The state Department of Health’s immunization chief told lawmakers Thursday that a statewide plan for COVID-19 vaccinations should be ready for public review early in December.
A draft vaccination plan the state submitted last month to the U.S. Centers for Disease Control and Prevention used a working date of Jan. 1 for coronavirus vaccine availability. Ronald Balajadia told the House Health Committee the actual date a vaccine will be rolled out “is still unknown.”
Balajadia said the plan was taken to 150 individuals representing 90 organizations statewide to “see if we hit the right notes” and to make sure the plan is “Hawaii-specific.” Balajadia called neighbor island input “really critical” to coming up with a successful plan for distribution of vaccine once one becomes available.
“Right now, we’re currently conducting these outreaches to our stakeholders. They’re reviewing all the documents and then they’re providing the input to this … ,” he said. “There’s so much unknown still as we move forward in this process, and we’re just taking information from the federal government as … they provide them to us, and then, we’re adapting that and including that into the plans.”
Clinical trials of vaccines by two American pharmaceutical companies, Pfizer and Moderna Inc., are in phase three to assess their safety and effectiveness. Both have a two-dose protocol, with Pfizer’s vaccine administered with a 21-day interval and Moderna’s a 28-day interval.
The most promising of the vaccines require storage in ultra-cold temperatures of about minus-70 degrees Celsius, which is minus-94 degrees Fahrenheit.
“The most important thing is ensuring that the vaccine that we get is properly kept in its cold chain so that it’s viable from production to administration to the individual,” Balajadia said.
The plan does call for administration by hospitals, community health centers and by mobile teams that bring vaccinations to remote areas and to individuals who can’t leave their homes, but as an Oct. 25 Associated Press story notes, “maintaining the cold chain for coronavirus vaccines won’t be easy, even in the richest of countries.”
“Investment in infrastructure and cooling technology lags behind the high-speed leap that vaccine development has taken this year due to the virus,” the story states.
The state plan has several tiers as to whom will receive the vaccination first — with hospital and health care workers being the first priority, followed by first responders, patients in nursing and long-term care facilities, and then those older than 65 and with health conditions that make them more likely to have a poor outcome should they be infected. Those groups would be vaccinated before the general public.
Balajadia said DOH is “looking for 60-70% of our population to get vaccinated” to achieve “the community immunity that we want for Hawaii.”
He added the time frame for public immunizations would be “dependent on the number of doses that are available.”
“That is the limiting factor for a lot of these operations,” he said. “… We also know that … there’s a lot of people that are hesitant in wanting to get vaccinated, so that’s going to play a significant factor in how we roll out and how we get to that 60-70% that we would like for the state.”
Thursday’s briefing was streamed on Facebook Live, and most of the comments were from vaccination opponents — some who accused the state of trying to poison the population, as well as some who postulated the vaccinations, when made available, will be made compulsory by authorities — accusations the lawmakers denied.
The economic downturn during the pandemic has had a negative impact on state tax revenues, and Rep. Bertrand Kobayashi, an Oahu Democrat who also sits on the House Finance Committee, asked how vaccine distribution will be paid for.
“There is currently, right now, as far as we know, no cost to the patient, and a provider that’s vaccinating can submit for administrative costs to Medicaid and Medicare and/or their insurance, and then they will be compensated for the administration of the vaccine,” Balajadia said. “But the vaccine is provided by the federal government without any cost.”
In a follow-up online media conference, Rep. John Mizuno, an Oahu Democrat and the committee chairman who will become vice speaker in the 2021 legislative session, said he has logistical concerns.
“How do you have these mobile units go out to those rural areas so some of our people in those areas can get vaccination?” Mizuno mused. “And one of the critical areas was the storage. You heard it was 80 degrees below, minus, Fahrenheit it needs to be? So, how do you make sure the vaccination’s still viable if I’m going out to Puna or some other places in rural areas?
“So there’s still a lot of questions and concerns about rolling out the vaccination plan, but we’re hoping we can come up with some really good solutions for this.”
Email John Burnett at firstname.lastname@example.org.