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How NYC Is Preparing To Roll Out COVID-19 Vaccines
By
Sydney Pereira
Published Dec 10, 2020
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By
Sydney Pereira
Published Dec 10, 2020
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New York City is preparing to start vaccinating hundreds of thousands of people for COVID-19 in the coming weeks, as the Food and Drug Administration is expected to approve emergency use of the Pfizer and Moderna vaccines this month.
NYC already has more than 450,000 of those vaccines on the way, Mayor Bill de Blasio said last week.
The city plans to prioritize vaccines for healthcare workers and nursing home residents and staff first, in line with the state’s priority plan, should the FDA authorize the Pfizer vaccine this week followed by the Moderna option. Both the city and state have opted into a federal program to vaccinate nursing home residents and staff at the long term care facilities in partnership with CVS and Walgreens. (The city is waiting on further guidance from the CDC’s Advisory Committee on Immunization Practices to detail further priority levels, according to a health department spokesperson.)
The potential FDA approvals would kickstart the shipment of thousands of doses of the Pfizer vaccine as soon as Tuesday from Michigan to dozens of NYC hospitals’ ultra-cold freezers first.
“Our hospital colleagues have been drilling and preparing to understand how it will be taken out of the box, into the ultra-cold freezer, and starting the process of actually unloading the vials to turn them into the injections that will eventually be vaccinations,” city Health Commissioner Dr. Dave Chokshi described during a press briefing Wednesday.
But challenges lie ahead for the massive undertaking that will set the next phase of coronavirus.
Both vaccines currently closest to being injected into people’s arms require two doses a few weeks apart. The city must track who is getting the vaccine, ensure they qualify in the priority groups, and encourage that individual to return for a second dose—or risk losing the protection seen in early efficacy rates shown in studies of the Pfizer and Moderna vaccines.
“There’s no question that having to give everyone two doses of a COVID-19 vaccine is an added challenge,” Dr. Jane Zucker, the assistant commissioner at the Bureau of Immunization at the city’s health department, said in a phone interview with Gothamist/WNYC this week.
The dual-dose requirement could pose difficulties for vaccine’s administration. Some experts have pointed out how the HPV vaccine, which requires three doses over the course of several months, has low completion rates which fall along racial lines. Just 18.9% of African-Americans and 20% of Hispanics completed the series, compared to 34.3% of white patients, according to a 2019 study.
Other more positive data shows higher completion rates for another vaccine, according to an associate director at the Immunization Action Coalition, Dr. Kelly Moore. A two-shot vaccine for shingles, called Shingrix, has 75% to 85% completion rates despite side effects causing a sore arm or flu-like symptoms, according to early data presented to the Advisory Committee on Immunization Practices in 2019. Such symptoms are likely after the COVID-19 shot too.
“When people are motivated and understand how well a vaccine works, they will come back and finish the series to protect themselves,” Moore said. In NYC, according to Zucker, those who complete the series will get a vaccination card.
Zucker said the Citywide Immunization Registry—the record-keeping database for all immunization records of children and adults in NYC—will be an important tool for the city to keep track.
The city is encouraging providers to make second appointments for those getting a shot before they leave.
“Someone shouldn’t leave without a second appointment,” Zucker said. Data between the state’s separate registry and the city is exchanged for existing vaccines, which would be done for COVID too.
Zucker, who led H1N1 vaccination efforts more than a decade ago in NYC, said department upgrades as simple as how the city orders more doses would impact rollout.
During the H1N1 crisis, a fax machine snafu led to some orders getting lost at the time.
“It was very challenging,” she said. “These are small things that make just a huge difference.”
The archaic way of communicating via fax machine and outdated government technological infrastructure generally posed difficulties during the pandemic for officials across the country—from doling out jobless benefits to keeping up with test results.
Now, vaccines are ordered online, including for COVID, and officials have conducted a test run of the ordering process in preparation.
“We conducted a successful trial run of the entire COVID vaccine order process with BronxCare—from submitting the order to the facility confirming receipt of the test package,” Chokshi said.
The city is prepared to set up emergency vaccination sites at locations besides vaccination programs at hospitals or nursing homes. During the H1N1 crisis, the health department set up "points of dispensing" sites—PODS—to vaccinate New Yorkers, which is expected during the coronavirus vaccination effort.
A lingering challenge the city faces is convincing New Yorkers to get the vaccine in the first place. Experts have said about 75% of the population needs to be vaccinated to achieve “herd immunity,” but some caution against the concept because it is unknown whether the vaccine prevents asymptomatic transmission to others who haven’t been inoculated. Roughly two thirds of New Yorkers said they would definitely or probably get the vaccine when it is approved in a recent poll.
The city recently announced its own surveys suggesting people who are Black or Hispanic are less willing to get the vaccine than white people. A union led survey of FDNY members indicated that more than half of the first responders would refuse the vaccine. And urging ultra-Orthodox Jewish communities to take public health precautions amid a wave of COVID denial has been an uphill battle for health officials staving off a second wave. Just last year, the health department had to undertake initiatives to combat measles vaccine misinformation in ultra-Orthodox neighborhoods that led to the largest outbreak in the country since 1992.
Dr. Micaela Martinez, assistant professor in environmental health science at Columbia University's public health school, said her main concern is communities of color who have been historically and currently “abused by the medical system”—examples including horrific studies like the Tuskegee trials and research on sexually transmitted diseases in which Guatemalans were purposefully infected in the 1940s.
Martinez worries that “the fear of continued abuse is reinforcing vaccine hesitancy and will make it a larger problem than we’ve dealt with in the past.”
The city has been developing a to-be-released vaccine equity plan to ensure equal access and track vaccine uptake among neighborhoods with “greater barriers to vaccination,” according to health commissioner Chokshi.
“For these other outbreaks, the partnerships we had were also really critical to combatting the vaccine hesitancy,” Zucker said. “At the heart of it, also, is access. People will have questions, people need to have their questions answered.”
With reporting contributed by WNYC’s Fred Mogul.
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vaccines
new york
COVID-19
coronavirus
Sydney Pereira
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