As potential COVID-19 vaccines show promising results, who will get it first?


RALEIGH, N.C. (WNCN)– With potential COVID-19 vaccines showing promising results, CBS 17 wanted to know where local hospitals and health departments stand in their plans to start vaccinating people. How will the people who need the vaccine first get it, and will they even want it?

While drug makers race to develop and test potential COVID-19 vaccines, health departments and hospitals are putting plans in place to distribute whatever vaccines get approved, but there won’t be enough for everyone.

“Supply is going to be controlled centrally by the federal government; they are going to distribute it to the states based on population size,” explained Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services.

The state’s 140-page plan lays out who will get the vaccine first in North Carolina. Priority 1A includes healthcare workers and first responders at high risk of exposure to COVID-19 and people needed for vaccine distribution, but who exactly meets those criteria?

Dr. Cameron Wolfe, an infectious disease expert at Duke, is helping to create the hospital’s COVID-19 vaccination plan.  

“There’s a lot of logistic planning already underway to say how many people do we have that fit those roles.  It’s not every healthcare worker,” he noted.  

“Part of what we are doing at the moment is to generate lists saying,  ‘Look, here are all the normal people who during day-to-day jobs come in contact with COVID patients frequently,” Wolfe explained. “Then you sort of draw a bigger circle, if you will. Who are the extra people who either through serendipity run into someone who is COVID positive on a ward or in the clinic or might be pulled into helping emergency room?”

At the Wake County Health Department, stick figures and diagrams are part of a complex plan to distribute the first round of COVID-19 vaccines.  

“In priority group 1A we have identified approximately 2500 personnel,” said Dr. Jason Wittes, pharmacy director for Wake County Human Services.  

He described group 1A as “your frontline healthcare workers,  people who are vital to our COVID-19 response,” and said they could include EMS crews, firefighters, and people who work at COVID testing sites, among others.

Wittes says it’s not clear whether the county will get enough doses to cover everyone who falls into the first group eligible for vaccinations.

“We do have plans in place for a priority group for our priority groups, if you will, and that needs to be determined by our senior leadership and county manager’s office,” said Wittes, adding that county leaders will wait to find out how many doses the county receives before making decisions.

“We do have those numbers and we do have a list of people. As soon as we get the call, if you will, we will be able to mobilize.”

While there may not be enough shots to go around, Wittes worries we could see the opposite issue.

“My personal biggest fear, similar to Operation Warp Speed, is we have all these plans in place, we have a vaccine on the ground and no one shows up,” he said.

CBS 17’s Maggie Newland asked Wolfe if he shares that concern.

“Sure,” he replied, adding, “I think that’s something we’ve really got to work hard towards helping them through that. I think issues upon us are going to be very clear transparency about the process.”

Cohen emphasized transparency is vital.  She says she is comfortable with the speed at which trials are moving.

“I am,” she said. “I think there’s really a good amount of scientific rigor that is going on. I have spoken with a number of the FDA regulators myself. I have heard from them directly; I have heard from a number of the scientists involved in the trials. I do think it’s really good work but we have to give it time We have to continue to encourage the research community to be incredibly transparent with their data.”

Although some hospitals and health departments mandate flu shots for employees, Cohen said she does not expect anyone to mandate a COVID-19 vaccine.  

Doctors who spoke to CBS 17 said they expect data to drive decisions.

“I would be first in line, as long as the data proves that the vaccine is going to be safe and effective,” said Wittes.

Wolfe believes personal experience will also play a role for healthcare workers.  

“My colleagues and I have seen so many patients in the last nine months coming in with COVID,  breathless sort of sick, and in many instances passing away from this,  that the recognition of one’s own risk if I’m sitting here working in the COVID unit is pretty significant,” he said. “I think you’ll see most healthcare workers, who have in fact been dealing with COVID, hopefully understand the risks they are undertaking every day and that will be their compelling reason to move forward and line up.”

Long term care facility workers are also in North Carolina’s first group to receive vaccinations.

According to the state plan, pharmacies will work directly with many long-term care facilities to administer vaccines.

Potential COVID-19 vaccine side effects

Once vaccine administration begins, data will still be collected and any potential serious side effects analyzed.  CBS 17’s Maggie Newland asked Doctor Cohen about the process.

“We are also required by the federal government, and rightly so, to be tracking to understand if anyone has a bad outcome or if something happens to them after they get the vaccine, so we will be tracking that,” Cohen responded. She went on to say, “We know we are going to have to track even after a vaccine is approved and that will be part of the data collection we will be doing in coordination with our doctors and hospitals.”  

“There’s a process for collecting that data and for trying to understand it. Was it related to the vaccine? There are a lot of protocols for how to do this kind of data collection and then investigation if something has gone wrong,” she added.

The Vaccine Adverse Event Reporting System

The federal government already has a system of reporting issues related to any type of vaccine. It’s called the Vaccine Adverse Event Reporting System, or VAERS, and it’s comanaged by the CDC and FDA.  

In addition to traditional safety monitoring, according to the CDC website, there will also be a smartphone-based program for the essential workers who are the earliest COVID-19 vaccine recipients.

People will receive text messages or emails from the CDC checking on their health, daily for the first week after vaccinations and weekly for the next six weeks.  

Anyone reporting a “clinically significant” adverse event will receive a phone call, and if it’s determined that a VAERS report is necessary, that will be done over the phone.

The CDC’s VAERS analysis for COVID-19 reports

The CDC has provided a preliminary list of VAERS adverse events of special interest (AESI), which includes:

  • COVID-19 disease
  • Death
  • Vaccination during pregnancy
  • Guillain-Barré syndrome (GBS)
  • Other clinically serious neurologic AEs (group AE)
    • Acute disseminated encephalomyelitis (ADEM)
    • – Transverse myelitis (TM)
    • – Multiple sclerosis (MS)
    • – Optic neuritis (ON)
    • – Chronic inflammatory demyelinating polyneuropathy (CIDP)
    • – Encephalitis
    • – Myelitis
    • – Encephalomyelitis
    • – Meningoencephalitis
    • – Meningitis
    • – Encepholapathy
    • – Ataxia
  • Seizures / convulsions
  • Stroke
  • Narcolepsy / cataplexy
  • Autoimmune disease
  • Anaphylaxis
  • Non-anaphylactic allergic reactions
  • Acute myocardial infarction
  • Myocarditis / pericarditis
  • Thrombocytopenia
  • Disseminated intravascular coagulation (DIC)
  • Venous thromboembolism (VTE)
  • Arthritis and arthralgia (not osteoarthritis or traumatic arthritis)
  • Kawasaki disease
  • Multisystem Inflammatory Syndrome in
  • Children (MIS-C)

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