Local health officials face challenges with eventual deployment of COVID vaccine

With health experts predicting a COVID-19 vaccine will likely become available in limited quantities by the end of the year, Flathead County health officials are busy planning for how they will navigate various challenges associated with the mass deployment of the prospective immunization.

On Monday, two companies that partnered earlier this year to create a COVID-19 vaccine announced preliminary test results showed their two-dose product is more than 90% effective.

According to a joint press release from the companies, Pfizer and BioNTech, nearly 44,000 participants enrolled in their clinical trial and of those individuals, half received the vaccine and the other half received a placebo. Thus far, only 94 participants have contracted the virus.

The promising news came a few weeks after the Montana Department of Public Health and Human Services (DPHHS) submitted a draft of its statewide COVID-19 vaccination plan to the Centers for Disease Control and Prevention. The three-phase plan would roll out over the course of several months, beginning when the state receives its initial shipment of the vaccine.

The ambitious plan will require close collaboration with local health departments. And according to the Flathead City-County Health Department’s Deputy Health Officer Kerry Nuckles, although coordination details are still coming together, some aspects of the plan, including who will receive the first vaccines and what measures will be required of the health department, are becoming more concrete.

For example, Nuckles said the “first tier to receive the vaccine” includes health-care workers, long-term care patients and other high-risk populations over the age of 65.

Beyond priority groups, Nuckles said the health department is anticipating needing additional equipment considering this particular experimental vaccine would need to be stored at extremely low temperatures.

Pfizer and BioNTech’s immunization needs to be kept at minus 70 degrees Celsius — a temperature that requires specific, costly equipment that is not readily available in many rural hospitals and health departments across the United States.

According to one August report from the CDC, reaching rural areas will be a major challenge for equitable administration of the COVID-19 vaccine. In other words, urban hospitals that often boast larger budgets are the ones that most likely will have greater access to the vaccine.

Aside from investing in additional equipment, Knuckles said one of the biggest needs is appropriate staffing — an issue that has plagued the health department since the pandemic first emerged in Montana. She said the task of vaccinating an entire county will further strain overburdened staff who are focused on case investigations.

“Current nursing staff at FCCHD are managing the more complex COVID outbreaks including [those in] long-term care facilities. It’s a judgment call for how much staff capacity within FCCHD should be dedicated to vaccinations and how much to managing outbreaks,” Nuckles said in an email. “We also have to keep on top of all other communicable disease investigations and promote influenza vaccinations simultaneously.”

Nuckles said two additional nurses are joining the health department’s immunization program and two former nurses are returning to assist with various tasks. In addition, Kalispell Regional Healthcare and other partners throughout the valley are looking into ways they can assist with immunizing patients.

EQUIPMENT AND staffing concerns aside, one major obstacle to be addressed is Flathead County’s troubling immunization rates.

In recent years, more and more individuals have opted out of receiving the annual influenza vaccine as well as other communicable disease immunizations.

For example, last August, the health department announced the overall vaccination rate for kindergarteners from 2018 to 2019 was 87.7%, which was down from 91.3% from 2017 to 2018.

In addition, the measles, mumps and rubella vaccination rates in all local schools was 92.6%, down from 93.7% from the previous year. The rates were the subject of a press release in which the health department stated that, as a whole, Flathead County’s population of young students was “not sufficiently protected” and thus, at risk for a measles outbreak.

“Flathead County has seen increased vaccine hesitancy over time,” Nuckles acknowledged. “The best way we can address this is by talking to patients one-on-one and addressing their specific concerns. Our public information officer also works to promote accurate information about vaccines.”

Health experts say a 95% vaccination rate is needed in order to slow the spread of communicable diseases and protect those in the community who are most at-risk for contracting such diseases. But Montana allows religious exemptions for students, which has been a major contributing factor as to why it is difficult for certain areas to reach 95%.

WHILE IT is currently unclear how Flathead County’s immunization trends will translate over to the number of locals who will get on board for the COVID-19 vaccine, results from national surveys suggest a large portion of adults in the U.S. has concerns about the safety and effectiveness of a possible vaccine.

According to a September Pew Research Center study, only about half of 10,092 U.S. adults surveyed by the organization said they would “definitely or probably” get a vaccine if it were available at that time. That percentage was a far cry from the results of a separate survey performed several months earlier in May, in which 72% of U.S. adults said they most likely would get the vaccine, had it been available then.

A September article from Pew states, “concerns about side-effects and uncertainty around the effectiveness of a vaccine are widely cited as reasons by those who would not get a COVID-19 vaccine if one were available today.”

And in the case of communicable diseases, when a large portion of individuals in a given community are not vaccinated, those diseases are more likely to spread in those areas and the impacts of that spread could be widely felt in schools, hospitals and elsewhere. This will most likely be the case for the COVID-19 vaccine as well.

“The more people who receive the vaccine, the better we can prevent COVID-19 transmission in the community,” Nuckles said. “High vaccination rates will help us prevent outbreaks and keep vulnerable community members safe.”

Nuckles said in the meantime, while state and local health officials focus on how a COVID-19 vaccine can be widely administered, Flathead County residents can focus on getting their annual flu vaccination.

According to a Thursday press release from the health department, everyone 6 months of age and older should get the vaccine, which is available by appointment at the Flathead City-County Health Department Immunization Clinic or at other community clinics, pharmacies and health-care providers.

“Getting an annual flu vaccine is the best way to protect yourself from the flu,” Jillian Boll, an immunization nurse at the health department said in a prepared statement. “Each year, the flu vaccine is updated to match the viruses that are expected to circulate during that season. That is why it is so important to receive a flu vaccination every year.”

While seasonal influenza can occur year-round, cases are most common during the fall and winter. During the 2019 to 2020 season, there were 1,203 confirmed cases of influenza in Flathead County and 45 cases that required hospitalization.

Those who are at higher risk of developing serious flu complications include individuals 65 years of age or older, children younger than 5, people with weakened immune systems and pregnant women.

Reporter Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com