Hot Topic #39 | Vaccine FAQ 3.0

||| FROM BRENDAN COWAN for DEPARTMENT OF EMERGENCY MANAGEMENT |||

As the COVID immunization effort moves forward, it is time to provide updated information and answer common questions from the community. As with previous FAQs, some key reminders:

• Patience and flexibility are required. As with all things COVID, the details, timing, and understanding of everything about the COVID vaccine will shift from week to week, if not day to day. Many details are only estimates at this time.
• No single organization is responsible for the vaccine effort. It will take a well-coordinated campaign between pharmaceutical companies, local healthcare providers and pharmacies, delivery services, all levels of government, response agencies, and a range of non-profit community organizations. There will be bumps in the road – this is a complex undertaking.
• Just because people are getting immunized does not mean that we can relax our safety precautions. Even those who are vaccinated may still have the ability to transmit the disease in some cases (the vaccine may prevent severe illness, but may allow for asymptomatic or mild infection where transmission may still be possible).
• To summarize: patience, decency, and flexibility will be the keys to getting through this final stage of the pandemic. Demand will be greater than supply. Some will get the vaccine before others. There will be some individuals who lie or misrepresent their situation in order to jump the line, while others will sacrifice their turn for the greater good. The situation will bring out the best and worst in people. For the islands, our most thoughtful and successful approach is to remain informed, engaged, empathetic, and decent towards one another. Nearly everyone is doing the best they can in a terribly difficult situation.

On to the questions…

QUESTION: Before we get to vaccines, what are the details on the Governor’s recently updated plan for reopening of some businesses and activities?
This week the Governor released details on a new two phase plan for limited reopening of some businesses and a return of some activities. The details are found here.

In brief, all Counties begin in Phase 1, which is very similar to the restrictions currently in place in San Juan County (here are full details). In order move to Phase 2, a number of metrics must be met on a regional basis. For San Juan County, our region includes Whatcom, Skagit, and Island Counties. Once in Phase 2, the same metrics must be maintained in order to avoid rolling back to Phase 1.

Some highlights of Phase 2 include: indoor dining at 25%, indoor fitness facilities at 25%, and a further loosening on restrictions on sports. Again, for full details, please review this graphic.

The metrics will be calculated weekly, and will be displayed on the WA State Department of Health Risk Assessment Dashboard. Note that as of January 7 th this dashboard is not yet displaying the regional metrics.

At this time there are no details or plans available for any reopening beyond Phase 2.

QUESTION: OK, now let’s talk about vaccines. Who is eligible for vaccine now, and who is currently providing vaccinations in San Juan County?
Individuals who fall into “Phase 1a” are currently eligible for vaccination. This group is limited to healthcare professionals, emergency responders, and staff and residents of nursing homes and assisted living facilities.

This guidance document from WA State Department of Health provides detailed information about who falls into Phase 1a.

As of January 6, the only provider of vaccine to Phase 1a individuals in the islands is the San Juan County Health & Community Services vaccine team. They are hosting weekly clinics on each of the islands, and performing direct outreach to Phase 1a eligible organizations and individuals to schedule vaccine delivery.

QUESTION: That’s Phase 1a, what about Phase 1b? Who is next in line?
On January 6, the WA State Department of Health released guidance for Phase 1b, and the four tiers within 1b. Here is a link to the new information, and here is a simple graphic:

In short, the new eligibility grouping open up access to the vaccine to a much larger group of individuals that have been eligible in Phase 1a.

QUESTION: When will Phase 1b open up?
An exact date is impossible to know at this point, but a general estimate is before the end of January. Remember though: that doesn’t mean that there will be enough vaccine on hand to immunize everyone in Phase 1b right out of the gate.

Further complicating this question is that the vaccine requires two doses. About the time Phase 1b opens, there will be a need to give second doses (28 days after the first dose) to everyone who was vaccinated as part of the Phase 1b group. This will further complicate supply chain and delivery issues.

QUESTION: If I’m in Phase 1b, what can I expect, and what should I do now?

The reality is that there are still lots of unknowns. The two biggest ones are vaccine availability, and the number of providers in the islands who will be delivering the vaccine (see question below).

There are some things we do know:

• For some time to come, demand will be greater than supply.
• Even when vaccine is available, not every dose will be given on the first day it is available.
• To some degree, the system depends on people being honest about their eligibility. And yes, clearly there will be individuals who break that trust- but the hope is that vast majority of islanders  will be respectful and truthful when it comes time for Phase 1b. While healthcare providers will be evaluating all requests to some extent, they do not have the time to be investigating every individual claim of eligibility. Just like kindergarteners lining up for lunch, don’t cut the line.

At this time, individuals in Phase 1b should not contact the Health Department or their medical providers. There is no sign-up list. WA Department of Health does have a tool to evaluate eligibility and to notify individuals when it is their turn. It can be found here, but please know that there is incredible demand on the site, and it is expected that the site will continue to improve with time.

The move to Phase 1b will be very well publicized, including in local media and on the San Juan County COVID Vaccine Information Page.

Overall, the message to the public is please be patient. Just like waiting in line to get into the stadium for a Seahawks game, everyone will get in- but it will take time and decency.

QUESTION: Will any other medical providers or pharmacies be delivering the vaccine?
Yes. A number of local healthcare providers and pharmacies are in various stages of applying to the WA State Department of Health to be approved as vaccine providers. Some have been approved and are awaiting vaccine, and others are working their way through the process. The decision to deliver COVID vaccine or not is a choice made at the provider or business level.

Once a provider has been approved and has vaccine on hand, they will begin delivering vaccine to those eligible at the time to receive the immunization.

QUESTION: How much vaccine does San Juan County Health & Community Services have on hand, and
how much has been delivered?
San Juan County’s vaccine team initially received a shipment of 600 doses of the Moderna vaccine, and an additional 200 doses have just arrived as well.

Of that total supply of 800 doses, approximately 250 doses have been administered to date at clinics on Lopez, Orcas, and San Juan Islands. These events have been led by San Juan County Health and Community Services with incredible support from local EMS agencies. At least an additional 250 individuals will be immunized by the end of next week, and between 150-200 doses will be provided to local healthcare providers to support their vaccine efforts once their final WA DOH approval is granted. As with all immunization programs, local healthcare providers will play a vital role in the delivery of vaccine.

All of these doses are being provided to Phase 1a individuals in the islands – emergency responders, healthcare workers (including support staff), and long-term care facility residents and staff. It is hoped that all Phase 1a individuals in San Juan County will be immunized within the first two weeks of January, and that the County team will be well poised for the move to Phase 1b.

QUESTION: When will more vaccine arrive in the islands?
Unfortunately, the exact timing of the arrival of additional vaccine is unknown at this time. San Juan County has been promised by WA State Department of Health that second doses of each immunization given will be delivered to San Juan County in time for the second round of
immunizations (remember, all vaccines being delivered at moment require two doses, 28 days apart).

Clearly this isn’t the most satisfying answer, but remaining patient is the key.

QUESTION: Where can I learn more?

CDC’s COVID-19 vaccine information page
WA State Department of Health’s COVID Vaccine Info Page
WA State’s DRAFT COVID Vaccination Plan
San Juan County’s Vaccination Info Page