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Vaccine distribution needs to be equitable, but fast, OSU experts say | News

A panel of researchers from Oregon State University met Tuesday, Jan. 13, to share their expertise on Oregon’s COVID-19 vaccination rollout.

Many in the state have felt that rollout has been slower than it should be, given that less than half of the vaccine doses delivered to sites across the state have actually been administered to patients.

Overall, the researchers ranging from a medical ethicist to a communications expert agreed the state’s vaccine rollout needs to be equitable and transparent — and fast.

Gaurav Sahay, an associate professor of pharmaceutical sciences at the university, discussed the science behind the vaccines. His research has focused on the microscopic delivery system the vaccines use to introduce defense mechanisms to the body.

That delivery system is fairly new technology, Sahay said. That means — while clinical trials showed the effectiveness and safety of the vaccines — there are still some unanswered questions about the vaccine, including how long its protection lasts once in the body.

“It is not possible to say how long it will last, because it’s a new vaccine for a new virus. What Moderna is saying is for a year, but we’ll have to wait and see what happens,” Sahay said. “The good news is they’re very effective.”

Those vaccines are about 95% effective at preventing vaccinated individuals from catching COVID-19, Sahay said.

But new technology also means getting vaccines produced takes time.

“Right now, with the current vaccines that are approved, ramping up has been a sort of challenge,” Sahay said.

Oregon has received only around 270,00 doses of the vaccine, a fraction of what it’ll need to achieve community immunity from the virus. Sahay predicts that level will require 70% or 80% of the community to get vaccinated.

That development and production time is the first reason COVID-19 vaccines are taking some time to hit the community. But there are also other challenges when hospitals and clinics have doses of the vaccine ready for distributing, as they do now.

“The main challenge is encountered with personnel available to administer the vaccine,” said Joe Agor, an assistant professor of industrial engineering focusing his research on how hospitals have prepared for virus surges.

Each step of administering the vaccine takes time and expertise, Agor said. It requires trained staff to receive and properly store doses of the vaccine, pharmacists to properly mix the vaccine and prepare it for use, nurses to administer the vaccine and staff members to track who’s receiving doses.

That’s an entire process that hospitals and health care professionals are still working to understand and comes on top of those staff members needing to take care of their normal duties at the hospital, Agor said.

“Another challenge that has been observed to us is that the supply chain can be somewhat unpredictable,” Agor added.

Since manufacturers are still ramping up production, and information is limited, it can be difficult to predict when states and hospitals will receive doses and have the staff ready to administer them — not to mention having the patients ready to receive them.

“In the absence of a national strategy, you have 50 different strategies, or 50 states trying to figure out how to go about this,” said Daniel López-Cevallos, an associate professor of ethnic studies who researches disparities in public health and access to care.

Without that consistent national strategy, López-Cevallos said states have been left to spend time and resources determining the prioritization

“It is clear — again, it is not unique to Oregon — but it is clear that the prioritization process has slowed down quite a bit the distribution,” López-Cevallos said.

In Oregon, the basics of the prioritization process come from the federal government’s recommendations. But the specific plan is ironed out by the Oregon Health Authority with the guidance of its vaccine advisory committee.

According to Courtney Campbell, a professor of religion and culture who studies medical ethics, the decisions made by OHA and the recommendations of that committee are reflections of the ethical principles at play.

“Clearly one principle is health equity, that is a fairly significant one,” Campbell said, noting that the committee largely focuses on ensuring the vaccine distribution doesn’t skip communities that have received unequal health care in the past.

But equity alone doesn’t explain all of Oregon’s vaccine decisions, Campbell said.

He pointed to school staff as an example, since the state’s been one of the few to break with the U.S. Centers for Disease Control and Prevention by moving educational staff up the priority list to phase 1B of the vaccination schedule.

Campbell said the ethical principles behind that decision — like a commitment to saving the most lives, or the idea of treating people equally regardless their position — aren’t quite clear yet.

“We need some principled articulation from the vaccine advisory committee for OHA,” Campbell said. “Right now, it’s really focused on health equity, and that doesn’t get you all the way to the rationale for prioritizing teachers and others.”

That was a central theme of the researchers’ comments Tuesday: The importance of transparency in the vaccine distribution process.

“Addressing (access to care) issues might not be enough,” said Beth Marino, an anthropologist researching effective public health messaging. “We know that there are high levels of distrust in government and scientific institutions in some of these groups.”

Without recognizing the distrust that communities have in government and health experts, Marino said they may choose not to get the vaccine, which could slow the fight against the virus, or could continue spreading misinformation.

“It’s very important because the social context is so divided,” Marino said. “So there needs to be messaging about when to get vaccine, and there needs to be consistent messaging about who’s getting vaccine and there needs to be justification for all of those decisions.”

Her research has focused on what kind of messages work for educating various groups — on political, cultural or ethnic lines — about the virus and the vaccine.

“Generally, (messaging about) taking care of one’s elders is effective across a very wide swath of those we surveyed,” Marino said.

But the bottom line from Tuesday’s research panel?

“The ones that are being given are safe, and we should vaccinate as much as we can,” Sahay said.

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