COVID-19 vaccine: What we know (and don't know) about New York plan to end pandemic
A series of revelations surrounding New York’s plans for rolling out the first 510,000 doses of COVID-19 vaccine in December stirred echoes of scientific triumphs over infectious diseases throughout history.
But many details about distributing millions of additional doses remain unclear, underscoring why the entire nation is far from declaring victory over the coronavirus as it spreads rapidly across the U.S, adding to the death toll of more than 292,000 Americans.
From politically charged battles over governmental funding for immunizations to overcoming vaccine hesitancy, the dire push to end the pandemic is expected to continue until June, perhaps stretching into early fall 2021, before enough people get vaccinated to reach herd immunity, experts and authorities said.
“This is the weapon that wins the COVID war and we have to get serious about this,” Gov. Andrew Cuomo said recently, displaying mock COVID-19 vaccine doses developed by Pfizer and BioNTech.
“The distribution is a massive undertaking by government. It has to be fair, it has to be equitable and the state has to have funding to do it,” he added, referring to immunizations expected to begin this month, pending Food and Drug Administration approval.
Against that backdrop, USA TODAY Network New York analyzed records and questioned health officials about the vaccination effort, revealing new details about what is publicly known and what remains unclear about state officials’ strategy for vaccinating New Yorkers.
How many COVID vaccine doses your region will get in NY
The initial COVID-19 vaccine shipments could flow to 90 different cold-storage sites in New York in coming days, launching the historic push to immunize thousands of nursing home residents and workers.
The majority of the initial shipment of 170,000 Pfizer/BioNTech vaccine doses will go to New York City and Long Island, with the regions receiving 72,000 and 26,500 doses, respectively, Cuomo said, adding the distribution is based on the number of nursing home residents and health care workers.
The regional breakdown of remaining doses included 19,200 for the Mid-Hudson, 11,500 for the Finger Lakes (which includes the Rochester area), 4,500 for the Southern Tier and 4,200 for the Mohawk Valley.
State officials said the initial shipment will result in 170,000 New Yorkers being vaccinated, noting each person will receive a second dose as required within the following 21 days.
New York expects to receive another 346,000 doses of a COVID-19 vaccine developed by Moderna by the week of Dec. 21, pending Food and Drug Administration emergency use authorization.
State officials said that is enough vaccine for 346,000 New Yorkers, noting they will receive a second dose as required within the following 28 days.
How do NY’s COVID vaccine shipments compare to other states
Federal officials expect to distribute about 40 million doses of COVID vaccine by the end of December, enough to immunize 20 million people because each person requires two doses.
“Having substantial quantities of a safe and effective vaccine that’s been authorized by FDA before the end of the year is a remarkable achievement, and it will start saving lives very soon,” Health and Human Services Secretary Alex Azar said Wednesday.
The vaccines will be distributed to states based on population, meaning New York’s share of the overall December shipments could be close to 2 million doses, or enough to vaccinate its health care workers and nursing home residents.
Florida, for example, is expecting up to 2 million doses in December, according to media reports from that state, which has 21.5 million people compared to 19.5 million in New York.
Other COVID-19 vaccines, including candidates developed by AstraZeneca/Oxford and Johnson & Johnson, are expected to pursue FDA approval in 2021, which would greatly expand the number of doses being shipped to states.
Who gets the COVID-19 vaccine first in New York
New York’s initial shipment of 170,000 doses by mid-December consists of the vaccine produced by Pfizer/BioNTech, pending FDA emergency use authorization.
The companies have reported the vaccine is 95% effective and ongoing review of the data has not reported any serious safety concerns. In addition to the first shipment, New York expects to receive another 170,000 doses within 21 days to meet the two-dose requirement.
The initial shots will go to nursing home residents and staff, state officials said, citing the fact that frail and elderly New Yorkers in long-term care facilities are most vulnerable to COVID-19, the respiratory disease caused by coronavirus.
Additional shipments of yet to be determined size are expected of Pfizer/BioNTech vaccine as well as doses of the Moderna vaccine, which has reported to be 95% effective.
The vaccination effort will exclusively focus on reaching as many of the 210,000 total nursing home residents and staff as possible before the effort expands into other groups, state officials.
Cuomo said New York will opt-in to the federal government program that handles all COVID-19 vaccinations in nursing homes, referring to the federal partnership with CVS and Walgreens to conduct the immunizations.
After nursing homes, the New York vaccination effort will focus on high-risk health care workers on the frontline of the battle against COVID-19, such as emergency room and intensive care staffs.
Hospitals will be identifying which members of this high-risk group get vaccinated first based on state guidelines, Cuomo said.
After nursing homes, front-line health care workers and people in other congregant settings, such as adult care facilities, will be receiving priority until enough vaccines arrive for other essential workers, such as public transit and grocery store workers.
There are about 904,000 health care workers statewide and 90,000 nursing home residents, state records show. That means about 17% of that pool could be covered though the initial 170,000 vaccinations.
When will most New Yorkers get COVID-19 vaccine
After the initial focus on health care and front-line essential workers, the priority shifts to New Yorkers above age 65 and people with underlying health conditions that make them more susceptible to COVID complications and death, such as cancer and lung disease.
Federal officials this week detailed plans to vaccinate the most high-risk populations across the country in early 2021.
“End of February, we will have potentially immunized a 100 million people, which is really more or less the size of the significant at-risk population; the elderly, the healthcare workers, the first line workers, people with comorbidity,” said Dr. Moncef Slaoui, chief scientific adviser to Operation Warp Speed, the federal vaccination program.
If successful, it could begin to turn the tide of pandemic battle considering about 90% of New York’s deaths had at least one underlying condition, and 85% of fatalities were age 60 and above, although the virus has caused serious illnesses in all ages.
Lastly, New York’s plan calls for vaccinating other essential workers not regularly interacting with the public, followed by healthy adults and children.
The vaccination of children, however, is expected to be delayed until later in 2021 because clinical trials just recently started including the age group, which is less likely to have severe COVID cases.
In October, for instance, Pfizer became the first one to lower the age of participation in its trial to 16.
How will New Yorkers receive COVID vaccination
Many details about vaccination sites remain unclear in New York amid political clashes between Cuomo, a Democrat, and the Republican Trump administration over governmental funding for the effort.
For example, state officials are tasked with enrolling doctor’s offices and clinics in the federal COVID vaccination distribution program, but the state Department of Health would not answer USA TODAY Network questions about the effort.
In other words, New Yorkers remain in the dark about key vaccination site details with initial deliveries just days away.
The state’s draft vaccination plan in October indicated hospitals, pharmacies and other medical offices will be providing vaccinations, as well as mass vaccination sites similar to COVID testing locations. Schools, businesses, colleges and other sites could also be included in the effort.
Further, the state Department of Health declined to say where the vaccine may be housed, citing safety concerns.
“To ensure the security of vaccine supplies and participating locations, as well as the safety of facility staff, at this point, we are not releasing any information that could identify the specific sites that will be used to pre-position the COVID-19 vaccines," the agency said in a statement.
Cuomo said the state is developing plans for identifying vaccination sites in the community for the general public, which could begin in late January or February.
How will government fund COVID vaccination effort
Meanwhile, Cuomo has asserted inadequate federal funding could hinder New York’s vaccination effort, suggesting state government needs $1 billion for outreach, education and other costs.
But General Gustave Perna, chief operating officer of Operation Warp Speed, said on Wednesday that the vaccination-related cost burden for states will vary based on specifics of the distribution plan.
For example, federal government can deliver doses directly to providers enrolled in the vaccine program or locations designated by the state under a hub-and-spoke model, Perna said, noting different approaches carry varying costs to the federal and state governments.
Federal government has provided states with $200 million for vaccination efforts this fall, with another $140 million being distributed this month, Perna said.
It is difficult to address the vaccination-related costs for New York, however, without further details about its plan.
Centers for Disease Control and Prevention Director Robert Redfield has stated Congress needed to allocate $5.5 to $6 billion to the states for the vaccine distribution, according to New York state’s draft vaccination plan. New York had received about $7.8 million by late October.
Will COVID vaccine reach communities of color
In addition to the funding debate, Cuomo has issued letters urging federal officials to eliminate a requirement that states sign a data sharing agreement before commencing the vaccination program.
The agreement "requires identification of each person who is vaccinated - the federal government suggests that states use Social Security numbers, driver's license identification numbers, or passport numbers to fulfill this requirement," Cuomo wrote in a letter to Azar on Tuesday.
Cuomo has expressed concern the information could be used by other non-health related federal agencies such as the U.S. Department of Homeland Security or Immigration and Customs Enforcement to pursue deportations.
"If undocumented Americans are dissuaded from participating in the vaccination program, it would jeopardize both their health and the efficacy of the entire vaccination program," the letter stated.
White House officials, however, disputed Cuomo’s claims, asserting federal officials are not seeking social security numbers, driver license numbers or passport numbers. Rather, the plan seeks minimal personal information to ensure people receive the appropriate second vaccine dose, officials said.
In the letter, Cuomo also urged Azar to provide states with additional funding for vaccination efforts in communities of color.
"This has to be an inclusive process," Cuomo said this week, addressing concerns about inequitable vaccine distribution.
"The Black, Brown and poor community has paid the highest price for COVID. Why? Because it exposed an inherent discrimination in our health care system," Cuomo said, adding he will not enhance and aggravate the discrimination by hindering access to the vaccine.
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