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IOWA CITY - As soon as next week, University of Iowa Health Care expects to be administering doses of the game-changing COVID-19 vaccine to its front-line workers, and campus leaders said Wednesday they're finalizing logistics to ensure they're ready.
'We expect to receive at UI Health Care, relatively imminently, doses of the Pfizer vaccine, assuming there is emergency use authorization,” UI Hospitals and Clinics Chief Executive Officer Suresh Gunasekaran told reporters. 'We have been planning for over months to be ready to distribute this in a fast and efficient way for our employees.”
In that health care workers are among the Americans prioritized to receive the first vaccine doses - but initial supplies are going to be limited - UIHC has broken its 18,000-some employees into four groups for vaccine prioritization, Gunasekaran said.
The first group of about 1,500 to 2,000 employees includes physicians, midlevel providers, nurses, therapists, housekeepers and others who are most directly involved in patient care.
The second group covers those supporting patient care on the main campus, while the third group involves workers supporting patient care off-site and at clinics.
The fourth group includes all other UIHC staff involved in supporting health care delivery - but who are not on the front lines.
UIHC leaders don't yet know exactly how many doses the campus will get in its first shipment - although Gunasekaran estimates about 1,000.
'We are going to finalize the numbers probably over the next couple of days with (the Iowa Department of Public Health),” he said. 'Right now, we're being told we will only be told one week at a time how many doses that we're getting.”
Gunasekaran said logistics around administering this specific vaccine are seemingly endless - considering it must be stored at ultracold temperatures requiring specialized freezers, which UIHC ordered months ago to be ready.
'You have to figure out how to get everyone into a central location, and how we dose it is very different,” Gunasekaran said. 'Once you thaw it and start using it, you have very little time - just a few hours if you will - to get all of that vial used. So when we're looking at the logistics, there's been a lot of planning that has gone into this.”
Should doses become more available, he said, UIHC storage space shouldn't be a problem.
'We could store a lot,” he said. 'We could store more than 50,000 doses easily.”
Even with other vaccine candidates coming down the pike - with a Moderna version close behind Pfizer's - UIHC Vaccine Treatment and Evaluation Unit Director Patricia Winokur told reporters Wednesday that 'storage capacity is not going to be the limitation. The limitation is going to be how much vaccine we get.”
The U.S. Food and Drug Administration on Thursday will livestream its final review needed to authorize Pfizer's vaccine for emergency use. The United Kingdom took that step last week, as did Canada on Wednesday.
But even after Americans begin receiving vaccine - including Iowans and UIHC employees - Winokur warned two doses spaced weeks apart are required for 95 percent efficacy. That means everyone should continue masking, social distancing and taking other precautions for some time.
'After the first dose, the efficacy is only about 52 percent between the first and second dose,” she said. 'So there is still going to be a need for the people who have been vaccinated to continue to maintain social distance and masking.”
Researchers also don't know yet whether the vaccine reduces shedding of the virus.
'We know that it reduces the number of cases of symptomatic COVID-19,” she said. 'What we need to learn more about is whether it truncates transmission from person to person.”
UIHC isn't at this time requiring employees get vaccinated, although Gunasekaran said they'll be strongly encouraged.
'They will be required to give us their vaccination status, i.e. whether they have received the vaccine or they declined,” he said. 'But, at this time, we will not be making them, which is our usual practice - even for flu.”
Still, Gunasekaran said, getting UIHC employees vaccinated serves multiple purposes - including modeling to the community and ensuring its capacity to continue serving it.
'We have to manage the message to our staff and hope that our staff will be role models to the broader community that this is a vaccine that we think we should take,” he said. 'We think that it will create stability within UI Health Care so we can know that we will have the clinical teams that are necessary to take care of Iowans through the rest of this pandemic.”
UIHC last month saw its highest COVID-19 hospitalizations to date - nearing 100 in mid-November. Those numbers have ebbed down to about 50 patients this week. But Gunasekaran and Winokur noted that leveling off is a plateau - not a decline. And a high plateau at that, meaning the public also shouldn't expect to be free of the advisement to wear a mask and socially distance any time soon.
'It's encouraging to have seen the plateau,” Winokur said. 'But I think the global picture is that the plateau is still way too high. … And we're not going to have enough vaccine available quickly to start releasing the usual recommendations of face masks, hand washing, and social distancing.”
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