COVID-19 vaccine circulating in county bloodstream

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Dallas County EMS Director Mike Thomason, left, vaccinates one of the 46 health care workers treated in the Dallas County Public Health Department's first phase 1-A clinic Dec. 22.

The Iowa Infectious Disease Advisory Committee classifies health care workers eligible for vaccination in the phase 1-A into some 25 categories of service.

In the 17 days since the COVID-19 vaccine arrived in Dallas County, the preventative shots have started circulating among the 100,000 county residents, first among health care workers and residents of long-term care (LTC) facilities.

Abigail Chihak, community health administrator in the Dallas County Public Health Department, said her department if administering phase 1-A vaccinations in conformity with guidance from the Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC) and the  Iowa Infectious Disease Advisory Committee (IDAC) of the Iowa Department of Public Health (IDPH).

“We will be moving through the phases together as a state,” Chihak said. “How quickly we move through the phases will depend on vaccine supply and is very tentative at this point.”

According to Washington Post data, Iowa has been allocated 217,723 doses statewide, enough to vaccinate 100% of the phase 1-A population, and 74,224 doses have so far been administered, which is about 30% of the prioritized population.

Chihak said the IDPH has not yet provided guidance on phase 1-B, but phase 1-B will begin once everyone eligible under phase 1-A has been vaccinated and when the county has a sufficient supply of vaccine for phase 1-B.

According to the ACIP guidance, phase 1-B will take in people aged 75 and older and frontline essential workers, and phase 1-C will vaccinate persons aged 65–74 years, persons aged 16–64 years with high-risk medical conditions and essential workers not recommended for vaccination in phase 1-B.

Phase 2 will include all other persons aged 16 and older who were not already recommended for vaccination in phases 1-A, 1-B or 1-C. The timelines for the phases is still very provisional, Chihak said.

“Our speed will depend on the amount of vaccine that is allocated to us,” she said. “Nothing is set in stone, but we hope to be entering other phases by spring and get to the general public by summer or fall. The IDAC is currently working on defining phase 1-B. We hope to see their recommendations by the end of the month.”

Forty-six health care workers received their first round of shots Dec. 22 in the first vaccination clinic held by the Dallas County Public Health Department. A “super rough estimate” of 3,000 to 4,000 health care workers live in Dallas County, according to Abigail Chihak, community health administrator in the Dallas County Public Health Department.

“This number is probably a low estimate once you include all the support staff needed in direct patient care,” Chihak said.

The vaccine received by the Dallas County Public Health Department during initial distribution was produced by Moderna Inc., according to Ann Cochran, health navigation coordinator in the Dallas County Public Health Department.

On the LTC side, all the facilities in Dallas County have joined the CDC’s Pharmacy Partnership for Long-Term Care Program, under which three national pharmacy chains — Walgreens, CVS and Community Pharmacy — provide distribution logistics and staff to administer free vaccines to residents and workers at LTCs.

“All of our long-term care facilities will be vaccinated through the federal pharmacy partnership program,” Chihak said. “The state and pharmacy partners are directly handling the long-term care program. Their vaccine supply does not come from our county allocation.”

There are about 489 licensed LTC beds in Dallas County, but the current number of LTC residents is unknown. The number of LTC workers in Dallas County was estimated at about 1,000 in May, when surveillance testing was offered. The LTC facilities in Dallas County include:

  1. Adel Acres in Adel
  2. Arbor Springs in West Des Moines
  3. Edgewater in West Des Moines
  4. Granger Nursing in Granger
  5. Legacy Pointe in Waukee
  6. Pearl Valley Nursing and Rehabilitation in Perry
  7. Perry Lutheran Homes in Perry (3 campuses)
  8. Spurgeon Manor in Dallas Center

LTC vaccinations started Tuesday in Perry, when more than 100 residents and workers at the Perry Lutheran Homes were vaccinated, with CVS providing doses of the Pfizer vaccine in an onsite clinic. Other Dallas County LTCs are also giving shots.

“I have seen that many have already had their first round of shots in our county,” Chihak said. “It is hard to know exactly how many people in this phase that we will vaccinate as the vaccine is not required, but anyone eligible in this phase that chooses not to receive it now can always receive it at a later point should they change their minds.”

The CDC expects the Pharmacy Partnership program to continue onsite for about two months. After the initial phase of vaccinations, facilities may continue working with the federal pharmacy partner they were matched with or shift to another pharmacy enrolled within the jurisdiction, according to the CDC.

IDPH Director Kelly Kennedy Garcia estimated in November that there should be enough vaccine available by mid-2021 for anyone who wants to receive it.

“We hope that by the time we get to mass vaccination events,” Chihak said, “that we will be able to do this through a variety of community partners in order to avoid mass gathering. People should be able to make an appointment with their doctor’s office, pharmacist or occupational health provider. We will likely continue clinics at our office as well. If the county fairgrounds or other site is used for mass vaccination, it will likely be much like the TestIowa site set up where people come by appointment. We will make sure it is posted widely once we get to that point.”

In the meantime, Dallas County residents are encouraged to continue with the standard mitigation practices.

“We highly encourage everyone,” Cochran said, “regardless of vaccination status, to continue wearing a mask in public spaces, distancing 6 feet from those outside your household, washing hands frequently and staying home when sick. By using a layered public health strategy, we can get control of this pandemic, reduce illness and prevent serious complications and deaths.”

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