Illinois’ plan for COVID-19 vaccine distribution puts front-line health care workers first, but many details still up in air
The state of Illinois’ plan for distributing a COVID-19 vaccine when one becomes available puts front-line health care workers first in line to be inoculated, but shifting projections on how many initial doses the state is likely to receive, the various temperature storage requirements for different vaccines and changing federal recommendations make it uncertain exactly how that plan will roll out.
Gov. J.B. Pritzker said this week the state will “be ready to go, we believe, as soon as those vaccines hit the ground,“ as promising developments about coronavirus vaccine effectiveness continue to trickle out from studies by drugmakers. But he made clear the many challenges of distributing a long-awaited vaccine that could put an end to restrictions that have upended life and commerce in the state.
“We’re coordinating with the (Centers for Disease Control and Prevention), which has been changing its recommendations along the way, which is fine, we want to make sure we get their expertise. There’s also a level of complexity because the vaccines aren’t all going to be the same. Some are going to require this -94 degrees to be stored. Some will not require that but will have different temperature requirements,” Pritzker said during one of his daily coronavirus briefings. “And so all of that should be taken into account in terms of the timing, the amount of preparation.”
Mayor Lori Lightfoot said Wednesday that the initial doses of a vaccine could be available as soon as next month, although it will be next year before shots are available for the general public.
The state in October laid out the framework for how it intends to distribute a COVID-19 vaccine with top priority going to the “critical workforce” that provides health care, staff and residents in long-term care and assisted living facilities, and essential workers outside the health care industry.
Projections of the number of doses the state will receive are “constantly in flux,” said Illinois Department of Public Health Director Dr. Ngozi Ezike, who in one week gave dramatically different estimates.
Ezike said last week that officials were initially told Illinois would at first get about 400,000 doses. As of Tuesday, she said that estimate had been reduced to “something like 80,000” initial doses.
“We know that even if everything goes smoothly in the next couple of weeks and the vaccine is shipped, we know there won’t be many doses,” Ezike said Tuesday.
“We are staying very nimble to be able to adjust. As the feds give us more information, we adjust and tweak our plan. The CDC and the feds have seen our plan, and they’ve told us that we look good with what we’re planning. We have hospitals that have signed up to be COVID vaccine providers, and so we know that first tranche of vaccines will go to the hospital workers, individuals who are on the front lines in terms of working directly with COVID patients, who are in the face of COVID every day, as well as our first responders, which will also include our National Guard,” she said.
The plan the state made public in October prioritizes health care workers over first responders. From there, other “essential workers” outside the health care industry and people at high risk of experiencing a severe illness if they contract COVID-19, including residents of long-term care facilities, others with high-risk medical conditions, and those aged 65 and over, would take priority.
As more doses of the vaccine becomes available, and the most critical groups, as identified by the plan, have had the opportunity to be inoculated, the vaccines would start becoming available to the general population.
The timeline for how long it will take to reach the general population stage in distribution after the vaccine first becomes ready isn’t clear at this point, but public health officials have predicted it will take months for the vaccine to become that widely accessible.
This week, the pharmaceutical company AstraZeneca reported that the vaccine it’s developing with Oxford University was up to 90% effective. Earlier this month, Moderna and Pfizer reported results from studies that showed their respective vaccines were nearly 95% effective.
AstraZeneca’s vaccine does not need to be stored at ultracold temperatures like Pfizer’s does, which would likely make it easier to distribute.
The ultimate mission of the state’s vaccination plan is to administer potentially two doses of a COVID-19 vaccine to 80% of Illinois residents, in line with CDC guidelines. That’s the percentage of the population that’s considered necessary to be immune to the virus in order to achieve herd immunity, according to the plan.
The state’s vaccine framework calls for local public health agencies to create their own complementary plan to the state’s, and to gauge the capacity of hospitals, long-term care and assisted-living facilities, and other potential vaccine providers for ordering, receiving and administering vaccines to the public.
The state public health department will estimate allocations of the vaccine from there based on population, the level of illness in the area and vaccine availability, with a goal of administering the vaccine equitably through the state.
Based on population alone, if the state received a shipment of 200,000 doses, for example, suburban Cook County would get 56,000 of them. Downstate Calhoun County, the state’s smallest public health jurisdiction, would receive 100 doses.
Those proportions will be adjusted to account for virus hot spots, which could cause certain areas to receive a larger share, as well as to ensure an equitable distribution across the state.
Chicago would get its own distribution of the vaccine directly from the CDC under the plan.
Lightfoot this week reiterated that the city is still working on how it will distribute vaccines when they become available. Who gets the vaccine first and the order from there will be determined by federal guidelines, but she said the city already has a robust system for distributing vaccines. Initial doses will go to health care workers, followed by high-risk individuals. But all adults should be able to get vaccines sometime in 2021, Lightfoot said.
Tracking vaccine administration across the state is another key part of the state’s plan, and once a vaccine is available, the state will build off its existing vaccine registry system that tracks immunizations for children to log the geographic distribution of the virus. As more doses become available, the state’s plan will prioritize harder-hit areas and places where a smaller share of the population has been immunized.
If the vaccine requires two doses separated by a few weeks, the tracking system can trigger reminders for timing on additional doses. Tracking is also needed for reporting adverse effects or reactions after the vaccine is administered.
The state’s plan calls for vaccine providers to include in their reporting procedures “clinically important adverse events,” including identifying a safety coordinator and a point of contact who would be available 24/7. Adverse effects of vaccines are reported on a national scale using the existing Vaccine Adverse Event Reporting System that is co-run by the CDC and the federal Food and Drug Administration.
Vaccine providers are required to report daily vaccine administration and inventory to the state Department of Public Health.
The plan also calls for a wide range of guidance and training to vaccine providers once a vaccine is available, including ordering, storage and handling, administering the vaccine to the public and documenting that, as well as a statewide media campaign with information about the vaccine and to encourage people to seek it out.
The state’s plan draws on lessons learned from the H1N1 mass vaccine administration, including a need for better coordination with local public health agencies on identifying and approving providers to administer the vaccine; more efficient systems for ordering doses, and tracking inventory and administered vaccines; and “developing fair and equitable vaccine allocation practices.”
Ezike this week ticked through an array of things the state’s public health agency is doing in order to get ready for the initial vaccine shipments.
“We’ve been working since the beginning on this in terms of securing — we have freezer trucks that are going to be able to carry the vaccine that we know have to be held at that especially low temperature,” Ezike said. “We’ve been working with our local health departments that put their plans in place for how we will get this vaccine disseminated, we have our ground game giving virtual town halls and talks to different groups to prepare them, to have them ask questions about the vaccine so that they can have all the information they need to make the most informed decision.”
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