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The federal government’s “Operation Warp Speed” is aiming to develop a coronavirus vaccine by January. While that might seem like an eternity to front-line workers and those vulnerable to COVID-19, Utah health officials are already working to get the state ready.
But even the experts face plenty of unknowns, like how many vaccine doses will initially be available, who will need a dose the most and whether enough Utahns will be willing to get the shot at all.
“I’m hoping it will go smooth,” said Rich Lakin, immunization program manager for the Utah Department of Health. “I just don’t know enough about the vaccine yet. And how fast, how many doses they’ll have … that’s a tough question for me to answer.”
The federal Centers for Disease Control along with the Department of Defense will distribute vaccines once they’re ready, Lakin said. From there, the state health department will help counties and health districts order doses.
One thing public health officials said they can safely assume is that vaccines will be in short supply as pharmaceutical companies scramble to make enough doses for the masses.
“Say it’s 2 million doses, or even 10 million doses [to start]. Utah’s competing with 50 states and other territories,” Lakin said. “We just don’t know how much of that vaccine we’d get in the beginning. California, New York, Texas are probably higher priority than Utah.”
The state health department is currently forming a committee that includes Lakin, physicians and other health officers to develop a sort of triage system that will determine which high-risk groups receive the vaccine first.
Audrey Stevenson, director of family health services for the Salt Lake County Health Department, said health officials had to develop a similar tiered system when they received limited supplies of the H1N1 vaccine.
She said health care providers and first responders will likely top the prioritization list, “but that could change dramatically over the next few weeks as we see how this disease is impacting communities.”
The county is already trying to figure out how to get the vaccine to the people who will need it most, coordinating with community-based clinics, churches and schools. But Stevenson said more people might initially be eligible for the vaccine than the state has doses to provide.
“The other wrinkle in this situation is, most likely, any vaccine products developed for COVID-19 will require a two-dose series,” Stevenson said, meaning that patients will need to get a booster shot four weeks later. “That would be another logistical challenge for us.”
Combating vaccine skepticism
“Vaccines have been one of the greatest public health developments in the past two centuries,” Stevenson said, but “we’ve done such a good job in the development of vaccines that a lot of people are more afraid of the vaccine than the disease.”
Although the vast majority of Utahns get routine vaccinations, Utah Department of Health information shows exemptions among schoolchildren is on the rise. Those cases have especially grown in the Southwest and Summit health districts, where the department’s most recent data shows the number of exemptions for kindergartners is close to 10%.
“I think this is a super version of normal vaccine skepticism,” said Brian Poole, an associate professor of microbiology and molecular biology at Brigham Young University. “Usually people who are anti-vaccine tend to be part of a group. This is much more widespread.”
Poole is working on a study to understand why the public is so reluctant about a COVID-19 vaccine, but he said the sea of misinformation circulating could be partly to blame.
“There’s a meme or something going around that it’s a DNA vaccine that’s going to change your cells. … That’s not something anyone needs to worry about,” Poole said. “And I can absolutely guarantee that Bill Gates is not slipping microchips into the vaccine. That one I’ve heard a lot.”
Much of the vaccine media coverage has focused on experimental technology, including RNA vaccines. Those vaccines trigger cells to produce antigens and show promise in fighting diseases from COVID-19 to cancer, but they have yet to be licensed for human use. That could cause additional hesitation, Poole said.
“Tried and true technology might be easier for people to accept, even though there’s not really any risk to an RNA vaccine,” Poole said. “It might make people nervous.”
Large-scale clinical trials are underway to ensure the eventual COVID-19 vaccines are safe. Both CDC and local public health experts assure the COVID-19 treatment will undergo the same rigorous testing as other vaccines, despite its rapid development.
“The best thing you can do … is volunteer,” Poole said. “They want to test it on all types of people.”
Researchers especially want to test the vaccines with front-line workers in law enforcement, schools, grocery stores, personal care, health care, retail and meatpacking plants. J. Lewis also hopes to recruit people of color who are high-risk for COVID-19 infection in Utah, including Black, Latino and Polynesian communities.
“Will it work? We think it will. We’ve seen good results so far,” said Chris Mickelson, president of J. Lewis Research.