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How Different States Will Approach COVID-19 Vaccine Distribution


Now, of course, it's up to the states to get the coronavirus vaccine at the places they think need it most. We're going to talk with some top health reporters at NPR member stations, WBUR's Martha Bebinger in Boston, Blake Farmer at WPLN in Nashville, KPCC's Jackie Fortier in Los Angeles. Thank you all for being with us. Martha, let's begin with you, if we may, please. How's Phase 1 supposed to work in Massachusetts?

MARTHA BEBINGER, BYLINE: Scott, Massachusetts expects to vaccinate about 60,000 hospital workers starting just in the next day or two. Some hospitals will begin with all of the staff in their ICUs, while other hospitals will start with nurses, medical assistance and other employees in outpatient clinics because they see patients in the early, most infectious days of COVID. Many frontline health care workers are anxious to get vaccinated. But there will only be enough for about a third of health care workers next week. So Doctor Paul Biddinger, who chairs the Vaccine Advisory Group in Massachusetts, says there may be some disagreement about who should go first.

PAUL BIDDINGER: It's important to acknowledge the stress that's on the health-care workforce right now. You know, any time you have a limited allocation of any resource, I think it does create tension. What we're trying to do is communicate as transparently as we can about what the situation is. And, hopefully, people will understand that logic.

SIMON: And Martha, after hospital staff or at least a portion of them are vaccinated, who's next in line?

BEBINGER: Nursing home residents and staff will be up next in Massachusetts, followed by EMTs, police officers, firefighters and home care workers. Massachusetts, unlike many other states, will offer vaccines during this first phase in homeless shelters and prisons. And that's because we've seen a lot of outbreaks in those settings. But vaccinating prisoners ahead of people with risky underlying medical conditions or essential workers who are in Phase 2 - that's kind of controversial.

SIMON: Jack Fortier.

JACKIE FORTIER, BYLINE: California is trying to roll out a similar vaccine distribution plan, but it's happening during the worst surge in cases that the state has seen, really, since the pandemic began. California is averaging more than 28,000 new cases every day. And LA County accounts for about a third of those cases. Claire Jarashow is the director of the county's vaccine preventable disease control program.

CLAIRE JARASHOW: This is going to be the hardest logistical challenge, I think, that we face and in the middle of a surge. So it's all hands on deck.

FORTIER: She says LA will get 83,000 Pfizer vaccines early next week. And those will go exclusively to those frontline health workers.

JARASHOW: We welcome as much vaccine as possible. But it's very challenging. We're figuring these things out as we get information, new information daily.

SIMON: Jackie, you've reported that California averages more than 28,000 cases a day. And does that mean hospitals are pretty much at capacity?

BEBINGER: Yeah, especially the intensive care units where the sickest COVID patients are treated. There is widespread transmission. LA is seeing about 10,000 new cases every day. We actually broke a record yesterday. So vaccinating these health workers is really the top priority. Most Californians are back in a lockdown. In some regions, there are very few ICU beds left. To kind of give you an idea of the situation, in LA County alone, more than 61,000 people tested positive in the last week. That is more than enough people to fill Dodgers Stadium. And, of course, deaths are going up. Here's LA Mayor Eric Garcetti.


ERIC GARCETTI: Every 20 minutes somewhere here in LA County, someone is dying from COVID and its complications.

FORTIER: So with that backdrop, everybody agrees frontline health workers should get it first. But there is tension brewing over the next phase of the plan. Who should be considered an essential worker? Groups are really jockeying to get first in line, from the longshoremen in the port of LA to airline pilots because these early supplies of vaccines are limited. A state advisory committee is meeting next week to really define who's essential and who's going to need to wait.

SIMON: Blake Farmer, let's turn to you in Nashville. I know you've done some reporting on this. Do states put hospital staffers first in line because they are the most at risk?

BLAKE FARMER, BYLINE: Well, not exactly. I mean, a nurse who works in a COVID unit certainly could be exposed. But hospitals are already trying to make sure that they didn't put the most at-risk staffers, like someone with diabetes or who's older, working directly with COVID patients. The strategy here is to keep health care workers healthy and on the job, so hospital capacity is less of a problem. Hospital capacity isn't a shortage of space, at least here in Tennessee. It's been a shortage of staff because so many nurses, doctors and respiratory therapists have been out due to exposure or having a positive case themselves.

At one point last week, Vanderbilt University Medical Center had more than 400 people out because of COVID. Now, once they're vaccinated, staffing should become slightly less of a problem. And in turn, some of the capacity concerns should lessen.

SIMON: And how full are hospitals right now?

FARMER: Well, you know, there was a time it kind of depended on where you were in the country. But at this point, the pinch is just about everywhere. I talked to a flight nurse based just outside Nashville named Mark Tankersley (ph). Usually, their helicopters are flying patients from rural hospitals who need a higher level of care into some of the big medical centers in Nashville.

MARK TANKERSLEY: Nashville has reached maximum capacity for their bed space. So now we're having to utilize some of our larger rural hospitals to transfer patients from some of our smaller rural hospitals.

FARMER: He says, often, these patients need ventilators or other critical care that some hospitals just can't provide. We're actually seeing hospitalizations in some states leveling off a bit. But we're told that is not necessarily a good thing because it may mean more people are being turned away because they're just not sick enough.

SIMON: Martha, do we know when there may be enough vaccine distributed to relieve some of the stress on hospitals?

BEBINGER: Well, Dr. Anthony Fauci said yesterday that it will be two to three months before vaccines have an impact on the public's health. So in the most optimistic scenario where all of the vaccines in the pipeline are cleared for emergency use, and there are no supply-chain problems, the federal government says it will be able to distribute roughly 300 million doses in the spring. That's when the shots will be available to anyone who wants to be vaccinated. But, you know, there's still a lot of hesitancy out there that - it's starting to shift as people get more details about how well these vaccines protect against serious illness.

The bigger problem may be more of what one expert called, Scott, the Beanie Baby effect. You might remember the demand - time when...

SIMON: Sure. Yeah.

BEBINGER: ...Far outstripped the supply of those cute little creatures. I guess the message that Dr. Fauci and others keep coming back to, though, is that even this spring, summer and in the fall, when millions of us will have been vaccinated, we will still be wearing masks and avoiding close contact until we know for sure that the vaccine actually prevents against transmission of the coronavirus as opposed to just protecting us from getting sick.

SIMON: Well, thank you all very much for the fine reporting you've been doing for us and for joining us this morning. Martha Bebinger from WBUR in Boston, Blake Farmer at WPLN in Nashville and Jackie Fortier at KPCC in Los Angeles. Thank you all.

BEBINGER: Thank you, Scott. Transcript provided by NPR, Copyright NPR.

Martha Bebinge
Jackie Fortier
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