Oregon health authorities expect “somewhere in the neighborhood” of 100,000 vaccines to arrive in the state by the end of the month. Fewer than 2,000 of those will be headed to Deschutes County, said Deschutes County Health Services Director Dr. George Conway at the Regional Public Health Update Dec. 3. The two vaccine frontrunners from Pfizer and Moderna will go before the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee for emergency approval on Dec. 10 and Dec. 17, respectively. If the vaccines are approved, people could start receiving vaccinations a couple days later.
The state hopes to first vaccinate “a very small number of very high-risk individuals,” Conway said. “Primarily frontline healthcare workers that are serving persons that either have COVID or at risk of COVID. So, people in things like hospitals, emergency rooms, potentially first responders.” This group also includes staff and patients of long-term care facilities because of the high mortality rates associated with those cases, he said.
Deschutes County Health Services expects “a very rapid ramp-up” in January—especially if Moderna’s vaccine receives approval. Pfizer’s vaccine requires ultra-cold storage—meaning minus 70 degrees Celsius. For context, dry ice is at about minus 79 degrees Celsius. That means the average freezer just can’t cut it.
“[Moderna’s vaccine] is a little more straightforward as far as shipping and handling goes,” Conway said. “It doesn’t require the extreme cold.” Both vaccines do require two doses, however, which complicates vaccination efforts.
With a vaccine on the horizon, Deschutes County Health Services is pleading with people to continue to follow recommended COVID-19 guidelines.
“This isn’t going to be an endless, total change to everybody’s life; this is time-limited,” Conway said. “I think sometime in the spring, at the latest in the early summer, we’re going to see a major change moving much more back to normal life.”“I think sometime in the spring, at the latest in the early summer, we’re going to see a major change moving much more back to normal life.” — Dr. George Conway
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Central Oregon nurses: Cautiously optimistic about COVID-19 vaccine
Nurses in Central Oregon have received the vaccine news with “cautious optimism,” Kevin Mealy, communications manager for the Oregon Nurses Association told the Source.
“In many ways nurses are being forced to run a multi-year marathon,” Mealy says. “It’s encouraging to see an aid station up ahead, but there are still a lot of miles left to go because we know that this rollout will take time.”
Along with the complicated logistics of getting two doses of vaccine to everyone in the world, he sees vaccine hesitancy as a potential challenge.
“There is a natural questioning point when it comes to a new medical development that’s being developed very quickly,” Mealy says. “It is incumbent on the healthcare community to be open about the risks and benefits and to share information and work with trusted partners to make sure people have enough information to make the right decision and get a vaccine that is safe and effective.” And he says it’s clear that the benefits of an approved vaccine will far outweigh the risks.
As an additional safety precaution, Oregon joined California, Nevada and Washington to form the Western States’ Scientific Safety Review Workgroup. The panel will review the safety and effectiveness of any COVID-19 vaccines that receive emergency FDA approval.
While people wait for a vaccine, Mealy asks for continued support for nurses.
“For a nurse working on the COVID unit seeing patients deteriorate in hours, it’s a challenge. When you’re doing that type of work, you see the impacts in a way that others don’t,” Mealy said. “A vaccine is a long-term solution, but we do have effective short-term solutions, and that includes wearing your mask, remaining socially distanced, washing your hands. Those can be extremely effective if we have good buy-in and leadership from our local elected officials.”
The current increase in Deschutes County’s infection rates and hospitalizations mean nurses continue to struggle with safe working conditions. They need adequate PPE, contact tracing, and appropriate COVID sick leave, along with better testing, Mealy said.
“In this interim where we don’t have a vaccine, and we won’t have a vaccine for healthcare workers—even those in direct patient care—for a while yet, implementing regular testing for nurses and healthcare workers on the COVID units and for those in potential exposure cases is going to be critical,” Mealy said. “If you look at what California did: they just required testing weekly for providers in the hospital setting, and I think that’s a wise move. It ensures that you’re not bringing COVID into the hospital.”
Getting the COVID-19 vaccine to Central Oregon
The Oregon Health Authority’s phased approach asks county health officials to partner with local organizations to get the vaccine to where it’s needed most in an equitable manner—paying special attention to historically underserved populations. For that, Deschutes County Health Services could lean on previous vaccination partnerships.
“We partner annually with organizations serving underserved populations to provide free flu vaccinations,” Morgan Emerson of Deschutes County Health Services said via email. “We also coordinated with the Latino Community Association this year to provide free flu vaccines. These partnerships have been valuable in allowing public health to meet people where they are to provide important public health services.”
Deschutes County is in the early stages of planning a local rollout, but assuring equitable access to the COVID-19 vaccine is an important part of the framework, Emerson said. Gov. Kate Brown established an equity framework that calls for communicating to underserved communities through trusted local stakeholders and community-based organizations. With its successful flu vaccine clinics in the past, the LCA could be an ideal candidate.
Joanne Mina, Volunteer Coordinator with the Latino Community Association, says the Central Oregon nonprofit has already been working throughout the pandemic to mitigate the effects of COVID-19 on the Latinx community, while building the trust with health officials that a successful COVID vaccine rollout will require.
“Since May we’ve been giving out boxes of fruits and vegetables and also masks and information,” Mina said. Later in the year, LCA received grants to support local health departments with contact tracing, and provides education on how to self-quarantine and effectively use masks. The nonprofit also supports community members suffering from COVID by delivering groceries to their doors and providing financial assistance while they’re healing.
“Now we’re also able to do testing clinics in partner with Mosaic Medical and our local health department,” Mina told the Source. “That is a way in which we are proactively laying the groundwork and making the community aware and comfortable connecting with our local health department.”
Mina says the health department understands “there’s no quick fix” to addressing community concerns and the systemic issues driving them. For example, as part of its COVID-19 response, the agency appointed a Health Services Navigator to help guide community members through the healthcare and social services system—providing information and support. But it won’t be easy.
“There are many fears that the Latinx community is feeling because of COVID,” Mina said. “There’s a fear that any service you receive will be public charge. There’s the fear that your information will be shared, and you could put yourself in a vulnerable situation where you could experience family separation. There’s also fear of retaliation if you ask too many questions of your employer, if you don’t show up to work. All these things are weighing on people on top of the fear losing their homes, not being able to provide for their children, losing loved ones, being sick themselves.”
In its Dec. 2 COVID-19 report, OHA stated that “persons of Hispanic ethnicity” account for 13% of Oregon’s population but 40% of cases to date—for those cases in which the person’s ethnicity is known. The Centers for Disease Control and Prevention updated a report in July explaining such disparities. Along with discrimination and inequitable access to health care, BIPOC community members are more likely to serve as essential workers in healthcare facilities, farms, factories, grocery stores and public transportation, which puts them at greater risk for infection.
