Stories to Watch 2021: Vaccine Rollout

Vanderbilt University Adult Hospital chief nursing officer Robin Steaban administers the hospital's first COVID-19 vaccine to Tesha Akins, Dec. 17

As I write this, many health care providers in Nashville are receiving the Pfizer-produced COVID-19 vaccine. As you read this, it’s likely even more medical workers will be receiving Moderna’s vaccine, which was cleared for emergency use by the Food and Drug Administration late last week.

“Both of them are really highly effective in the clinical trials, so we’re optimistic,” says Dr. Rand Carpenter, the Metro Public Health Department’s chief epidemiologist.

Indeed, clinical trials have shown the efficacy rate of the Pfizer vaccine to be about 95 percent, and Moderna’s to be about 94 percent. That’s significantly more effective, Carpenter points out, than the average flu shot. When the Scene caught up with Metro’s top epidemic expert last week, he explained that about 5,000 doses of the Pfizer vaccine were being shipped to hospitals in Davidson County, to be administered to members of what the state has designated as the Phase 1a1 group in its vaccination plan.

The state’s tiered plan — which, Carpenter explains, Davidson County will be in step with — begins with “people who work in the ICU, the emergency department, staff that come in direct contact with COVID patients or infectious materials.” Other members of the state’s Phase 1a1 group include first responders and COVID-19 testing site staff.

“The Moderna vaccine is what will go to county health departments across the state, including Davidson,” Carpenter says. “The state will also take some of that Moderna shipment to start the work at the long-term care facilities that retail pharmacy partners are going to be engaged in.”

Once the first group has been vaccinated, members of Phase 1a2 will receive their shots — pharmacists, dentists, behavioral health providers and other health care workers who come in regular direct contact with patients. After that, vaccination of the general public will begin.

“Right now we’re outfitting one point of distribution and working with community partners on another couple points of distribution,” Carpenter says. “And we’ll try some of that out with these early phases — with Phases 1a1 and 1a2. And then we’ll plan to use some of those same points of distribution as well as adding others in critical locations so that we [can] make it easy for the community to get in.”

Carpenter explains that it’s tricky selecting these points of vaccine distribution, as they’ll need to have plenty of room for social distancing and parking. What’s more, the Metro Public Health Department and their colleagues in the Office of Emergency Management will need to be able to adjust to meet the needs of various communities as the rollout continues and the phases progress in the weeks and months to come: Phase 1b (adults with multiple high-risk conditions), Phase 2 (teachers, infrastructure workers, adults with single high-risk conditions, corrections staff and inmates), Phase 3 (young adults and children, frontline workers) and Phase 4 (everyone else).

Scientists and public health officials, of course, are loath to speculate, and so when asked just when we might see the ultimate end of All This, Carpenter politely declines. “We’re not speculating on that much, in our building,” he says. “I think there’s some at the national level — more commentators and analysts, political analysts and public health analysts who are speculating more. But no, we’re just hoping it’s soon.”

One contributing factor in regard to the slow rollout of vaccination is its two-part administration. The Pfizer vaccine, which must be stored at minus 70 degrees Celsius, consists of two doses given roughly three weeks apart. The Moderna vaccine is stored at minus 20 Celsius, with shots coming about four weeks apart. (While trials have found the vaccine to be roughly 50 percent effective after its first dose, both must be administered for full efficacy.) And while Carpenter notes that there is plentiful freezer storage in the county, “We’re hoping that things don’t stay in the freezer for long,” he says.

According to Vanderbilt University’s biannual statewide poll, released last week, 75 percent of Tennesseans say they’re likely to get vaccinated. That’s good, as — according to Carpenter — the ultimate goal is to vaccinate roughly 70 to 80 percent of the population. And yes, there are minor side effects, but he hopes those won’t discourage the general public.

“There’s a bit of inconvenience with maybe feeling a little grumpy,” he says with a laugh. “Maybe body aches, certainly a little injection-site pain. But mild fever and achy for a day or two, and then it goes away. Which is inconvenient, but we’re seeing it rolled out really safely, and I think people are realizing that this is how we get to where we need to be as individuals and families and a community, to have that high immunization rate.”

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