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With two COVID-19 vaccines potentially near approval, what is the plan for inoculating Minnesotans?

State and local officials are coordinating plans to vaccinate Minnesotans in the coming months — maybe even weeks for some.

It’s possible some Minnesotans could be vaccinated as early as late December.
It’s possible some Minnesotans could be vaccinated as early as late December.
REUTERS/Dado Ruvic

With potential COVID-19 vaccines on the horizon in the coming months — or even weeks, for some — state officials and local public health departments are making plans to vaccinate Minnesotans as soon as the inoculations become available.

In recent weeks, both Pfizer and Moderna have announced they have reason to believe they’ve developed  highly effective COVID-19 vaccines. Both may seek emergency authorization from the Food and Drug Administration to make them available soon. Data suggest both vaccines are roughly 95 percent effective, far more so than some in public health had dared hope.

“From a scientific and potential public health standpoint, this is an extraordinarily important advance,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR earlier this week.

With this news, it’s possible some Minnesotans could be vaccinated as early as late December. But for the rest of us, it could be a bit. Here are some questions you might have about Minnesota’s vaccination plans, answered:

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So Pfizer and Moderna both sound like they have promising vaccine candidates. What do we know about them?

Pfizer announced Wednesday that its data find the company’s vaccine is 95 percent effective at preventing COVID-19. Moderna’s data suggest its vaccine is 94.5 percent effective. The FDA had initially said it would consider approving vaccines found to be at least 50 percent effective, and numbers at 90 percent and above would put these vaccines in line with most childhood vaccines. In a briefing with reporters Thursday, Minnesota Department of Health Infectious Disease Director Kris Ehresmann emphasized that the data are still not peer-reviewed but called the trial results very encouraging.

Both vaccines would require two doses, weeks apart, which creates some logistical challenges for health officials who need to track who got which doses, and when: they aren’t interchangeable, so you couldn’t get your first round vaccine from Pfizer and the second from Moderna.

This all happened pretty quickly. How do we know the vaccines are safe?

These vaccines have been developed remarkably quickly: It’s less than 11 months since the genome of the novel coronavirus was sequenced, and now we’re talking about a vaccine.

Kris Ehresmann
MinnPost photo by Peter Callaghan
Director Kris Ehresmann
Ehresmann said the public should be assured that just because the vaccine is being moved on a fast timeline, that doesn’t mean corners are being cut that could jeopardize its safety.

While drug companies hurried to recruit participants for vaccine trials so they’d be lined up as soon as they were needed for each phase, the trials are happening as they would for other vaccines, Ehresmann said.

“This vaccine has gone through the same safety evaluations that you would expect for any of the other regular vaccines,” she said.

Another reason a COVID-19 vaccine is expected to be available so soon is that the federal government is footing the bill to manufacture promising vaccine candidates before they’re even approved. If a vaccine doesn’t pass muster, the manufactured units won’t be used. But for vaccines that do, doses will be ready.

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OK, so these vaccines sound like they might be approved. What has to happen for people in Minnesota to get them?

Minnesota will begin using a vaccine only after the Food and Drug Administration and the Centers for Disease Control’s Advisory Committee for Immunization Practices (ACIP) give the green light, Ehresmann said.

Pfizer has said it plans to submit its application to the FDA within days, and Moderna could follow soon. Once applications are submitted, Ehresmann said she expects a two week timeframe for the agency’s review.

If a vaccine gets the go-ahead from the FDA, it then goes to the ACIP, which is a committee that makes recommendations about vaccines’ use. The ACIP could make decisions within days, Ehresmann said.

While some states are planning to do their own safety evaluations, Ehresmann said Minnesota officials trust the ACIP based on experience. Ehresmann has served on the committee previously, and another MDH staffer currently serves on it.

Presuming the ACIP recommends a vaccine, it will also issue guidance on how to administer it. Ehresmann expects it would be a week before Minnesota would be able to get trained on the recommendations and start vaccinating.

Who gets the vaccine, and when?

Who gets vaccinated and when will come down to what the ACIP recommends. But right now, MDH is planning to roll out vaccines in three phases.

First, people who ACIP deems first priority would get the vaccine. The expectation is that this would include people who work in health care, though it might not include every group of health care workers right away.

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“When we talk about who needs to be vaccinated, it doesn’t mean that every single person who works in health care in an acute care setting would be a priority for vaccination before, say, long-term care,” Ehresmann said. An allocation work group will help tailor federal guidance to Minnesota. Phase 1 vaccination will likely happen through workplaces, such as hospitals and clinics.

Once more vaccine is available, people with the second highest level of priority would be vaccinated. These are likely to be people who are in vulnerable populations, those who have been disproportionately impacted by COVID-19 or have more severe virus outcomes. In this phase, people may get vaccines through their health care providers.

Officials expect more vaccines to make it through the FDA and ACIP approval process at some point in this timeframe, which will increase supply. Once the people in priority groups one and two are vaccinated, the shots should be available to the general public. In addition to health care providers, counties and local jurisdictions are likely to help provide vaccination sites to make sure the vaccine is available to all.

Counties are already being asked to work on plans for vaccinating their residents in this phase of the efforts. Katie Albert, of St. Louis County Public Health, said much is still in the works, but St. Louis County  has been drawing up plans for drive-through vaccination clinics during phase 3 of vaccination.

“We would likely do drive-through clinics simply because of the risk of being indoors and trying to vaccinate people presents its own problems, especially with the need for PPE,” she said.

Fauci has said a vaccine may be available to the average American as soon as April.

What if some people refuse to get the vaccine?

In recent years, skepticism towards vaccines has been on the rise, despite that scientific evidence overwhelmingly finds them safe and effective. But the degree to which Minnesota can reach herd immunity — with an estimated 70 percent to 80 percent of the population inoculated — will affect how widespread COVID-19 continues to be.

Ehresmann said having a vaccine that is 90 percent or more effective helps: If the vaccine was only 50 percent effective, you would expect a quarter of the population to have antibodies if half the population got the vaccine. But health officials are trying to get the message out that a COVID-19 vaccine that passes the FDA and ACIP will be safe.

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“The higher effectiveness makes a difference in terms of the number of people needed to be vaccinated to really have an impact on disease transmission.”

She also hopes that having a vaccine that’s 90 percent or more effective bolsters the public’s confidence in it, because if you get the vaccine, it’s highly likely you’re protected.

“It’s a confidence boost for the public, if you’re on the fence about getting vaccinated and you hear that the vaccine is 95 percent effective, that is certainly going to be weighed in the pro side of getting vaccinated as compared to ‘I don’t know if I should do this, the vaccine’s only 50 percent effective.’”