vaccines,” Chaguturu said at the task force’s meeting Wednesday afternoon. He said the the Pfizer vaccine was tested in clinical trials on people who were ages 12 to 85. The trials found that the vaccine was 85% effective.

He said there were “no real, serious safety concerns that were reported,” however, he added that some side effects include headaches and fatigue. He said some trials showed that there were less side effects in older populations than younger.

Cox said that once the CDC gives the green light to a vaccine, Rhode Island will have to approve distributing the vaccine on the state level, and CVS will be able to distribute the drug “within 48 hours.”

“We know when we are starting with certain jurisdictions, but we’re still waiting on Rhode Island,” said Cox.

Alexa Gagosz is a PBN staff writer. Contact her at Gagosz@PBN.com. You may also follow her on Twitter at @AlexaGagosz.

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