A COVID-19 vaccine from Pfizer is nearing FDA approval for distribution across the United States. Now what happens here?

The vaccine — especially in the earliest days of distribution — won’t bring an end to soaring daily totals of new cases, hospitalizations, and deaths and officials warn that social distancing, hand washing, and masks must remain habitual until the number of people sick with coronavirus nears zero.

In Washington, Gov. Jay Inslee and state officials have said they are preparing to receive enough vaccine to protect 200,000 people over the final weeks of 2020. Around half of that is lined up to come from Pfizer. The rest will be Moderna’s vaccine which also must still be approved by the FDA. That decision is expected by December 17th.

A third vaccine, from AstraZeneca, is reportedly easier to store and transport and could follow the others closely to speed distribution.

The vaccine candidates are reported to have greater side-effects than the typical flu shot with some people who recieve them likely to need a day or two to recover.

Washington’s adult population is more than 5 million people. Dr. Anthony Fauci of the White House’s COVID-19 task force has said the typical American can expect to get their shots in April or May. Most children won’t likely be in line for immunization until 2021 when more testing has been completed but it’s not yet clear what the FDA will recommend. This New York Times tool can give you an idea of how long your wait might be.

Washington officials have said “regular weekly shipments” of vaccine will follow and should begin in January.

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For the first wave, federal officials say there are plans to begin distributing the vaccines 24 hours after FDA approval.

For Washington, an additional signoff will come from the Scientific Safety Review Workgroup, as part of the Western States Pact agreement forged earlier this year.

“The review by this workgroup will provide another layer of scrutiny and expert review to this process and should take about 1 to 2 days,” the state said in a statement last week on the preparations for vaccine distribution . “This will be done while the vaccine is still being processed and shipped, so it should not cause any delay in making vaccine available to people in Washington,”

Pfizer has said it plans to ship 50 million doses across the country before the end of the year. With the two shots required for immunity, that’s enough for 25 million people. Both vaccines require two doses. Pfizer’s requires a three-week schedule while Moderna’s second shot will come four weeks after the first.

States submitted their plans for distribution last week. Most, including Washington, have said they intend to follow Centers for Disease Control and Prevention guidelines and prioritize health workers, workers in essential industries, those 65 and older, and people “at high risk for severe COVID-19 illness due to underlying medical conditions.” The CDC has provided states with an outline recommending prioritizing health-care workers and nursing homes to try to most effectively slow the spread of the virus.

From the CDC:

Groups considered for early vaccination if supply is limited

Before making an official recommendation, ACIP considered four groups to possibly recommend for early COVID-19 vaccination if supply is limited:

• Healthcare personnel
• Workers in essential and critical industries
• People at high risk for severe COVID-19 illness due to underlying medical conditions
• People 65 years and older

Healthcare personnel continue to be on the front line of the nation’s fight against this deadly pandemic. By providing critical care to those infected with the virus that causes COVID-19, many healthcare personnel have a high risk of being exposed to and getting sick with COVID-19. Healthcare personnel who get COVID-19 can also spread the virus to their patients seeking care for medical conditions that, in turn, increase their patients’ risk for severe COVID-19 illness. Early vaccine access is critical to ensuring the health and safety of this essential workforce of approximately 21 million people, protecting not only them but also their patients, communities, and the broader health of our country. Learn who is included under the broad term “healthcare personnel.”

Workers in essential and critical industries are considered part of America’s critical infrastructure, as defined by the Cybersecurity & Infrastructure Security Agencyexternal icon. Current data show that many of these workers are at increased risk for getting COVID-19. Early vaccine access is critical not only to protect them but also to maintain the essential services they provide U.S. communities.

People with certain underlying medical conditions are at increased risk for severe COVID-19 illness, regardless of their age. Severe illness means that the person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe, or that they may even die. Early vaccine access is critical to ensuring the health and safety of this population that is disproportionately affected by COVID-19.

Among adults, the risk for severe illness and death from COVID-19 increases with age, with older adults at highest risk. Early vaccine access is critical to help protect this population that is disproportionately affected by COVID-19.

In Washington, state officials have identified distribution sites for the vaccines and are expected to announce details next week.

“What we know for sure right now is that the first phase of vaccination, called 1a, will focus on workers in healthcare settings serving patients who either have confirmed or suspected COVID-19, along with staff and residents of long-term care facilities,” Olympia’s statement on the distribution plan reads. “We’ll know more about who will be vaccinated in later phases based on input from our community engagement and decisions made by (the federal Advisory Committee on Immunization Practices).”

“Getting vaccine to the people of Washington is a large, coordinated effort and the timeline for when all eligible people can receive the vaccine is still a work in progress,” officials said last week.

The state has posted questions and answers about the vaccines and distribution here.

The Department of Health estimates there are 300,000 to 400,000 health care workers in the state that will need to be vaccinated in the first rounds.

Nearly 200 organizations are enrolled as vaccine providers in the state. Any clinic, pharmacy, or hospital can enroll in the program. Pfizer’s vaccine requires storage at “ultra-cold” temperatures but the state is allowing facilities without that type of unit to apply. “The manufacturer of the ultra-cold vaccine candidate plans to ship vaccine in containers with dry ice pellets. If you follow the required dry ice management protocols, you can keep the vaccine in these containers, called thermal shippers, for up to 15 days,” the state guidelines read.

The vaccines acquired with taxpayer money will be free but providers may charge an administration fee that can be reimbursed by health insurance companies or Medicaid and Medicare.

The first round of distribution will be extremely limited with around 20 large sites across the state getting doses for distribution to frontline health workers and assisted living facilities. Eventually, the vaccines will be distributed for access by the general public. In the early days especially, the vaccination sites will probably be set up like the typical COVID-19 testing facilities or flu clinics. More innovation will likely follow including drive-thru and walk-up solutions and possibly neighborhood locations like fire stations or churches.

Organizing the status of who gets shots when falls to the states. In Illinois, a site launched to accept sign-ups for COVID-19 vaccines was swamped with early registrations. Other states are expected to implement similar solutions.

Dr. Moncef Slaoui, head of the federal coronavirus task force, said the country should be able to distribute enough vaccine to immunize 100 million people by the end of February. Officials have said that timeframe would put nearly complete vaccination by June.

292,000 Americans have died so far from the virus. By June, that totals will be even more terrible as current daily death totals have climbed above 3,000.

And there remain concerns not everything will go as planned.

“As vaccines potentially become available in the near future, cities need direct funding and policy guidance to build a distribution network that can quickly and safely reach our essential workers, most vulnerable populations, and all of our residents working in concert with other state and local officials and stakeholders,” a letter to incoming President Joe Biden and Vice-President Kamala Harris from mayors in 16 of the nation’s largest cities reads.

“In Seattle, the results of the election meant that we have a federal partner who is committed to the fight against COVID-19 and building a just and equitable recovery,” Seattle Mayor Jenny Durkan said.

While that hope is likely shared by most, here’s hoping that the next six weeks to get there also help move the recovery forward.

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