With shipments of the first FDA-approved COVID-19 vaccine arriving in all 50 states this week, Wyoming officials are ironing out the details of what rollout will look like here.
The task poses an enormous logistical challenge, complicated by the fact that the two-dose vaccine has stringent time- and temperature-sensitive storage and handling requirements, and that the first shipment is expected to cover only a sliver of the population.
A few things are known: The vaccine will be free in Wyoming, it will be limited and it will initially be prioritized for healthcare workers involved in direct patient care and residents of long-term-care facilities.
As of Monday afternoon, the first shipments had started to arrive in the state. The initial batch of 4,875 doses will go to public health departments in Casper and Cheyenne as well as hospitals in Cody, Jackson and Gillette — facilities that can store and share doses with other communities. The federal government is also expected to provide doses directly to tribal health clinics, military bases and U.S. Veterans Affairs facilities, according to the department.
Wyoming will then implement a phased campaign in accordance with the state vaccination plan, State Health Officer Alexia Harrist said.
“We are prepared for, I think really any scenario at this point,” she said Dec. 7.
Harrist did not provide details regarding if Wyoming had finalized who exactly belongs to the small group of individuals who will get initial doses. Uncertainty, a theme that has dominated the entire pandemic story, also underscores vaccination plans in Wyoming and across the country.
“Uncertainty about details is our biggest challenge right now,” DOH spokesperson Kim Deti told WyoFile of the state’s plan. “We have to consider these plans ‘living documents,’ as the information available changes frequently.” Despite the complexities, Deti wrote, “we feel largely prepared.”
Running parallel with the uncertainty, however, is hope.
“I really think that we should look at the promise of effective vaccines as the light at the end of the tunnel,” Harrist said on the Dec. 7 press call. “We have an end in sight at this point. Which is not true for many months during this pandemic. We have hope and a reminder that it is for now, and not forever.”
‘A living document’
The latest version of Wyoming’s 49-page COVID-19 Vaccination Plan calls for a phased approach, with each phase targeting recipients based on their exposure or vulnerability to the virus.
The initial phase will seek to immunize healthcare personnel “likely to be exposed to or treat people with COVID-19,” as well as residents of long-term care facilities — who have thus made up a large portion of the state’s COVID-19-related deaths.
The state has contemplated multiple scenarios for how the first doses “will be distributed and all the logistics of cold chain management,” Harrist said, referring to specialized cold-temperature handling. “But I do think that unless we get many, many more doses than we expect, it will take multiple shipments before we’re really able to cover everybody in that tier.”
So how does the state decide who to prioritize within the first tier?
A panel of healthcare and technical experts advises Wyoming on that question, Harrist said. The medical ethics committee is tasked with recommending subgroups based on factors like limiting mortality and minimizing social disruption and economic losses, according to the plan.
And which facilities will get the first vaccines? “In many cases we will direct vaccines to be shipped to key sites such as hospitals or local public health offices that are prepared to meet storage requirements,” Deti wrote in an email. The state is also working with pharmacies, clinics and other healthcare facilities.
The state’s second phase will target people at increased risk for severe illness from COVID-19, those over 65 and non-healthcare essential workers. After that, the plan focuses on additional critical workers, people with underlying conditions, those in congregate settings and residents with limited access to vaccination services. The final phase aims to vaccinate everyone else.
So how does one find out where he or she stands in line?
The state plans to launch a robust communication strategy, Deti said.
“We will do our best, together with our partners, to communicate about priority groups,” she wrote in an email. “This will be an effort that takes significant time and the early amounts will be quite limited. Local vaccine opportunities will vary and helping people know where to go will be part of the needed communications.”
Living with exposure
Eight months of working in close proximity to COVID-19 has taken a toll on the employees of Stitches Acute Care in Laramie, said co-owner and nurse practitioner Amy Surdam. It’s just been one layer in an onslaught of changes and challenges the pandemic has brought. The whole journey, she said, has “been exhausting.”
For Surdam, the vaccine promises much-needed protection for her employees.
“The relief I have with this is that after really just a long eight months of worrying about our team, is this light at the end of the tunnel that they are going to receive some extra protection,” Surdam said.
Surdam is not clear on where her staff sits in the priority list, she said, but after attending a DOH meeting and researching the plan, she trusts the state’s process.
“I’m sure they’ve developed a fair and equitable method that we all just have to trust is the right thing,” she said.
She’s hearing increasing optimism about the vaccine from her peers as well, she said.
Surdam thinks there’s a fairly common evolution as people move from initial skepticism to hopeful enthusiasm about Pfizer’s COVID-19 vaccine and others in development. People start out reluctant, but as they learn more about the studies and the process, she said, they transition from uncertainty to “I absolutely want to get it.”
Stitches also registered with the state to administer the vaccine, Surdam said, though it’s also unclear when that will begin.
After all of the quick-pivots and logistical challenges of the pandemic, she said, “this is just another maneuvering point for us. But at least it feels very proactive.”
Achieving ‘herd immunity’
Deploying and administering vaccines across Wyoming is one thing. Convincing a meaningful percentage of a famously government-skeptical population to get the shot is another challenge.
A recent University of Wyoming survey found that 31% of respondents said they would definitely take the vaccine and another 27% said they would probably take it. Meanwhile, 13% said they would probably not take it and 27% said they definitely would not. Survey interviews were conducted in October.
Having three-fifths of Wyoming residents express willingness to take a vaccine puts the state in line with the rest of the country, said UW professor Jim King, who directed the survey. Some reluctance can be traced to distrust of vaccines in general, King said. Other people, who tend to be younger than 50, don’t believe it’s necessary.
Health experts have estimated that 70% of the U.S. population will need to be inoculated to achieve “herd immunity.”
Rep. Landon Brown (R-Cheyenne) traveled to Washington D.C. last week to attend the Operation Warp Speed Vaccine Summit. There, he and the other socially distanced attendees — state, federal and local politicians from all over the country — learned about the Pfizer vaccine, its efficacy and best practices for distribution, he said. Speakers included everyone from President Donald Trump to Centers for Disease Control Director Robert Redfield and Louisiana Gov. John Bel Edwards, a Democrat.
Brown said he was already planning to take the vaccine. The summit reinforced his views.
“After getting this information from these people and knowing the science that went into this stuff, there’s no question in my mind 110% I will be getting this vaccine as soon as it’s available,” Brown said.
The vaccine isn’t just something that was slapped together too quickly, as some have argued, he said. An enormous amount of money, brainpower and collaboration poured into the effort, he said, and scientists relied on proven practices. “This is what you get when you have a total dedicated effort.”
Brown hopes to get the message to Wyoming residents that “we have to get vaccinated.
“If we get the population there to [70% vaccinated], that’s where we can eradicate COVID-19 and get back to quote-unquote normal,” Brown said.
Gov. Mark Gordon has also stated he will take the vaccine.
“Should the FDA approve a vaccine,” Gordon’s spokesperson Michael Pearlman wrote in an email Dec. 7, “the Governor believes it will reflect the scientific consensus that it is safe and effective and has been thoroughly vetted.”
CORRECTION: This story has been updated to correct the spelling of Amy Surdam’s name. -Ed.