The idea of a COVID-19 vaccine raises some interesting practical and ethical questions about who should get one first, especially if limited supplies may be available. States were required to submit a plan for how they would distribute a vaccine to the Centers for Disease Control and Prevention by the weekend.
Dr. Eric France, chief medical officer for the Colorado Department of Public Health and Environment, joined KUNC’s Colorado Edition to explain what is included in our state’s plan.
Interview Highlights
These interview highlights have been lightly edited for length and clarity.
Eric France: The plan was submitted this past Friday and it was actually required of all states to follow a CDC template at answering a series of questions about how we will be prepared to distribute this vaccine once it arrives.
That's the first step. We're now doing some work to identify where the vaccine might actually go in terms of health care facilities, who could store it in particular and hold it as we plan our work for actually administering the vaccines.
So, much of how this will go forward will depend, of course, on the development of the vaccines themselves. There are four of them that are in their final trials. These large phase three clinical trials as we call them, looking at, does it actually work? Does the vaccine work in the real world, and is the vaccine safe? So we're waiting for those time periods to run through for those vaccine trials. And once those trials are done, there'll be the data and information that affirms that the vaccines are effective and are safe, and that will in many ways drive the timeline then for distributing to the states.
It's true that once the vaccines are approved, we’ll probably get limited numbers of doses and so the state — in partnership with a variety of important advisory groups across the United States — will make recommendations about who should get the first shots, the first doses, of the vaccine.
Erin O’Toole: And that's understandable if there are only so many doses to work with, you have to prioritize. So who might be included in phase one?
Clearly we want to protect those who are taking care of persons with COVID. So our physicians, and most importantly the physicians, nurses and healthcare providers that are in the hospitals that take care of hospitalized patients have to be a top priority so that they don't get sick and they're available to take care of us.
We would likely prioritize those in the hospital over physicians, nurses and others working in clinics in what we call an outpatient setting. However, it all depends on how many doses we get in as we work through our prioritization list — inpatient providers, nurses, doctors, outpatient.
Then we move down to the level of first responders, so the emergency medical services providers, the paramedics who are taking care of people before they get to the hospital. Firefighters and other first responders will be that next level.
Finally, the next one down moves us to looking at people who are at really high risk of having a severe illness if they got COVID. So we're thinking about the residents of nursing homes and other residential care facilities as being a big priority group.
What about in phase two? And my understanding is this is if a large enough number of doses are available for the supply to meet the demand.
I like the way you're talking about it in phases. It will likely be that we will do this in phases as doses come.
I'm not sure how many phases though there will be, but in our prioritization we have our first priorities or phase one priorities. Second priorities are essential workers. People who are taking a risk every day, making sure that they're doing what they can to keep the economy going.
And also persons who are at higher risk of having a more serious outcome or illness if they get sick with COVID. So we know that people with certain chronic medical conditions like diabetes and heart disease are more likely to have a longer hospitalization or get more sick, and so they'll be an important priority as well in that second phase of our vaccination.
It finally then moves down to the third level of priorities, which are many of the general public, adults in particular, children and pregnant women will likely be in that phase as well. Our challenge there is that the vaccine studies that are happening today don't enroll pregnant women and don't enroll children, so we will have them at a lower priority in part because we don't have the data to show that it works or that it's safe among those populations. And two, there are just higher disease complications in adults as we know with COVID, than with children. So it makes sense for us to prioritize the adults above the children.
How close are we to getting a vaccine? When are you realistically expecting Colorado may get one?
Well, the question is will we get some before the end of the year? Or maybe some early next year. And we did hear, I think, from one of the vaccine manufacturers that they may have their effectiveness and safety data from their vaccine trials available by the end of November.
So would we really get it into December? I'm not sure, but it could be December, January at the earliest, but the months following that, I think, is more realistic.
There are three other vaccine manufacturers as well, so I think our expectation is that early part of next year we’ll be getting our first shipments and that our larger volumes of vaccine will probably be spring and summer, assuming everything looks good with them.
This conversation is from KUNC’s Colorado Edition from Oct. 21. You can find the full show here.
