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Officials outline the timeline behind the coronavirus vaccine distribution plans across Missouri

Missouri's health director said he expects all healthcare workers, as well as the more than 120,000 people who work and live in long-term care facilities, will have a chance to get the COVID-19 vaccination by the end of December.

Posted: Dec 4, 2020 9:49 PM
Updated: Dec 4, 2020 11:03 PM

(JEFFERSON CITY, Mo.) Missouri's health director said he expects all healthcare workers, as well as the more than 120,000 people who work and live in long-term care facilities, will have a chance to get the COVID-19 vaccination by the end of December.

“We now have a commitment for 339,000 and 775 doses of vaccine for initial vaccination by the end of December," said Dr. Randall Williams, the director of the Department of Health and Senior Services, in a news briefing Friday. "With that amount alone, we should be able to move through all of our long-term care facility residents staff and healthcare providers, forward-facing healthcare providers.”

The COVID-19 Vaccine in Missouri by the Numbers:

Vaccination Shipments by Company by Week:

*According to DHSS Director Dr. Randall Williams, Operation Warp Speed is allocating Missouri about 2% of all vaccination doses based on the state’s population size. Missouri will then distribute doses to each region based on geographic and population needs.

  • Week 1 (around Dec. 12-15): Pfizer will ship 51,675 doses to Missouri
  • Week 2 (around Dec. 21): Moderna will send 105,000 doses to Missouri and Pfizer will send 63,000 doses in its second shipment.
  • Week 3: Moderna will send 46,000 doses in its second shipment and Pfizer will send 110,000 in its third shipment to Missouri.

The Priority/Composition of Groups:

  • Group 1 (referred to as 1A): About 339,000 people
    • Individuals who work and live at the 1300 longterm care facilities in Missouri
      • Includes 58,000 longterm care residents
      • Includes 70,000 people who care for them.
    • Healthcare Workers:
      • Includes 15,000 physicians
      • Includes 5,000-6,000 medical students
      • Includes 130,000 nurses
  • Group 2 (referred to as 1B): about 3 million people
    • Essential workers: First responders, childcare workers, teachers, etc.
    • Individuals age 65 and older.
  • Group 3: The rest of Missourians.

Timeline:

*Moderna vaccine to be administered once and then again 4 weeks later.

*Pfizer is meant to be administered once and then again 3 weeks later.

  • Phase 1A:
    • December-January: First doses administer to the 339,000 Missourians in the highest priority group.
    • January-February: Second round of vaccine doses administered to the high priority group.
  • Phase 1B: 
    • February-May: The second group begins the vaccination process with the help of the National Guard and state selected regional implementation teams.
      • DHSS said Friday the plan for Phase 1B should be finalized by Dec. 10.
  • Phase 2:
    • May-August: The rest of Missourians will be offered the chance to be vaccinated with many locations set up throughout their community.

Earlier this week, the CDC issued guidance recommending states include long-term care residents in the first phase of vaccination plans. Dr. Williams said Missouri has decided to follow that recommendation and has enough vaccine doses for the entire group.

By the end of 2020, Pfizer and Moderna together will have shipped enough supplies for 339,000 vaccinations to Missouri, according to DHSS spokesperson Lisa Cox. Operation Warp Speed is reserving the second dose, or the next set of 339,000 shots, to send to hospitals and congregate facilities in January and February so they can complete both rounds required to be effective against COVID-19 as ordered by the pharmaceutical companies.

However, Missourians are looking at a plan that will take possibly 9 months to execute. State officials say the good news about vaccines is not a reason to take your foot off of the neck of the virus.

“Absolutely not a doubt that as we go into January, February, and December that we will be at a very pivotal point because we will not have enough people vaccinated,” Dr. Williams said.

He added handwashing, mask-wearing, social distancing, and skipping social gatherings will continue to be vital through next fall.

Groups at the front of the line: Healthcare workers and longterm care residents

Of those health care workers, 5,000 medical students, 100,000 nurses, and 15,000 physicians will be offered vaccination in the first phase, according to a spokesperson for the Missouri Department of Health and Senior Services. Of those long-term care facilities, shots will be provided to all 58,000 residents and the 70,000 individuals who care for them at one of the 1300 long-term care sites across the state.

The first group will also include all personnel and staff who have the potential for direct or indirect exposure to COVID and are unable to work from home which would include, for example, a facility’s housekeepers or clergy that goes into those facilities.

Williams said he anticipates the first dose of the vaccine will be administered to healthcare workers and long-term care residents in December and January and the second dose will follow in January and February.

By February, state officials hope to roll out Phase 1B, the DHSS name for the stage, with the help of the National Guard. This phase includes vaccinated 3 million essential workers and individuals ages 65 years and older. State officials also anticipate Astrozenica and Johnson & Johnson to begin shipping vaccine doses before or around Spring.

“We fully expect by May 1 we’ll be moving to that and that will involve very much mass vaccinations. That will be gymnasium drive-thru clinics, doctors, pharmacies, FQHCs,” Williams said “By July or August, we feel like we will be able to vaccinate anybody in Missouri who wants a vaccine."

He said the state team has been planning the vaccine distribution process since July and the meetings state officials and at least 30 partners throughout the state. But there are still potential places the plan could snag dragging down the entire timeline. For example, each part of the plan is still dependent on a company, whether it’s Pfizer, Moderna, or another, securing approval from the FDA for Emergency Use Authorization.

The other issue, having enough individuals who can administer the vaccines. As of right now, hospitals and nursing homes are overwhelmed and idle nurse hands with the right certifications are not easy to come by.

“We think that’s going to be the rate-limiting step in this equation is the number of vaccinators,” Williams said.

To wrap its arms around the size of the issue, DHSS held a webinar Thursday with about 1,000 individuals that may be able to administer the vaccinations. This skilled group will be necessary to get all Missourians across the vaccination finish line next summer.

How will it be allocated geographically in Missouri?

Dr. Williams said Missouri was initially approved for five sites to administer the Pfizer vaccine but then the state was allowed to increase it to at least 10 locations.

Referring to a New York Times article published Thursday, Williams said the cyberattacks referred to in that article were the reason the federal government has asked state health directors to keep the locations of approves sites under wraps.

To be approved, each of the sites had to be able to store the vaccines at -94 degrees and it had to be able to administer all doses within 10 days of receipt.

“If you say you can only vaccinate 1,000 people in 10-days, 100 people a day, then that’s all the vaccine you are allowed,” he said. “Operation Warp Speed will not allow you to hoard it.”

Williams said the administration of vaccines at long-term care facilities will be handled by Walgreens and CVS pharmacies. He said through a contract with the CDC, Walgreens and CVS employees will go into each of the 13,000 long-term care facilities and provide the shots to residents and staff.

The state plans to have phase 1B detailed and organized by Dec. 10 which will include how and when 3 million essential workers will be vaccinated. With the expectation that it would go into effect on February 1st.

The vaccine should be less than $25 but no Missourian will be turned away for financial reasons, officials said.

US officials are potentially securing federal aid to cover administration fees and costs but, Cox said even without it, no Missourian will be denied a vaccine if they cannot afford the $25 or less administration fee or due to a lack of insurance.

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