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R.I. House COVID-19 Vaccine Task Force hears from public health experts on vaccine distribution

Dean of School of Public Health Ashish Jha, former RIDOH Director Michael Fine, discuss expectations for equitable, efficient vaccine distribution

The new Rhode Island House of Representatives Task Force for COVID-19 Vaccine discussed vaccine distribution and prioritization in the state and the challenges that lay ahead during its first meeting Wednesday.

Members of the task force, which was created in response to representatives receiving numerous questions from their districts’ constituents on the distribution of newly developed COVID-19 vaccines, heard from former Rhode Island Department of Health Director Michael Fine and Dean of the School of Public Health Ashish Jha. 

Pfizer and Moderna, the two companies with the leading COVID-19 vaccines in effectiveness, have applied for authorization from the Food and Drug Administration for emergency use and will be reviewed in the next two weeks, Jha said. He expects approval of Pfizer’s vaccine by Dec. 10, with the first batch arriving in Rhode Island Dec. 11, and approval of Moderna’s vaccine by Dec. 18, which will arrive the following day. 

Between 10,000 and 60,000 doses of COVID-19 vaccines will likely arrive in December, and another 60,000 will be delivered to Rhode Island next month, Fine said. The shipment will account for the two shots required for a person to gain full immunization.

The Centers for Disease Control and Prevention has recommended that health care workers and nursing home workers and residents should be the first group to receive vaccines. “I generally am supportive of the CDC approach,” Jha said, adding that health care workers are needed on the frontlines, and nursing homes have “been hit so incredibly hard by this pandemic.” But he noted that states can determine how closely they follow the CDC’s prioritization guidelines.

Emergency medical technicians, like firefighters, have also been allotted to the first priority group and will be immunized at the same time as frontline healthcare workers, Fine said. 

According to CDC recommendations, education workers, such as teachers and school staff, are in the next group to receive vaccines, Jha said. 

Other members of the public fall into later prioritization groups. Specifically, Fine said he does not expect a vaccine to be ready for children for at least another three to six months since the current vaccine has only been tested on adults.

Building public confidence in the vaccine will also be a significant issue as some have raised concerns over the unprecedentedly rapid 10-month development of the vaccines, Jha said. “We have cut no corners — the scientific process by which this vaccine has been developed has been of the utmost integrity,” he said. 

Representatives raised questions during the meeting to confirm the vaccine’s safety and effectiveness for certain groups. Rep. David Place (R-Burrillville, Glocester) cited a survey of Americans in which roughly 40 percent of respondents said that they would not get vaccinated. 

Seventy percent of the state’s population will need to be vaccinated to achieve herd immunity — a rate of infection low enough that further vaccination will no longer be needed, Jha said. Those in the 40 percent who are hesitant would therefore need to be convinced of the value of the vaccine, he said. “If we speak with openness and transparency and let data drive these conversations, I remain hopeful that we can get to 70 or 80 percent.” 

Those who have been previously infected with the virus and may have protective antibodies are not being considered separately in the distribution process and will receive vaccines according to the priority group they fall under like everyone else, he added. 

“We have to be aware of the potential for more side effects than we know about now. The first two vaccines are said to have some level of small side effects for around 40 percent of people,” Fine said. These side effects, which include fever, tiredness and headaches, are similar to those observed from the flu vaccine, but reactions may be more severe for the new vaccines, he added. 

This may mean that those who are vaccinated will need to prepare to take two days away from work. One challenge is “designing systems to make sure (frontline workers) get immunized in phases so they’re not all immunized at once (and) that they’re available to work,” Fine said. 

The FDA may also request a pause in vaccinations to study unforeseen side effects, which could slow distribution, he added.

Consideration of financial barriers and equitable access to the vaccine should be another large focus in distribution planning, according to Jha and representatives at the meeting. “We have to make sure that the communities and individuals who are most vulnerable, who have been hit hardest, are not left behind in this process,” he said.

Fine said he hopes that densely populated communities, such as the city of Central Falls, will be prioritized. Dense population has been correlated with high infection rates due to residents needing to work in person and living in close proximity to others, he said.

To assemble the COVID-19 vaccine task force, House Speaker-nominee K. Joseph Shekarchi (D-Warwick) chose a broad group of representatives who had expressed interest in participating and who had relevant experience, he told The Herald. For example, task force member Rep. Kathleen Fogarty (D-South Kingstown) previously worked as a pharmaceutical saleswoman for vaccines. 

Rep. Carol McEntee (D-South Kingstown, Narragansett) serves as the voice for many small businesses in her district that want information on mandatory employee vaccination, while Rep. Karen Alzate (D-Pawtucket) can speak to the state’s Spanish community as a bilingual figure, Shekarchi added. 

During the meeting, Jha shared a grim outlook on the pandemic in its current stages but expressed optimism of a much improved situation by next summer if the state follows the strategy developed by the CDC and the RIDOH. 

“We are probably in the darkest days of the pandemic,” Jha said, citing the continued rise in infections and crowding of hospitals in Rhode Island and across the country. The next six to eight weeks will be difficult, he said, and people need to follow public health measures, such as mask-wearing and avoiding indoor gatherings, to keep infection rates as low as possible. 

Shekarchi, who is immunocompromised as a Type 2 diabetic, said that he would receive the vaccine as soon as it becomes available to his priority group. Jha and task force chair Rep. Raymond Hull (D-Providence, North Providence) also said that they would get vaccinated to show support for the vaccine’s legitimacy. 

“We as a state can … really show the country how to do this in a way that's efficient, that's fast, but highly equitable, and we've got the right mix of leadership to do that,” Jha said in his concluding remarks.

The House COVID-19 Task Force is scheduled for two more virtual meetings this month and plans to continue meeting next year, according to a Dec. 1 press release. The upcoming meeting on Dec. 9 will hear from representatives from Pfizer — which chose Rhode Island as one of four states to participate in its pilot immunization program, The Herald previously reported — and Woonsocket-based CVS, which will help distribute the vaccine. The task force will then meet with the RIDOH Dec. 16 to discuss the state’s vaccination plan. 

All meetings will be open to the public in the interest of transparency, Shekarchi said. 

The goal of the new task force is “really about information,” he said. “Getting it, giving it to the people (and) figuring out what the best practices are so we can move forward and distribute the vaccine as quickly as possible to as many people who want it as possible.”

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