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Challenges Related To The COVID-19 Vaccine Rollout

STEVE INSKEEP, HOST:

Now, as we consider the next steps, let's make an analogy to war. When we tell stories about war, we focus on stories of individual courage. But the war may be won by logistics, getting people and supplies where they're needed. Something similar is true in this pandemic. We tell stories about government that focus on speeches and conflict and hot takes and hot-button issues and tweets. But saving lives in a pandemic takes logistics - most recently, getting a vaccine where it's needed. So how's that going? NPR science reporter Pien Huang is here along with Martha Bebinger at member station WBUR in Boston. Good morning to both of you.

MARTHA BEBINGER, BYLINE: Good morning.

PIEN HUANG, BYLINE: Good morning. Hi.

INSKEEP: OK, Martha. We'll start with you. In the shrine of medicine, is the vaccine starting to reach Boston?

BEBINGER: Well, the shrine got shut out, Steve. No, I'm kidding a little bit.

INSKEEP: OK.

BEBINGER: Here's the deal, in Massachusetts, five of the 75 hospitals that expect to start Pfizer vaccinations this week received a shipment yesterday. Now, the explanation seems to be shipping glitches and delays during a crazy time. So while there was some grumbling, all of the large hospitals are expecting vaccine shipments today and the smaller ones tomorrow. So in the end, hospital leaders say, what difference does one day really make?

INSKEEP: Yeah. Hopefully, it is only one day. Now, once the vaccine has arrived, how's the rollout work?

BEBINGER: Well, we have already started to vaccinate a few people at a VA hospital north of Boston. They started yesterday with a 96-year-old World War II veteran named Margaret Klessens. A few hospitals will have media events today vaccinating hospital leaders or a range of employees, especially staff of color. You just heard on the show a little bit about why that's important. It's to build more trust in the vaccines. Then tomorrow and Thursday, we'll start to see the clinics with a couple of hundred nurses, doctors, respiratory therapists and members of the cleaning staff coming in and out every day.

INSKEEP: OK. So that's one location across the country. This is happening everywhere or as many places as possible. And Pien, as you monitor Operation Warp Speed, how do the next few days and weeks look?

HUANG: Yeah. Well, Boston is not alone here. You know, around 140 or 150 sites got their first vaccines yesterday. And more than 400 are expecting to get them today. Here's Health Secretary Alex Azar speaking in Washington, D.C., yesterday.

(SOUNDBITE OF ARCHIVED RECORDING)

ALEX AZAR: By Wednesday, the vaccine will be delivered everywhere from sites here in Washington to the shores of Guam to the northeastern corner of Maine.

HUANG: All in all, around 3 million vaccines are going out this week. And government officials are saying this is just the beginning. You know, every week, states will be getting more vaccine shipments. And most of those first doses we've seen so far have gone to health care workers. But next week, some states are going to start immunizing nursing home residents as well - or they're expected to - through a federal partnership with CVS and Walgreens. Teams from these pharmacies will be visiting nursing homes to give shots to both residents and to staff.

INSKEEP: Martha, Pien is just there talking about who gets this first. Is there any debate about who is getting the vaccine first?

BEBINGER: There's been some controversy in Massachusetts, Steve, about including prisoners in Phase 1 along with people who live in other group settings like homeless shelters. In Massachusetts, prisoners will follow hospital staff, who care directly for COVID patients, nursing home residents and staff. And they'll follow first responders. But prisoners would come before home health care workers and all the hospital and clinic employees who do not care directly for COVID patients. We're told this was a unanimous recommendation from the state's vaccine advisory group. Dr. Paul Biddinger, who chairs that group, spoke on a webinar last night. He said the recommendation was based on the large number of outbreaks in prisons and other group residential settings.

(SOUNDBITE OF ARCHIVED RECORDING)

PAUL BIDDINGER: Our group elected to consider all congregate care settings with high priority because of the risk of spreading transmission so quickly to so many people, both affecting staff and, of course, patients, residents themselves.

BEBINGER: Massachusetts is one of six states that include vaccinating everyone in prisons and jails in Phase 1. And another seven plan to vaccinate in clinics in prisons but just for staff, not inmates. That's all according to the Prison Policy Initiative.

INSKEEP: Pien, I can imagine someone saying, hey, that's unfair. But what is the public health reasoning behind vaccinating prisoners?

HUANG: Well, sure. I mean, prisoners and other people who are jailed or who live in correctional facilities are a group that are at a particularly high risk for COVID because of their living situations. You know, they live in cramped quarters with poor ventilation. They can't physically distance. And, you know, staff and prisoners move between facilities. So once it's introduced, it spreads really quickly...

INSKEEP: Yeah.

HUANG: ...Or it can, you know? And at this point, more than one in 10 incarcerated people in the U.S. have caught the coronavirus. More than 1,500 have died. And a lot of staff have been infected as well. States like California, Texas, Florida, you know, states with large incarcerated populations have had the most cases and the most deaths. So it is up to the states who they decide to prioritize for a vaccine. And there are a lot of other groups that could also be next in line, you know, essential workers, people who work in grocery stores or drive buses, teachers, farm workers and, of course, you know, people with underlying health conditions. So these are all open questions. And the CDC is planning on coming out with more guidance on priority groups in the coming weeks.

INSKEEP: Yeah. And you can understand the logic. You have a super spreader event in prison. That can very quickly spread throughout the community because you have guards and other staff that go back and forth. And that seems to be the same logic as some of these other groups that you mentioned. Like, teachers are in contact with lots of students, or people in a grocery store in contact with all kinds of shoppers. So they're making these choices now because there is a limited supply. When does the supply get to the point where it's not so limited?

HUANG: Yeah, absolutely. Well, one big decision that's coming this week could really increase the supply of vaccines. The Food and Drug Administration is considering a second vaccine made by the drug company Moderna for authorization this week. And if that one gets authorized, the government says they have 6 million doses of that ready to ship out. And, in fact, that's actually something that the federal government is banking on in their estimates. They say that 20 million people could get their first vaccine shot this month if they pool what they have for both the Pfizer and Moderna vaccines. And they say 30 million more people could get shots in January. So in terms of when there's going to be enough vaccine for everyone to get one, they're estimating the end of the second quarter next year. So if all goes right, maybe around June.

INSKEEP: But tens of millions in the next couple of months. Pien, thanks so much.

HUANG: Thank you for having me.

INSKEEP: That's NPR science reporter Pien Huang along with Martha Bebinger at member station WBUR in Boston. Thanks so much.

BEBINGER: Thank you.

(SOUNDBITE OF PENSEES' "FACELESS ARTIST") Transcript provided by NPR, Copyright NPR.