New Year Starts with Challenges of COVID-19 Vaccine Rollout

December 30th, 2020

By Melinda Young, Medical Writer

Like certain celebrities, the “vaccine” does not need a first name or modifier. Data from both Pfizer and Moderna have shown their COVID-19 vaccines to be nearly 95% effective in preventing disease in people who received two doses, thus earning a green light from the Food and Drug Administration. Other vaccines in clinical trials also are showing promising results.

Although vaccine doses have been distributed to all states, limited quantities will force states to prioritize those who should get the first doses.

Healthcare administrators should anticipate uncertainty in vaccine distribution, says Tinglong Dai, PhD, associate professor of operations management and business analytics, Johns Hopkins University Carey Business School, Baltimore, MD. Dai also is core faculty at Hopkins Business of Health Initiative.

Physicians, nurses, and healthcare workers in hospital intensive care units, emergency departments, and long-term care facilities are first in line to receive the COVID-19 vaccine. Other hospital workers and healthcare professionals in ambulatory settings also were expected to be in the first or second phase of vaccination.

Once employees receive a first dose of one particular vaccine, their second dose will need to be the same vaccine. They also will need to time vaccines appropriately to avoid waste because a batch was opened too long and needed to be discarded.

The Centers for Disease Control and Prevention (CDC) issued recommendations on how to prioritize the first phase of vaccination, but states were left to decide which healthcare workers would be vaccinated first and which might have to wait for later phases of vaccine rollout, maybe even different COVID-19 vaccines, as vaccine supplies run out.

“Healthcare workers interacting with patients are in the first prioritization by the CDC, and this will be endorsed by most states,” says Eli Rosenberg, PhD, associate professor in the department of epidemiology and biostatistics at the University at Albany School of Public Health, SUNY – The State University of New York in Rensselaer.

Hospitals could mandate that all employees who have direct patient contact become vaccinated, in the same way they mandate flu vaccination, Dai says.

Since it's unlikely there will be as many doses of vaccine available as needed through the winter of 2021, there could be a conflict between health system demand for vaccine and available supply. In addition, administrators will need to overcome vaccine hesitancy, a problem that arises when staff refuses to be vaccinated.

For more information on the COVID-19 vaccine, please see the February issues of Hospital Case Management and Case Management Advisor.