Vaccine to roll out in 3 phases; no cost for shots

THE BAKER ADMINISTRATION laid out its COVID-19 vaccination plan in detail on Wednesday, with the first shipment of 60,000 doses to be delivered to 21 hospitals across the state as soon as the US Food and Drug Administration issues approval for the Pfizer vaccine.

Another 240,000 first-dose vaccinations will be received by the end of December, and will go to 74 of 77 hospitals statewide that have access to  the ultra-cold freezer storage of -70 degrees Celsius that the Pfizer vaccine requires. Vaccines will be distributed either by Pfizer or the Department of Public Health.

“The vaccine will be provided free of charge to all individuals and insurance companies will not charge any out-of-pocket costs or copayments,” said Gov. Charlie Baker at a State House press conference. The hope is that removing any cost barrier will lead to the widest distribution possible for the vaccines.

The first phase of vaccinations will run through February and focus initially on clinical and non-clinical health care workers performing “COVID-facing care.” They will be followed by residents and staff of nursing homes and assisted living facilities; police, fire, and emergency service personnel; employees and residents of congregate care settings, including jails, prisons, and homeless shelters; home health care workers; and health care workers not doing COVID-facing care.

The COVID-19 vaccines produced by Pfizer and Moderna, which are expected to be the first to hit the market, require two doses. Pfizer’s second dose can be taken 21 days after the initial dose and Moderna’s 28 days after. It is expected the vaccinated person will reach effective immunity six weeks from the first shot.

Phase two is expected to launch in February, targeting individuals at high risk for COVID-19 (two or more comorbidities); early education, transit, grocery, utility, food and agriculture, sanitation, and public health workers; people over 65; and individuals with one comorbidity.

During phase two, 20 percent of vaccines will be set aside for communities that have either been hit disproportionately hard by COVID-19 or deemed socially vulnerable, using as metrics socio-economic factors, household size, language skills, housing and transit needs.

“Communities of color and at-risk populations will be prioritized throughout this process,” said Rev. Liz Walker, pastor at the Roxbury Presbyterian Church and a member of the COVID-19 vaccine advisory board.

Marylou Sudders, the secretary of health and human services, said it is expected people of color will be able to receive vaccinations during every phase as they make up many of the workers in the healthcare field, including dieticians and home healthcare aides.

Assuming the vaccine supply chain holds up and other vaccines are approved, the vaccines are expected to become available to the general public in April. By that time, the vaccines will be available in many more healthcare settings, including doctor’s offices and pharmacies.

Vaccine distribution at every stage will include syringes and other equipment necessary to inoculate people, easing the cost burden on providers.

Dr. Paul Biddiger, chair of the vaccine advisory board and director of the Center for Disaster Medicine at Massachusetts General Hospital, reassured the public that the vaccines are going through a thorough testing process to make sure they are safe.

“Vaccines must have the highest safety profile in order to receive an emergency use authorization,” he said. “While the pace of vaccine creation has been unprecedented, what out group has focused on is how much is normal about the process of approval.”

The goal, Biddinger said, is to vaccinate every medically eligible person in Massachusetts, but “herd immunity” will require at least a majority, and probably 60 percent, of the population to be inoculated. The hope, he said, is that in six to nine months, the vaccine should reach a “good chunk of the country.”

Biddinger said the vaccine won’t change people’s lives immediately. People will need to continue following state guidelines around mask wearing and social distancing even if they receive the vaccine, he said.

“Here’s what we know about the vaccines,” he said. “They dramatically lower your risk of needing hospitalization or dying. They protect you. What we don’t know is if they completely prevent you from getting a low-level infection or transmitting the illness.”

Biddinger also said people who have had COVID-19 should also be vaccinated. Anyone who has had a documented case of COVID-19 in the past three months will have to wait 90 days from when they were first diagnosed before receiving the vaccine.