Who will get the first COVID vaccinations in Ohio?

When a vaccine against the coronavirus is available, first in line in Ohio to get immunized will be high-risk health care workers, first responders, older adults living in nursing homes and people with significant health issues, according to a 55-page plan released by the DeWine administration on Tuesday.

The second wave with access to immunizations would be workers in health care and public health, as well as those at high risk for exposure; school staff; people of all ages with health issues; older adults not included in the first phase; inmates and staff in prisons, jails and detention centers; and people living in homeless shelters.

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The priority list is not new — the plan follows the recommendations already laid out Oct. 2 by a National Academies of Sciences, Engineering and Medicine committee. But the Ohio draft plan gives new detail to the complex logistical, ethical, cultural and financial hoops that must be jumped through to get the vaccine to people.

For now, the plan is a draft framework of how decisions will be made when the DeWine administration know more about the vaccine. More details will take shape when there’s more information on when and what vaccines are available.

Initially, supplies of COVID-19 vaccines are expected to be limited, which is why a phased rollout will be aimed at maximizing equity and reducing illnesses and deaths.

Along with the ethical decisions of rationing initial supplies, the massive vaccine rollout will take significant coordination and resources.

Incoming shipments of vaccines will be allocated to counties based on the target population in each group, current case counts, social vulnerability factors, levels of natural immunity, vaccine provider capacity and other issues.

State officials plan to work with hospitals, pharmacies and local health departments to deploy the vaccinations.

Ohio expects 2,000 to 5,000 health care providers will enroll as pandemic vaccine providers.

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Successful vaccination campaigns aren’t just a matter of logistics and supplies but also trust. The issues state officials face are daunting: half of Americans report that they’re unsure about or would refuse being vaccinated, the vaccine might require ultra-cold storage and/or two-shots, and booster shots may be necessary.

As of early October, nearly 190 COVID-19 vaccines were either in preclinical development or undergoing clinical trials in the U.S., Europe and China, according to the National Academies. Multiple vaccines could be approved.

If a coronavirus vaccine requires cold storage, providers will have to demonstrate they have the storage capabilities, including temperature monitoring equipment. Ultra-cold storage includes keeping the doses at -60 to -80 degrees Celsius.

Gov. Mike DeWine described the plan as a “living document” and said Ohio is awaiting more information from federal officials.

The National Governors Association this week sent a list of questions to the Trump administration about how to effectively distribute and administer a COVID-19 vaccine and how the states and federal government will work together.

“We are now releasing a compilation of questions from governors all across the country, Democratic and Republican, saying to the White House: How is this going to work? We need to answer these questions before the vaccine is available so that we are ready to go and no one is caught flat-footed when the time comes to vaccinate people,” said NGA Chairman Andrew Cuomo, governor of New York, in a statement.

Key questions include how supplies will be allocated, who will pay for vaccinations of uninsured people, how will side effects be monitored and how will cold storage needs be managed.

The preparation for the vaccination campaign comes as coronavirus infection cases climb in Ohio and other states.

On Tuesday, the Ohio Department of Health reported 185,639 cases, including 2,015 new cases in the previous 24-hours. Since the pandemic began, Ohio has seen 17,388 hospitalizations and 5,083 deaths.

DeWine said Ohio’s ability to put the virus spread in check depends on people keeping their distance, avoiding gatherings, washing their hands and wearing facial masks.

“It’s only a mask. Think about sacrifices people have made for this country that have been huge. This is only a mask," DeWine said.

Laying groundwork

In early March, the state of Ohio created a standalone, dedicated entity to coordinate and lead the end-to-end pandemic response and report directly to the governor’s office.

This structure, the Governor’s Pandemic Response and Recovery Leadership Team, is led by Ohio Adj. Gen. John Harris and includes senior leaders from numerous organizations.

In March, members of the Ohio Department of Health began reviewing lessons learned from H1N1 and flu vaccination campaigns and started preparing for a COVID-19 vaccination campaign.

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