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Ramping up COVID-19 Vaccine Plans

By Herb Weiss, contributing writer on aging

As state health officials say they are clamoring for more doses of COVID-19 vaccine, just days ago, Health and Human Services Secretary Alex Azar said in an interview with NBC’s Lester Holt there is no “reserve stockpile” of COVID-19 vaccine doses left to release to states, and all vaccine has now been released to fulfill orders by the states. Azar’s comments come after his announcement on January 12th that the states no longer need to hold back a second shot because there is confidence that Pfizer and Moderna, manufacturers of the vaccine, could keep up with the demand.

In the January 12th announcement, Azar noted several steps the states should take immediately, and the federal government was taking:

Expand groups getting vaccinated to include all those over the age of 65 – Vaccinate those 16-64 with co-morbidities – Expand channels to include those more familiar with people to reach them where they are, such as pharmacies – release all supply to order by states.

Azar encouraged states that are holding back “second shots” to not do so, saying, “Every vaccine dose that is sitting in a warehouse means another life lost…”

In response to the rollout of COVID-19 vaccines, Katie Smith Sloan, president and CEO of Washington, DC-based Leading Age and acting President and CEO, of the Visiting Nurse Associations of American, had some thoughts. “With COVID-19 death tolls topping 4,000 a day, it’s chilling to hear that vaccine stockpiles may have been misrepresented, and that older Americans who have been dying in record numbers might suffer as a result,” she said in a Jan. 15 statement.

Making it a Priority of Giving COVID-19 Vaccines to Seniors

“We hope these reports are not true. For weeks, state policy makers, distribution partners and aging services providers have been basing their vaccine allocations and strategies on vaccine stockpile estimates,” Sloan noted.    

“Because more than 265,000 people 65 or over have died of COVID, we have been pleased that many states have made the right decision to prioritize older Americans and their caregivers for immunizations, and that the process is underway in long-term care.  We hope this news is not a setback for those people, as well as others waiting for vaccinations in home health, hospice, PACE programs, adult day or other settings,” says Sloan.  

Rhode Island’s plan not changing

However, Rhode Island has chosen not to prioritize the distribution of it COVID-19 vaccine to older Rhode Islanders. The Rhode Island Department of Health (RIDOH) expects residents age 75 and older who reside in the community to be vaccinated in February or possibility March. Specifics as to vaccinating residents ages 50 to 74 have not been announced. While other states are beginning mass vaccination sites at stadiums, no such plans exist in Rhode Island.

AARP Advocates for those over 50

“Since the start of the pandemic, over 95 percent of the deaths from COVID-19 have been among people 50 and older,” AARP Rhode Island State Director Kathleen Connell and State President Phil Zarlengo said in a Jan. 8 letter to Gov. Gina Raimondo, urging the state’s top official to “ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.”  (see Weiss Commentary printed here on January 11). 

AARP is fighting for older Americans to be prioritized in getting COVID-19 vaccines because the science has shown that older people are at higher risk of death.  On Jan. 11, the Washington, DC-based AARP sent a letter to HHS Secretary Alex Azar calling for his agency to take immediate action to address the issues that have slowed down vaccinations across the country.

RIDOH’s plans

On Jan. 15, in a Vaccine Update, Nicole-Alexander Scott, MD, MPH, Director, Rhode Island Department of Health, stated: “There was a lot of news this week about the federal government urging states to vaccinate people who are 65 years of age and older. We want to get vaccine to people older than 65, too. The limiting factor is not federal rules, or our approach in Rhode Island. The limiting factor is the amount of vaccine we are getting. We are getting 14,000 first doses of vaccine a week. There are close to 190,000 people in Rhode Island who are 65 years of age and older. It would not be honest or fair of us to say that all Rhode Islanders older than 65 can get vaccinated tomorrow, because we just don’t have the vaccine.” 

It is unclear if RI is holding “second shot” vaccine doses in storage. There is about a week’s lag from receiving the doses and distributing them. On January 15th, the state said they had administered a total (first and second shots) of 51,220 shots. On January 12th, the most recent report provided, the state says it has received 72,175 doses from the federal government.

Scott added:” We’ve seen the confusion and frustration that has resulted in states that have opened eligibility to groups that they did not have enough vaccine for. In Rhode Island, we are vaccinating older adults incrementally and thoughtfully. That means that when we tell you you can get vaccinated, you know that there is a real, physical vaccine waiting for you – not just that you fall into a broad category that is eligible to get a vaccine when we eventually have one. Please know that if we could, we would make sure that everyone got vaccinated immediately. But we’re just not getting enough vaccine right now, so we’re doing the best we can with what we have.”

Rhode Island’s report

After listening to the state’s reports on plans for getting out the vaccine to the group the Centers for Disease Control and Prevention is recommending, those over 65, and those under 65 with underlying medical conditions, there seems to be an overall lack of urgency in ramping up for this new directive, said Nancy Thomas, Publisher of the RINewsToday.com, who was on the update webinar this week, with other reporters. “There are no plans – or none they are willing to announce – for how people will register, or sign up, for when the 65 and over category is ready to go. Questions about how people will identify themselves at the site also were yet to be determined. When asked about mass vaccination sites, officials said they may consider schools, but had no plans for using McCoy Stadium or other large sites. We’ve seen states all around us opening up stadiums – many of whom are still vaccinating medical workers – but ramping up to do as many as they can until supplies are exhausted for that day. Massachusetts even has swag – pins, wristbands, and banners – to build up the sense of excitement, which also builds compliance. We have asked RIDOH about public education campaigns and they say they have a campaign coming.  

With such a large percentage of seniors in Rhode Island, are we ready to ramp up? Some states are vaccinating 24/7, with appointments at 2am and such. I guess a sense of frustration weighs on me and on others who do not see big plans, forward looking plans in the near future. Meetings with the public focus more on reporting of what has been done and where we’ve been, rather than where we’re going,” Thomas said.

Biden Releases COVID-19 Vaccination Plan

President-elect Joe Biden, speaking a day before he unveiled his COVID-19 Vaccine Plan on Jan. 15 in Wilmington, Del, unveiled a $1.9 trillion “American Rescue Plan” to combat COVID-19 and to shore up a wobbly economy. The emergency vaccination and relief package combine funding to reduce the economic impact of the pandemic (including direct stimulus payments of $1,400 per person, extending unemployment compensation, raising the minimum wage, continuing eviction and foreclosure moratoriums to increasing the Child Tax Credit) with strategies to fight to combat the virus itself.

About $400 billion of Biden’s “American Rescue Plan” is directed to controlling the virus by setting up mass vaccination centers, funding more sophisticated scientific analysis of new strains and creating teams of local health workers to trace the contacts of infected people.

President-elect Joe Biden’s Jan 15 press conference, lasting a little more than 19 minutes, warned that “We remain in a very dark winter. He noted that COVID-19 infection rates are creeping up 34 percent, COVID-19 related hospitalizations are increasing, and 3,000 to 4,000 people are dying every day of COVID-19.  “Things will get worse before they get better,” he said.

When releasing his five step COID-19 Vaccination Plan, Biden stated, “This is the time to set big goals and to pursue them with courage and conviction because the health of the nation is at stake.”  His strategy of getting 100 million Americans vaccinated during his first 100 days in office relies on the following steps: encourage states to vaccine more people age 65 and over including front line workers; creating thousands of community vaccination centers at gyms, sports stadiums and community centers; activating local pharmacies to give vaccines; ramping up supplies of vaccines by triggering the Defense Production Act and distributing vaccines quickly; and regularly updating state and local officials as to how much vaccine they are getting and when to expect the delivery.  Biden promised to give regular updates pertaining to the meeting of his goals, “both the good news and the bad.”

Mask Mandate – Wear that mask

During his first 100 days, Biden will be issuing an executive order to require masks for federal workers, on federal property, and on interstate travel, like trains and planes.  He is also urging governors to require masks in cities and states.

“I know masks have become a partisan issue,” says Biden, stressing “it’s a patriotic act.  Experts say that wearing a mask from now until April will save more than 50,000 lives, he noted.

Biden called on Congress to make his COVID-19 Vaccination Plan happen. “I’m optimistic. I’m convinced the American people are ready to spare no effort and no expense to get this done,” he said, stressing it “will take many months to get where we need to be.”

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

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Herb Weiss has enjoyed a distinguished 41 year career in journalism, earning a national reputation as an expert on aging, health care and medical issues. Over 780 articles that he has authored or coauthored have appeared in national, state and local publications. Governor Gina Raimondo appointed Him to the Rhode Island Advisory Commission on aging. Today, Herb’s weekly newspaper column appears in the Pawtucket Times and Woonsocket call, two North Rhode Island daily newspapers, and will now run in RINewsToday.com. Herb and his wife, Patty Zacks, reside in Pawtucket, Rhode Island.

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