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What you need to know about Minnesota’s plan to distribute the COVID-19 vaccine

FDA approval for Pfizer’s vaccine could come as soon as December 10.

Margaret Keenan, 90, is the first patient in Britain to receive the Pfizer/BioNtech COVID-19 vaccine at University Hospital in Coventry, Britain, on Tuesday.
Margaret Keenan, 90, is the first patient in Britain to receive the Pfizer/BioNtech COVID-19 vaccine at University Hospital in Coventry, Britain, on Tuesday.
Jacob King/Pool via REUTERS

On Tuesday, a 90-year-old woman in the United Kingdom was the first person to receive Pfizer’s COVID-19 vaccine outside of clinical trials, after the U.K. approved the drug for use last week.

Americans are anxiously awaiting the Food and Drug Administration’s approval of Pfizer’s vaccine here, quickly followed by another by Moderna, expected on Dec. 10 — Thursday — and Dec. 17, respectively.

Federal and state health officials have been working on plans to determine who gets the first, limited supply of vaccinations, assuming they’re approved, and when.

Minnesota officials briefed the public on those plans, at least as they currently stand, on Tuesday. “It is happening. It is ready,” Gov. Tim Walz said of the vaccine rollout plans.

Here’s a look at what we learned.

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This happened awfully quickly. Are we sure it’s safe?

The federal government nicknamed the vaccine project “Operation Warp Speed,” which is an apt description. It’s been just about 11 months since the novel coronavirus’ genome was sequenced, and now there are likely vaccines on the near horizon.

While the process has happened very quickly, health officials stressed that no shortcuts that compromise safety were taken in the clinical trial process. Instead, some parts of the process were sped up. This includes things like running multiple phases of clinical trials at once, and the federal government footing the bill to manufacture promising vaccine candidates pre-approval so they’d be ready when they were greenlighted. Trial data suggest both Pfizer and Moderna’s vaccines are 95 percent effective at preventing severe COVID-19.

That means the vaccines are going through the same safety checks that any other vaccine would go through.

When will the first vaccines arrive in Minnesota?

Assuming the Pfizer vaccine is approved this week, MDH expects vaccine doses to start arriving at sites in Minnesota — they’ll go directly to providers who will vaccinate people — as soon as the week of Dec. 14. That’s next Monday. That doesn’t mean they’ll go right into people’s arms as soon as they arrive, though.

Gov. Tim Walz at a Tuesday afternoon press conference: “We have got to stop the community spread. We have got to slow this thing down, even with this vaccine.”
MinnPost photo by Peter Callaghan
Gov. Tim Walz at a Tuesday afternoon press conference: “We have got to stop the community spread. We have got to slow this thing down, even with this vaccine.”

MDH expects it will take about a week to train providers to administer vaccines, so if all goes according to plan, the first Minnesotans will get vaccinated the week of Dec. 21.

“Perhaps an early Christmas present,” Ehresmann said.

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How many vaccine doses will Minnesota initially get?

That’s not set in stone, and MDH officials said the number keeps changing, but as of Tuesday afternoon, the estimate was 183,400, some from Pfizer and some from Moderna, within the first four weeks of vaccine administration.

That means 183,400 people could get their first shot in the first month. Each of these vaccines requires a booster shot (Pfizer’s is three weeks after the first shot, Moderna’s is four weeks), but Ehresmann said that when the federal government issues first doses, it’s reserving second doses to be sent at the appropriate time.

In this diagram, if all goes according to plan, week 1 refers to the week of Dec. 14.
Minnesota Department of Health
In this diagram, if all goes according to plan, week 1 refers to the week of Dec. 14.
Who will get the first vaccine doses?

The full roadmap for who gets the vaccine when hasn’t been determined yet but will fall largely to the the Advisory Committee on Immunization Practices (ACIP), a CDC committee of experts that makes recommendations for all vaccines. States will have some leeway within the ACIP’s guidelines.

But with limited initial supplies, the ACIP has already made the determination that the first vaccines will go to people in the top priority group: called 1A by health officials. One problem? There are an estimated 500,000 people in that group.

Within group 1A, first priority will go to those working in COVID-19 units, ICU, emergency departments and COVID-19 urgent care clinics, plus those living and working in skilled nursing facilities and nursing homes, EMS personnel, COVID-19 testers and community vaccinators.

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The second priority group inside 1A includes hospital, urgent care and dialysis center workers in direct patient service or those handling infectious materials not included in the first group, and personnel working in assisted living or as home care providers, plus residents.

The third 1A priority group is health care providers not included in the first and second priority groups, as well as adult residents of intermediate care facilities for people with intellectual disabilities and adults living in other residential care facilities.

Minnesota Department of Health
After group 1A comes 1B, which is expected to include essential workers, the parameters of which haven’t been determined yet. That might include workers in education, food and agriculture, utilities, police and fire fighting, corrections officers and transportation.

Finally, group 1C includes adults with high-risk medical conditions and those over 65.

Since limited vaccine supplies mean not all members of these priority groups can get vaccinated right away, officials also plan to use a “social vulnerability index” that was developed by the CDC and takes into consideration factors like income, employment, housing, access to vehicles, minority status and other factors that may affect an individual’s vulnerability to COVID-19.

“Locations with a greater social vulnerability were found to have greater disparities with COVID, so higher case fatality as well as they were locations that were more likely to become hotspots for COVID,” Ehresmann said.

The plan is for 85 percent of vaccine distribution to be based on population, with 15 percent determined by social vulnerability.

The chart below shows the expected geographic breakdown of vaccine distribution for first doses of the COVID-19 vaccine with the social vulnerability index factored in.

Minnesota Department of Health
How long will it take for the COVID-19 vaccine to take effect?

Ehresmann said after somebody gets their first shot, it’s expected to take six weeks from that first vaccination to be fully effective.

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There is evidence it doesn’t take that long to confer some protection, though: the FDA said Tuesday that in initial review, the vaccine appears to be 50 percent effective within one week of the first dose, NBC reported.

Will social distancing and masks go away once the vaccines roll out?

No. Gov. Tim Walz quoted an article in the journal Health Affairs that estimated that at current infectious rates, 160,000 more people in the U.S. will die in the next six months, even as the vaccine is administered.

That’s why he said it’s critical to continue to wear masks, socially distance and follow other public health recommendations to ensure hospitals aren’t overwhelmed.

“We have got to stop the community spread. We have got to slow this thing down, even with this vaccine,” Walz said.

In some settings, it will surely matter whether people are vaccinated or not. How will they prove it? 

Minnesotans who are vaccinated will get a card stating they have been vaccinated, Ehresmann said.

“We’re encouraging people to also take a picture of that, so that in case you lose it you’ve got documentation,” she said. Providers will also be reporting information to the state’s immunization information system.

Will people who have had COVID-19 be in priority groups?

Speaking in terms of first priority groups, Ehresmann said the recommendation is that people be vaccinated at some point even if they have already had COVID-19.

However, people who are otherwise in top priority groups who have had COVID-19 in the last 90 days may end up waiting to let others who have not had the virus go first.

What about kids?

It’s not clear when kids will be vaccinated at this point. Few children, who are at the lowest risk of developing complications from COVID-19, were included in the initial clinical trials for these two vaccines, so we don’t know how well the vaccine works among them. Trials are beginning to include them now, though, so there will presumably be some data out in the future.

Peter Callaghan contributed to this report.