newsPolitics

7 things to know about how Texas intends to parcel out its limited supply of coronavirus vaccine

A panel of lawmakers, experts has chalked out which health care workers get the COVID-19 shots first. It now must say which essential workers, at-risk Texans go next.

AUSTIN — Texas has received $14.4 million from the federal government to help it prepare for distributing vaccines against COVID-19.

More than 3,800 health care providers and institutions in 226 of the state’s 254 counties have signed up to receive shipments of vaccine and administer the shots.

Throw in pharmacy chain locations, and there will be at least 6,300 sites across Texas where health-care professionals will be giving shots, possibly starting next month, state officials say.

But decisions on priority populations and public education are still being worked out, said Imelda M. Garcia, who is the top infectious-disease official at the Texas Department of State Health Services, under Dr. John Hellerstedt, the commissioner.

Garcia, associate commissioner over the Division of Laboratory and Infectious Disease Services, holds a master’s in public health from Columbia University and has worked for the state agency for more than 10 years.

Garcia, who grew up in El Paso, is chairwoman of the Expert Vaccine Allocation Panel, a group of four lawmakers, three medical education leaders, three local health department directors and seven state bureaucrats whom Hellerstedt asked last month to advise him on strategies and who should get the shots against COVID-19 first.

On Monday, the panel recommended seven standards that should guide distribution of what initially should be a limited supply of vaccine. It also put out a definition of the health care workers who it said should be at the front of the line.

Hellerstedt, an appointee of Gov. Greg Abbott, will make the final decisions.

Garcia spoke with The Dallas Morning News about how the effort’s shaping up.

1. How will this work?

Think of the federal government’s approach to vaccine distribution as two funnels into Texas – one through the Department of State Health Services and the other through the major pharmacy-store chains.

The feds will give vaccine to each. The chains have to report to the state who’s getting shots in their stores, so the department will have the complete picture, Garcia said.

Health care providers and institutions can sign up with the department here to be become COVID-19 vaccinators.

In Public Health Regions 2 and 3, a combined entity that stretches from Dallas-Fort Worth to Abilene and Wichita Falls, 842 providers had enrolled as of Monday. Of those, 250 were in Dallas County; and 176 in Tarrant.

One provider can be a large hospital system or a single physician.

“Data-driven allocations using the best available scientific evidence and epidemiology at the time” constitute one of the Expert Vaccine Allocation Panel’s guiding principles.

Could El Paso County, which as of Tuesday led the state in number of active cases, with about 37,000, be elevated to the very top of the list of places where people get the first doses, Garcia was asked. (Dallas County had the second-highest number of cases, about 19,500.)

“Vaccine efforts are more about prevention than about trying to stop an outbreak because it takes several weeks for your body to develop the immune response and that kind of stuff,” she said.

“So it’s not necessarily the best tool to immediately deploy, because it is going to take a while before you have a big enough cohort of people that would be vaccinated to actually really bring it down. But we do plan on using the latest ‘epi data’ in order to help feed into our decisions on vaccine allocations.”

2. Is it really free?

The federal government is providing vaccine to states and pharmacy chains, free of charge.

Health insurers and the federal government will absorb the cost of administering shots, Garcia said.

“Part of the federal guidance is that no copays will be charged to anyone, whether you’re insured or not” for giving the shots, she explained.

“The expectation is that insurance companies will cover the cost of the administration for insured populations, with no copay to the individual,” she said.

“And then for the uninsured, again, no copays will be charged to the individual -- and the feds have indicated there will be a separate pot of money that will cover those costs for the providers to seek reimbursement,” she said. “We haven’t heard any details about that yet.”

3. Are health care workers really going to take the vaccine – voluntarily?

According to government surveys and news reports, as many as half of frontline health care workers have said they do not plan to get the shots, at least initially.

That’s of great concern, especially in hospitals where employees risk the most exposure to the virus, Garcia said.

At least at first, the vaccines will be distributed under “emergency use authorization” by the federal Food and Drug Administration, she noted.

That makes them “completely voluntary,” Garcia said.

“Whether you’re a health care worker or work at a grocery store or whether you’re a teacher in a school, you will only be vaccinated if you want to be vaccinated,” she said.

The only vaccines health care workers can be required to take -- as a condition of employment -- are drugs that the FDA has fully licensed and approved, she said.

“We’re hoping that with some of the additional data that comes out with the FDA emergency authorization, that we have better information that we can share about the safety and the risk profiles [and] that we can help allay some of those concerns,” Garcia said.

There are about 1.6 million Texans who fit the definition of health care workers who should get vaccine first, the state estimates. They include hospital, nursing home, EMS, home health, outpatient care and community pharmacy workers, as well as school nurses and vaccinators.

4. When do stockers at grocery stores, delivery-van drivers and other essential workers get their shots?

Next week, the Expert Vaccine Distribution Panel will discuss a definition of essential, non-health care workers, Garcia said.

The guiding principles document released on Nov. 23 define them as “at greater risk of contracting COVID-19 due to the nature of their work providing critical services and preserving the economy.”

They and frontline health care workers are to be vaccinated in Phase 1 of a four-part distribution process, according to a plan the state sent to the federal Centers for Disease Control and Prevention last month. Prison and jail inmates and residents of homeless shelters, who are at risk because they live in crowded settings, were originally envisioned to be part of Phase 2, along with Texans compromised by acute health conditions, Garcia noted.

“But the panel could shift” some such Texans living in congregate settings into Phase 1, she said. “We haven’t had those conversations yet.”

The state has held back about $10 million of the federal planning money it received so that in Phase 2, it can hire “specialized vaccine teams” to reach vulnerable populations in rural and urban areas, she said.

5. Could white collar workers who are able to work remotely from their homes somehow jump the line?

Providers who enroll as COVID-19 vaccinators agree to follow the federal and state rules on which people should get first dibs on doses, Garcia said.

However, the state probably will have “no way of definitively proving” a provider has ignored the priority rankings, she said.

The department could withhold additional shipments if it learned of “egregious” behavior, she said.

6. Have you come up with a marketing slogan as memorable as “Don’t Mess with Texas?”

A public education campaign is in the works, and Garcia said the department has selected Austin’s Sherry Matthews Group to help devise a multimedia advertising effort that will include messaging to racial and ethnic minorities disproportionately affected by COVID-19.

Asked if there will be as catchy a line as the 1985 anti-littering slogan, devised by Austin ad agency GSD&M for the Texas Department of Transportation, Garcia replied, “I don’t know what that’s going to look like yet. It’s still in development. But we have not taken anything off of the table for consideration.”

7. Given that some of the vaccines require cold storage, how are you handling refrigeration?

Although a vaccine by Pfizer Inc. will require storage at extremely low temperatures -- as low as -112 degrees Fahrenheit -- the department has followed federal guidance and not rushed out to buy ultra-cold freezers, Garcia said. Pfizer is planning to package its vaccine in thermal wrappings that last up to 15 days, Garcia has explained.

Moderna Inc. has advised that its shot will remain viable for 30 days, even under regular refrigeration. And AstraZeneca and the University of Oxford, developers of a third vaccine moving quickly toward U.S. distribution under emergency authorization, have said it doesn’t need to be stored at subzero temperatures.

Should ultra-cold freezers be needed for other vaccines, though, Garcia said, the Texas Division of Emergency Management has bought some.

Robert T. Garrett, Austin Bureau Chief. Bob has covered state government and politics for The Dallas Morning News since 2002. Earlier, he was a statehouse reporter for three newspapers, including the Dallas Times Herald. A fifth-generation Texan, Bob earned a bachelor’s degree from Harvard University. He covers Gov. Greg Abbott, the state budget and CPS and foster care.

rtgarrett@dallasnews.com /bob.garrett.39 @RobertTGarrett
Politics

Get Political Points

Receive the latest political news delivered every Tuesday and Thursday from reporters in Austin, Dallas and Washington.

By signing up you agree to our privacy policy