The Tricky Who, How And When Of Getting Kansans COVID-19 Vaccinations

Dec 8, 2020

WICHITA, Kansas — The first of potentially several COVID-19 vaccines could get emergency approval by the end of the week.

But that major milestone is just the beginning of the work for local and state health departments in Kansas that will have to get the pandemic-stalling shots to people — and decide who gets it first, when and how.

The Kansas Department of Health and Environment said trucks full of Pfizer’s coronavirus vaccine will ship this week to the five ultra-cold storage locations, including at the University of Kansas Health System hospital in Kansas City, Kansas.

“Which may mean we can begin vaccinating as early as Friday,” said Health System Chief Medical Officer Steve Stites.

But the logistic problems get more complicated from there.

Vaccinations might begin at the end of this week, but the state only expects to get 23,750 doses in the first deliveries. That’s not enough to even vaccinate all of the people considered to be in Phase 1a of the distribution plan — doctors, nurses and other staff in direct contact with COVID patients. The state estimates that's about 35,000-40,000 people, each needing two doses.

That means hospitals and clinics will have to make tough decisions about who is first in line.

“We’ve spent hours and hours and hours and hours and hours looking at how we’ll distribute the vaccine here internally and how we start identifying people,” Stites said.

In the state’s latest vaccine plan, Phase 1 will also include other highly vulnerable people, including nursing home residents.

As more vaccines become available, distribution will expand to other essential workers and at-risk populations in Phase 2, likely next spring. Then, as production ramps up more, the state will move to Phase 3 sometime next summer and provide the vaccine to everybody.

But the exact order of who gets it and when remains still vague and an advisory group is hashing out those standards.

Some of those decisions could be politically fraught, especially when it comes to serving vulnerable populations.

Statistics show that the coronavirus hit prisons particularly hard — after all, it can be hard to socially distance and hand sanitizer is banned because it’s made of alcohol. And there's a risk of the disease bouncing in and out of the prison, to the community and back. That makes inmates and guards good candidates to get the shots early.

“But one could easily anticipate that there will be pushback if a state announces it’s going to focus one of its earliest phases of vaccination on prisons before it makes it available for the general population,” said R. Alta Charo, professor of law and bioethics at the University of Wisconsin.

That’s just among the first challenges. The logistics of getting the vaccine from manufacturer to patient present another hurdle.

The first two likely approved vaccines need to be stored at temperatures ranging from -15 to -80 degrees Celsius. While the state doesn’t need to purchase extra or special freezers, getting the vaccine from storage into the hands of hospitals and clinics across the state, and ultimately into Kansans, is extremely complex.

The Pfizer vaccine, for example, can be stored for up to six months at one of the state’s five ultra-cold freezer storage locations.

But to leave the ultra-cold storage facility and get to individual clinics, it will need to be packed in special containers filled with dry ice. Those thermal containers can keep the vaccine at a safe temperature for up to five days.

When a clinic is ready to administer the vaccine, workers will thaw it, dilute it and place it in a syringe, which has to be used within six hours.

Get any of those steps wrong and the vaccine becomes ineffective and has to be thrown out.

Phil Griffin, KDHE’s deputy director of disease control and prevention, said the state has lots of experience with vaccines and is confident it can safely and effectively distribute COVID vaccines much like it does with so many others.

But even once the state knows who should get it, when, and how, there are still more hurdles.

“A vaccine is only a vaccine," Griffin said. “It’s the vaccination that really matters.”

So, how do you convince millions of people, spread out over the whole state, with varying access to information, to go get a vaccine?

“One of the things we talk a lot about is how we can really push the vaccine out versus trying to pull people to a vaccine location,” said Alice Weingartner, the chief strategy officer with the Community Care Network of Kansas — more than 40 clinics serving vulnerable and hard-to-reach populations.

In addition to COVID vaccine-specific events, the clinics will also push for patients to get the vaccine at normal routine visits to the office.

Weingartner said it will require a lot of effort and communication from public health officials to convince those skeptical of the vaccine of its usefulness and that it’s the best tool to beat the pandemic.

“Once the ball gets rolling, we’ll be in good shape,” she said. “And we’ll see people become very positive and accepting of this.”

Brian Grimmett reports on the environment, energy and natural resources for KMUW in Wichita and the Kansas News Service. You can follow him on Twitter @briangrimmett or email him at grimmett (at) kmuw (dot) org. The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.

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