State issues plan for distributing covid-19 vaccine; only 24% in self-selected Sept. survey in Anderson County said they'd take it

Pfizer's vaccine is in clinical trials. (Photo by Marco Bello, Reuters)

By Melissa Patrick

Kentucky Health News

The state Department for Public Health has issued its draft plan for distributing a covid-19 vaccine, when it becomes available, that addresses everything from who can get it first to how it must be stored. It also recognizes that "a portion of the U.S. population may hesitate to receive a covid-19 vaccine."

To address this hesitancy, the plan says the state health department is working with external partners on a statewide survey to help better understand Kentuckians attitudes about the vaccine. The survey results will help the agency develop appropriate messaging and delivery mechanisms for the public and providers, with the goal of increasing vaccine uptake.  

The chief spokesperson for the Cabinet for Health and Family Services, which includes the health department, told Kentucky Health News that it is too soon to do a survey, largely because there are still too many unknowns.  

"Until we’re in a position to provide detail about the vaccine, which might include efficacy, benefits and risks, from where it’s sourced, specifics about associated clinical trials, etc., we believe a survey is premature," Susan Dunlap said in an e-mail.

Dunlap was asked for comment after The Anderson News reported that the Anderson County Health Department did a survey to see how many doses of vaccine it would need and found that only 24 percent of the county’s residents said they would get a covid-19 vaccine when it is offered.

More than half of those surveyed, 56%, said they would not take the vaccine and the remaining 20% said they were unsure. The survey, taken Sept. 15-29 with the newspaper's Survey Monkey account, got responses from 450 households with 1,400 people.

Invitations to participate in the survey were titled "Covid-19 Vaccine Survey," so it could have been more attractive to people with stronger feelings about the topic that a random-sample poll would have been.

Daniel Miller, the health department's preparedness planner, said the agency did the survey because the federal government had asked states to be ready for vaccine distribution by Nov. 1. "If I've got 5,000 people that say they're going to take it versus 15,000 people, that's going to change plans a lot," he said. 

Last week the apparent front-runner in developing a U.S. vaccine, Pfizer Inc., said it did not expect to apply for emergency-use authorization before Nov. 15. The health cabinet's news release says "the first shipment of the vaccine is anticipated for delivery in late 2020 or early 2021" from the U.S. government. 

Miller said the health department had expected about half of the county would take the vaccine, which would have lined up with a recent national poll. A Gallup Poll taken in late September found 50% of Americans said they would be willing to take it, an 11-point drop from the 66% who said they'd take it in the August poll.

At the time, there was concern that President Trump would try to get the vaccine approved before the Nov. 3 election. Miller said he thought many Anderson County residents who still hadn't decided to get the vaccine were likely waiting until more is known about the safety and efficacy of it. 

Anderson County (Wikipedia map)

"People just want to know that it's safe before they start taking it," he said. "That's probably the biggest thing I am dealing with."  

Anderson News Editor-Publisher Ben Carlson offered another possible reason in his story: "The lack of people willing to take the vaccine may also be linked to an ongoing decline in the number of Anderson County residents who shun vaccines, including the flu vaccine, in general."

Carlson noted that 53 percent of the county's residents got a flu vaccine in 2012, but that number has declined each year since, with a current rate of 45%, which mirrors the rest of the state. 

Miller told Carlson that at this point the health department plans to order enough vaccines for 25% of the county's population, which would be 5,750 out of about 23,000.

He said he'll do another survey if needed, but, "I don't really expect it to change much." He acknowledged that there is a huge window for when the vaccine could become available, but said, "I still have to be prepared." 

For example, he said the health department has to plan for additional administrative and health-care staff  to document and administer the vaccine, and has only four registered nurses on staff; it will have to purchase a medical-grade refrigerator and freezer to store the vaccine; and will need to plan for drive-through vaccine clinics, perhaps in the middle of winter. 

Under his current computation, Miller said his health department will need upwards of $40,000 for equipment alone and that he still needs a firm commitment for how it will all be funded. 

"I'm looking at $10,000 just for a refrigerator and a freezer large enough for our little county," he said. 

He added that regional health department coordinators are working to find ways for health departments to work together. "It's a big puzzle and the pieces aren't fitting together yet," he said. 

The state's plan fills in some pieces of that puzzle, including a "detailed plan for how states should distribute the vaccine, once all safety trials are completed."

The federal government has funded rapid development of covid-19 vaccines. Johnson & Johnson's clinical trial was paused recently due to an unexplained illness in a study participant, Matthew Herper reports for Stat. On Sept. 8, AstraZeneca and Oxford University paused their studies because of a suspected adverse reaction in a patient in the United Kingdom.

Health Commissioner Steven Stack said the state plan's first phase would deliver the vaccine to "certain health care workers and first responders" in every county. 

“Supplies of the vaccine will be limited, at first,” he said. “This is the reason for a phased distribution approach. As supplies of the vaccine rise, all Kentuckians are expected to have access,” but getting it to all Kentuckians who want it will likely take a year or more, he added.

While waiting on the vaccine, Kentuckians should continue social distancing of at least six feet, keep their hands clean, and "signal support for a practice that can save lives by wearing a mask," the release said.

Kentucky's Covid-19 Vaccination Plan is posted at kycovid19.ky.gov, under "Healthcare/Labs" guidance, and is subject to federal comment and state revision.