First COVID-19 vaccines just weeks away for North Dakota, officials say | INFORUM  12/03/2020 01:00:00   Adam Willis | Dec

The first vaccine shipments to North Dakota are expected to be extremely, extremely limited, said Molly Howell, the Department of Health's immunization program manager, and the state is still hashing out its plans for how to ration vaccines in the later stages of the immunization process. But with two effective vaccines pending federal approval in the coming weeks, the state said it plans to prioritize the immunization of health care workers and nursing home residents in the early phases of distribution.

Two different vaccines developed separately by the pharmaceutical companies Pfizer and Moderna are up for federal authorization later this month, and Howell said she expects an initial shipment of the Pfizer vaccine to arrive in North Dakota during the week of Dec. 14. The federal Food and Drug Administration is slated to consider greenlighting an emergency use permit for the Pfizer vaccine on Dec. 10 and to hold a similar hearing on Modernas vaccine later this month, with initial batches of both vaccines ready for shipment within 24 hours of approval.

With both vaccines coming out of record-breaking development and approval processes, North Dakotas public health experts emphasized the safety of the injections on Wednesday, highlighting a rigorous federal approval process and the over 90% effectiveness of both companies' vaccines in their trial stages.

I really want to assure people that the reduced time frame was a remarkable feat that actually did not shortchange the key components of the FDA regulatory approval process that assures that a vaccine has to achieve a very high bar of safety, said Dr. Paul Carson, an infectious disease specialist at North Dakota State University and a consultant on the health department's pandemic response. Recipients of the vaccines should expect mild, short-term symptoms after injection, Carson said, but neither vaccine has shown major side-effects at this point.

As states gear up for a massive distribution endeavor aimed at immunizing some 70% of the country by next spring, coordination of the vaccine distribution is expected to pose an unprecedented test to local public health messaging and logistics. A recent poll by the North Dakota Newspaper Association found that about two-thirds of North Dakotans said they would take the vaccine, close to the threshold that epidemiologists say is needed for herd immunity. But both the Pfizer and Moderna vaccines require two doses several weeks apart, a requirement that Howell predicted could pose logistical challenges when vaccination of the general population begins in later phases.

Still, North Dakota has acquired freezers and shipping materials to facilitate storage and shipment of the vaccines at their necessary cold temperatures, and Howell said she expects the state is well-equipped to distribute the vaccines around the state. I think were very confident, and I think North Dakota is probably in a better position than other states to distribute to rural areas, she said.

In initial shipments later this month, North Dakota is expected to receive a small batch of 6,825 Pfizer doses and 13,000 Moderna doses, with the same numbers of second doses arriving later. Howell said that with these first doses, the state will prioritize health care workers in North Dakotas four major medical hubs of Bismarck, Fargo, Grand Forks and Minot, in addition to workers in some rural, critical access hospitals. There are about 70,000 health care workers and 12,000 long-term care residents in North Dakota, and Howell said she expects vaccination of long-term care residents to begin before the end of the year.

In the weeks after these initial shipments, the federal government will allocate additional doses to individual states. Uncertainty around the size of these subsequent allocations remains a major outstanding question for state officials as they decide how to ration the vaccines in later phases, Howell said.

And while states are still awaiting federal guidance on how to prioritize later shipments of the vaccines, Howell said that top-level instruction is likely to be vague. The North Dakota COVID-19 Vaccination Ethics Committee, composed of five public health volunteers, will advise state leaders on how to distribute those later phases at a more granular level. Howell laid out tentative plans to prioritize essential workers like police officers, firefighters and teachers, as well as residents 65 and older who live outside of long-term care facilities, among other high-risk populations.

For everyone else in North Dakota, Howell urged patience. Most residents who do not belong to high-risk groups likely will not receive their vaccinations until late spring or early summer.

Readers can reach Forum reporter Adam Willis, a Report for America corps member, at [email protected]

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