Local experts discuss COVID-19 vaccine, anticipated in Alaska mid-December

A special meeting of Alaska public health experts and Alaska native leaders was convened on November 23 to discuss the roiling jumble of COVID-19 issues in preparation for the vaccine’s December arrival. Here are the highlights of what they said. Dialogue has been edited for length and clarity, but substance remains unchanged.

When will the COVID-19 vaccine start arriving in Alaska?

[Dr. Anne Zink, Chief Medical Officer for the State of Alaska] “I was on a call with the governors and Operation Warp Speed just the hour prior to this. A timeline was shared with us. Pfizer is first, and the earliest would-be December 11th...

“And then the Moderna vaccine they're having on the timeline exactly one week after the Pfizer distribution, coming out with the FDA [Food and Drug Administration] approval if it all looks good ... with a vaccine distribution no later than the 22nd.”

Who will be prioritized to be administered the first COVID-19 vaccines to arrive in Alaska?

[Zink] “I think of this like nesting dolls. The ACIP [Advisory Committee on Immunization Practices, part of the national Centers for Disease Control] is putting out these large recommendations. And then within those recommendations, the state will look at those and see how that's going to fit Alaska. But even within that, communities, even local hospitals, are going to have some availability to make some adjustments as well. And that's going to really vary depending on the location as well as what phase [priorities] of the allocations that is going out. 

“We want to make sure that no vaccine is wasted. There are some physical limitations, like some of the bottles come in five-person doses. So, say a community has 432 health care workers that would meet the criteria. We're not going to throw away three doses of vaccine because of that, and we're going to work with those communities on who comes next and who doesn't.

“There are a lot of variables moving right now between these different vaccines -- the storage, who can get vaccinated, who can't get vaccinated, health care workers and the timing of when they're working. We're going to need a lot of flexibility with communities to have the quickest and best allocation process available following these general recommendations. So, there will be local control to a degree, kind of within these nesting dolls of the General ACIP and state recommendations.”

Will state employees be required to have a vaccination?

[Zink] “Currently, there is no requirement, no mandate from the state regarding a vaccination. And the process of an EUA, emergency use authorization [from the national Food and Drug Administration], makes it so that businesses actually cannot mandate it at this time. If it goes through a full authorization private business could, but at this time they have no requirement regarding vaccinations.”

If someone has tested positive for Covid-19, would they benefit from the vaccine?

[Joe McLaughlin, State Epidemiologist and Chief of the Alaska Section of Epidemiology at Alaska Department of Health and Social Services] “If you have a positive in any of those three categories of tests [antigen, antibody, molecular], the question is do you need to get vaccinated? And the answer is we don't know yet. That is a question that has come up too. We've all raised it to CDC, many states have, and CDC continues to say we're not sure yet. And that's something that the Advisory Committee on Immunization Practice will look at.

“I suspect that people who have had infection are likely still going to be recommended for the vaccine, partly because what it looks like is people who have milder infection -- they're either asymptomatic and infected, or they just have mild illness -- they tend not to have as robust of an antibody response to the infection. That's called in question, how long will they stay immune compared to somebody who had a more serious illness? 

“We know that when you get the vaccine, you're getting a lot of antigen that is being presented to your body, so you typically get a very robust immune response. So the current thinking is that the vaccine may provide a longer duration of protection for many people, then natural infection. At the end of the day, I still can't answer your question, but hopefully that helps you understand the thinking process that's going into this into this question.”

What is the Alaska COVID-19 Vaccine Task Force and what do they do?

[Tessa Walker Linderman, Nurse Consultant with the Division of Public Health, co-lead for the Alaska Vaccine Task Force] “We have a team of about 40 people, both from the state and ANTHC [Alaska Native Tribal Health Consortium], really working around the clock to get our communities, our hospitals, and our partner organizations prepared to receive, distribute, and administer vaccine. We're focusing in on what potentially might be our first prioritized groups, which potentially could be our healthcare workers, long term care facilities staff, and in EMS [emergency medical services]. 

“We're looking at partnering with hospitals, pharmacies, and in our community health centers to be vaccination sites for those potential initial groups. We also have outreach on a census and borough area level that we're really trying to work with in terms of their planning efforts -- especially when we get more vaccine and are able to vaccinate larger populations -- we really want to be working closely with our communities across the state. So, from when a vaccine arrives till when we get to the point where we have enough to vaccinate everyone, we're closely planning through all phases of that.”

Has the State of Alaska been working with Alaska Native organizations while planning for vaccine distribution?

[Verné Boerner, President and CEO, Alaska Native Health Board] “This plan recognizes the relationship between the tribes and the state. It also highlights the close relationship that we have between the Alaska tribal health system, and it's an essential role as part of the Alaska public health system. It builds off an existing infrastructure and partnership for immunizations, such as a flu vaccine. 

“And I would be remiss not to also recognize that the Operation Warp Speed and the HHS [Alaska Department of Health and Social Services] in developing the rollout for the vaccine recognized the Indian Health Service and tribes as their own jurisdiction. This again was very much supported by ANTHC, our members, and the tribes as well as respected by the state. We look forward to the rollout and protecting our frontline workers, our vulnerable in our communities, and our communities as a whole. And as we head into the holidays, with our health system stretched, and particularly in rural Alaska, where access to care is definitely a challenge, many of us are able to say that our loved one is fighting for his or her life.”