What you need to know: Minnesota's vaccine distribution plan

A nurse prepares a vaccination shot
A nurse at the Royal Free Hospital simulates the administration of the Pfizer vaccine to support staff training ahead of the rollout in London on Friday.
Yui Mok | Pool photo via AP

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Updated: Dec. 10, 6:28 a.m. | Posted: Dec. 8, 3:30 p.m.

As COVID-19 cases continue to surge across Minnesota, with the state’s death toll climbing above 4,000 people this week, Gov. Tim Walz offered a ray of hope as he laid out a distribution plan for the expected arrival of a coronavirus vaccine.

Front-line health care workers and residents of long-term care facilities will be the first to receive the vaccine as early as this month.

But the ramp-up of vaccine availability will be slow. Minnesota expects to receive fewer than 200,000 doses of vaccine during the first three weeks of rollout.

"We would expect, if everything goes according to plan, the week of Dec. 21, that people could start vaccinating. Perhaps an early Christmas present,” said Kris Ehresmann, the Minnesota Department of Health’s infectious disease and control director.

Walz and public health officials urged people to be patient, to remain vigilant, and to continue to practice protective measures like mask wearing and social distancing. 

“We’re committed to getting the vaccine to every Minnesotan that wants one and should be vaccinated,” said Health Commissioner Jan Malcolm. “In the meantime we ask for your patience, and your continued collective work and individual work to do the things we know will slow the spread of this virus.”

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Who will get the vaccine first?

Health care workers working at hospitals and long-term care facilities, and residents of long-term care facilities, including nursing homes and skilled nursing facilities, will be the first to get the vaccine. 

CEO of LeadingAge Minnesota on the vaccine distribution plan

That follows a recommendation made last week by a federal advisory group to the Centers for Disease Control and Prevention, which voted during an emergency meeting to prioritize those two high-priority groups once a vaccine is approved.

A presentation slide shows timeline of COVID-19 vaccine
The Minnesota Department of Health slide displaying the timeline for the vaccine.
Minnesota Department of Health

Because supplies of the vaccines will be ramped up slowly, not all people in the first tier will be able to get vaccinated immediately. So state officials have divided that group into different levels of priority to receive the vaccine. 

The highest priority is people who have direct contact with individuals who have COVID-19, including staff working in hospital COVID-19 units and at skilled nursing facilities, workers testing people for COVID-19 and people administering the vaccine.

The second priority is other health care personnel in hospitals, urgent care centers, and staff and residents in assisted living facilities. 

The third priority includes all remaining health care personnel.

How soon will the vaccines be available? 

People in Minnesota could begin getting vaccinated as early as the week of Dec. 21, if as expected the U.S. Food and Drug Administration grants an emergency use authorization later this week to Pfizer, the company furthest along in developing a vaccine. 

A decision on the Pfizer vaccine is expected Dec. 10. Ehresmann estimated it will be ready to begin to be administered in the state around Dec. 21, if not a bit sooner. That allows for a week to educate health care providers on vaccine administration.

In addition, people could begin to receive a second coronavirus vaccine, manufactured by Moderna, that’s also being considered for emergency use authorization by the FDA, around a similar timeframe.

Because states are being allocated limited quantities of the vaccine to start, Minnesota public health officials have been working with a group of physicians, hospital representatives, pharmacies and long-term care administrators to develop a distribution plan for the vaccine tailored to the state’s needs. 

Nationwide, as many as 40 million doses could be available by the end of December, with 5 million to 10 million available each week after that.

Malcolm said it could be six months before the vaccine is in wide distribution.

How many vaccines will Minnesota get? 

Over a three-week period beginning the week of Dec. 14, the state expects to receive 183,400 vaccine doses. That’s according to an expected initial delivery schedule based on the most recent forecast from the federal government. 

In the first week, Minnesota expects to receive 46,800 doses of the Pfizer vaccine. In the second and third weeks, the state expects to receive 94,800 and 41,800 doses of the Moderna vaccine.

Minnesota’s allocation was determined on a per capita basis, Ehresmann said. She said it’s “likely” the state gets more doses in the first few weeks of rollout, but she said officials wanted to be conservative in their estimate because the numbers have been changing so rapidly.

The state expects to hear on Dec. 11 about additional doses of vaccine it may receive from Pfizer.

A presentation slide shows potential availability of vaccines
A projection of vaccine availability in Minnesota.
Minnesota Department of Health

The initial 183,400 doses will be administered to that many people. The vaccine developers are holding back the second dose until they are needed.

Which vaccine will Minnesotans receive? 

A vaccine being developed by Pfizer is the first vaccine candidate in line to be approved. A second vaccine, manufactured by Moderna, would also be available in the state if it receives federal emergency use authorization. 

Both vaccines need to be kept cold, especially the Pfizer vaccine, which needs to be stored at a temperature of at least minus 70 degrees Celsius. That could pose a logistical issue for rural areas of the state, where cold storage space to protect the vaccine may be scarce. Pfizer says it has developed its own packaging designed to safely store the vaccine for a few weeks using dry ice.

State officials laid out a “hub and spoke” plan, in which the vaccines would be delivered directly to 25 hubs around the state, mostly large regional health centers that already have ultra-cold storage facilities in place.

From there, the vaccines will be distributed to 118 different “spokes” throughout the state, consisting mainly of smaller health care facilities.

When will others be eligible to receive the vaccine? 

Federal officials are still determining the next tier of people to be eligible to receive a vaccine, but state health officials anticipate that essential workers — including teachers, first responders and others — will be next in line for the vaccine after health care workers and long-term care residents.

People with underlying health conditions who are more likely to become severely ill if they contract COVID-19 are likely to be the next priority for receiving the vaccine, along with people 65 and older.

Only after those groups have been offered the vaccine will the general public be able to be vaccinated. Ehresmann said that’s still several months away, likely next summer.

When will a vaccine be available for children?

We’ve received several questions about the safety of the vaccine for children, and when children may be able to receive the vaccine. But at this point, it’s too soon to know.

So far very few children have been part of the clinical trials for the vaccines. Pfizer only recently began enrolling children as young as 12.

Earlier this month, according to NPR, the American Academy of Pediatrics called on researchers to broaden their trials to include more children, warning of a significant delay in access to a vaccine should they not act quickly.

Where will I be able to get vaccinated? 

Health care workers will be vaccinated at their workplace; likewise, long-term care residents will also receive the vaccination where they live.

Once the vaccines are distributed more widely, they will be administered in a variety of settings, from pharmacies and doctors' offices to health clinics and special vaccination sites.

Will I need to get two shots? 

Yes, at least at first. Both the Pfizer and Moderna vaccinations require two doses within three to four weeks of each other. You must get both doses from the same developer. Public health officials are considering strategies to make sure people who get their first shot come back for their second on time.

Health officials estimate that it takes about six weeks from the time of your first dose before you achieve full immunity.

Other vaccines that are currently undergoing trials could do away with the two-dose requirement, including a vaccine candidate being developed by Johnson & Johnson. But it’s unclear if or when a one-dose vaccine will be approved.

Are these vaccines safe?

The speed with which these vaccines have been developed — 11 months, compared to the several years it has taken vaccines in the past to be approved — has created a ripe environment for concerns over safety

The process has been accelerated in part because the companies making the vaccines have recruited clinical trial participants more quickly, and have also shown federal regulators their vaccine testing data in real-time instead of after the testing process is complete. 

The federal government also subsidized manufacturing to begin while the approval process was still underway.

But those trials have still been subject to the same safety evaluations as any other vaccine, said Ehresmann. The manufacturers have to show how their vaccine studies were designed, how they got their data and their results.

As with all vaccines, some people who are inoculated will have adverse reactions. While the FDA’s analysis of the Pfizer vaccine found serious reactions to be rare, it did find that side effects are common, with a majority of study volunteers experiencing reactions at the site of injection, headaches and fatigue.

A reporting system to track those reactions will be launched as soon as the vaccines are deployed.

Do I have to pay for the vaccine?

No. The federal government is covering the cost of the vaccine as part of its national response to the coronavirus; it’s buying the vaccine from the manufacturers and distributing it to the states.

People getting the vaccine are likely to be asked for their insurance, said Malcolm. That’s because the health care providers administering the vaccine are able to charge for a clinic visit, or for an administration fee for the vaccine. But individuals should not be charged.

How effective are the vaccines? 

Studies have shown that both the Pfizer and Moderna vaccines are about 95 percent effective after both doses are administered.

Ehresmann said it will take about six weeks from an initial vaccination for adults to develop resistance to COVID-19.

Am I required to take the vaccine? 

No, there is no mandate to take the vaccine. Walz said he’s asking Minnesotans to understand that the vaccine “not only protects you and your health, but protects your neighbor,” much like masking and social distancing.

Can I stop wearing a mask after getting a vaccine?

No. For a couple reasons, masks and social distancing will still be recommended for some time after people are vaccinated.

To start, the first coronavirus vaccines require two shots; Pfizer’s second dose comes three weeks after the first and Moderna’s comes after four weeks. And the effect of vaccinations generally aren't immediate.

People are expected to get some level of protection within a couple of weeks after the first shot. But full protection may not happen until a couple weeks after the second shot.

It's also not yet known whether the Pfizer and Moderna vaccines protect people from infection entirely, or just from symptoms. That means vaccinated people might still be able to get infected and pass the virus on, although it would likely be at a much lower rate, said Deborah Fuller, a vaccine expert at the University of Washington.

And even once vaccine supplies start ramping up, getting hundreds of millions shots into people's arms is expected to take months.

Fuller also noted vaccine testing is just starting in children, who won’t be able to get shots until study data indicates they're safe and effective for them as well.

Moncef Slaoui, head of the U.S. vaccine development effort, has estimated the country could reach herd immunity as early as May, based on the effectiveness of the Pfizer and Moderna vaccines. That's assuming there are no problems meeting manufacturers' supply estimates, and enough people step forward to be vaccinated.

What questions do you have about the vaccine and Minnesota’s distribution plan? Tell us here and we’ll try to track down the answers.

The Associated Press contributed to this report.

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