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Arizona’s COVID-19 vaccine plan suggests who may get priority

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Pressure to create a coronavirus vaccine is increasing by the day, but for a safe vaccine to enter the market, it takes time.

USA TODAY

Arizona’s COVID-19 vaccine plan doesn’t say for certain who gets immunized first when vaccines roll out, but the working document suggests priority will go to a broad category of health care workers.

Officials with the Arizona Department of Health Services recently submitted its draft coronavirus vaccine plan to the U.S. Centers for Disease Control and Prevention, which was a requirement for all states.

The state plans were due Oct. 16. Arizona’s draft plan builds off a model it used during the H1N1 (swine flu) pandemic of 2009. Arizona’s plan will be updated as more details are provided to the state from federal partners, state health officials say.

A more detailed “operational” vaccine plan is expected to be completed further along in the process. State health officials say they don’t have a definitive date for when that plan will be released.

In Thursday’s presidential debate, President Donald Trump said there was a COVID-19 vaccine “that’s ready.”

But experts say it’s unlikely a vaccine will be available until the end of the year, and many place wide distribution at sometime in 2021. To date, no COVID-19 vaccine has been approved by the FDA, either through the regular approval process or by emergency use authorization.

Who might be immunized first?

While more than one COVID-19 vaccine may become available, there might not be enough supply to initially go around. That’s why government officials need to consider who to immunize first, and the ways that they will distribute it.

The state plan references priority populations outlined in the CDC’s COVID-19 Vaccination Interim Playbook released in September, as well as guidance contained in a federal report released earlier this month.

Both the CDC playbook and the National Academies of Sciences, Engineering and Medicine report prioritize health care workers and first responders during the first phase of the vaccine rollout.

A state worksheet in the draft plan lists the priority order by category for receiving vaccines, before it would go to the general population:

  • 1a: Health care personnel, among them pharmacists, pharmacy techs, school nurses, home health aides, health care support workers, practitioners and first responders.
  • 1b: Other essential workers such as food industry workers, teachers and child care workers.
  • 1b: People at increased risk for COVID-19 illness, including people age 65 and older.
  • 2: People at increased risk of acquiring or transmitting the coronavirus, such as individuals attending colleges and universities and racial and ethnic minority groups.
  • 2: People with limited access to routine vaccination services, including people with disabilities and people who don’t speak English.

“While target groups and prioritization tiers may differ somewhat for each local jurisdiction, this worksheet will assist in estimations and reinforce key planning elements,” Arizona Department of Health Services spokesman Steve Elliott wrote in an email.

The state plan, CDC playbook and NASEM report all reference health inequities that need to be addressed

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Arizona’s COVID-19 metrics are showing an upward trend

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COVID-19 (Photo: Irina Shatilova, Getty Images/iStockphoto)

While it’s not at the epicenter of a recent surge in U.S. cases, Arizona’s COVID-19 metrics are worsening.

Dr. Cara Christ, Arizona Department of Health Services director,said Arizona is at a “pivotal” moment for COVID-19. She does not want to see another scenario like summer, when coronavirus cases exploded in the state.

“A lot of it is going to depend on the upcoming weeks,” Christ told The Arizona Republic on Wednesday. “This pandemic has been so hard to predict and watching what the other states are going through, it’s certainly a possibility, which is why I think right now I think is a pivotal point to remind everybody to keep doing those mitigation strategies.”

Arizona is not seeing the rapid surges spreading across many other states, including Wisconsin and other parts of the Midwest.

Comparatively, Arizona is doing much better than many.

But it doesn’t take much for case counts to escalate, which in turn leads to increased hospitalizations and deaths.

“Our sister states New Mexico and Utah are having very bad rounds of it right now, where their hospital capacity is getting stretched,” said Dr. Marjorie Bessel, chief clinical officer for Banner Health, which is Arizona’s largest health delivery system. “It’s not really practical to think some of that isn’t going to come into Arizona and we’re not going to have increased activity.”

Daily case counts, hospitalizations, ICU beds in use and ventilators in use have seen gradual increases. Arizona’s reproduction rate for the SARS-CoV-2 virus is at 1.16, around the same level as early June, according to rt.live, a tracking website created by Instagram co-founders Kevin Systrom and Mike Krieger, using data from the COVID Tracking Project.

The reproduction rate means the virus is spreading at about the same rate it was in early June, and at a faster rate than desired. The metric was below one, meaning infections slowed, from late June to early September, after which it’s gradually increased.

“It’s one of many metrics that we are watching. It’s an easy metric to direct Arizonans to,” Christ said. “Hopefully they can make changes in what they are doing to help bring that reproduction number down.

Arizona’s cases spiked in June and July to one of the worst surges in the world, causing a domino effect of hospitalizations, an increased need for ICU beds and a rise in deaths.

All of Arizona’s COVID-19 metrics remain far below the levels hit during the state’s summer peak for the virus, but experts caution that the increases seen in recent weeks could again quickly mushroom out of control.

“If you look at where we’re at now, it’s only a matter of time,” said Joshua LaBaer, director of the Arizona State University Biodesign Institute and leader of the university’s COVID-19 research efforts. LaBaer pointed to the upward-trending case increases since the end of September.

In a news briefing Wednesday, LaBaer said there’s no doubt in his mind that Arizona is in a COVID-19

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