Essex County Public Health Director Linda Beers on Tuesday, Dec. 8 briefed the county Board of Supervisors on the department’s tentative plans for vaccine distribution.

The county health department is exploring the idea of setting up pop-up, drive-thru, outdoor vaccine clinics. Essex County Board of Supervisors Chairman Shaun Gillilland said the county has considered using shuttle buses that were purchased for hiker transportation — but not used this summer, due to the pandemic — as mobile vaccine distribution clinics.

Beers’ briefing also provided some insight into how the department’s staff are training for what is likely to be a significant undertaking for a small team in a rural county.

“We do have a vaccination plan, we submitted it to the state,” Beers said. “It is a rough outline. We are working diligently.”

—

Drills

Multiple different local agencies and health care institutions have submitted plans for vaccine distribution to the state. The Essex County Health Department, Adirondack Medical Center in Saranac Lake, Elizabethtown Community Hospital and the Hudson Headwaters Health Network are a few of them, according to Beers.

This isn’t the first time the department has distributed vaccines, but the coronavirus pandemic has created some unique logistical problems.

“We would never want to put people in a building, gather people in a building, and the best way to successfully do this is the car model,” Beers said.

The department has tested out this drive-thru, outdoor model for years, since the H1N1 virus, according to Beers. More recently, the department tested it out with flu clinics.

“When we did our flu clinic, we drilled this,” she said. “Really, kudos to my staff, because it was cold, it rained the whole day, and they ate outside and did it. Which makes me know that we can do this. We didn’t have any shelter; we did it in our parking lot. We used some emergency services buses that they could warm up in, but all in all, we were completely outside all day.”

Beers said the department got their time down to four minutes per person.

She envisions the department staffing one clinic per day at different locations every week, then cycling through again to distribute the second vaccine dose to residents.

Under the state’s current vaccine distribution plan, the first people to be eligible for a vaccine would likely be essential health care workers and high-risk nursing home residents in areas where there’s a high number of cases. The next would be health care workers and nursing home residents in areas with relatively low numbers of cases, such as Essex County, which has one of the lowest test positivity rates in the state.

“We are a low-COVID prevalence in a geographic region at this time,” Beers said. “I assume, given downstate, we will stay that way.”

Next to be vaccinated would be first responders; teachers, school staff and child care providers; public health workers; high-risk people and essential front line workers who have regular contact with the public. Then vaccinations would open up to everyone over the age of 65, then all other essential workers, then the general population, according to the state’s COVID vaccination program book.

—

Logistical questions

It’s unclear at this time what vaccine will ultimately be distributed. Multiple companies have submitted vaccines to the U.S. Food and Drug Administration for emergency authorization.

Some of the vaccines use genetic material, and have to be stored at a low temperature with controlled humidity. Some of the vaccines have to be administered in two separate doses, while other vaccines in development are single-shot and don’t require temperature control.

If a vaccine that requires two doses is ultimately disseminated, like the one developed by Pfizer and BioNTech, that means whatever agency distributes it needs to keep track of which vaccine has been given to each person — a person can’t receive two different types of vaccine — and when that second dose needs to be administered.

That complicates the distribution planning process.

According to Beers, the county Health Department is prepared for the possibility of a two-dose vaccine. The department’s staff is trained to use a state system that would allow them to keep track of who has been vaccinated and when, and the department has already ordered more tablets for staff to use to input information.

—

About the vaccines

Pfizer, which has worked with German company BioNTech on its new vaccine, announced last month that it had submitted its emergency authorization application to the FDA.

Pfizer and BioNTech said that its late-stage vaccine trial showed its vaccine to be 95% effective after the second dose is administered. The vaccine has no serious side effects and an ability to prevent severe COVID-19 in older people, the New York Times reported. Documents from the FDA released on Tuesday show that Pfizer’s vaccine can provide some protection against COVID-19 even earlier — within 10 days of the first dose. The FDA’s analysis also revealed that the vaccine has worked well regardless or a person’s age, weight or race, and that trial volunteers did not experience any serious adverse effects caused by the vaccine.

That doesn’t mean there were no side effects, however. The trial did show that many participants experienced mild side effects after receiving the second dose, such as aches, chills, fatigue and fevers, according to the Times.

If authorized by the FDA, Pfizer’s vaccine could be administered to the first group of Americans by mid-December, according to the Times.

Another American company working on a vaccine is Moderna, which announced preliminary results that showed its vaccine to be 94.5% effective. Moderna has also applied for emergency authorization from the FDA.

There is also a single-shot vaccination in development by Johnson & Johnson, but it’s not as close to being ready for distribution.

“I would hope that’s what we would get here in rural Essex County, but we’ll see,” Beers said.

There are still some discussions to be had between the department and hospitals to decide which agency will disseminate vaccines to which populations, according to Beers. The health department doesn’t want to order vaccines for nursing homes if the hospitals, some of which operate nursing homes, plan to order vaccines for nursing home residents, she said.