Hawai‘i Releases Preliminary COVID-19 Vaccination Distribution Plan

No COVID-19 vaccine is yet available in the United States and may not be for months, but Hawai‘i has developed a preliminary distribution plan to be implemented as soon as one is.

Recent polling of US citizens has indicated significant skepticism exists that a vaccine would be safe, as some are concerned about political motivations to rush a vaccine to market. According to an executive summary outlining the state’s plans, however, Hawai‘i will not support the release of a vaccine that has not been approved by the Food and Drug Administration (FDA).

“We will not support any vaccine that has not been held to the rigorous safety standards of other vaccines,” said Ron Balajadia, Immunization Branch Chief with the state Department of Health. “It is really critical for us to be able to have confidence in this. We have a group of medical advisers that will be reviewing a lot of the data coming through to help support (our rollout of this plan). We will not be putting out a vaccine that is not safe and not effective.”

Governor David Ige said the soonest such a vaccine will be available is likely at least a few months.

Lt. Governor Josh Green added during a press conference Thursday that the state is holding out hope it can begin vaccinations in December and January. More vaccine will be readily available to serve a higher portion of the population between February and May, Green projected.

At least 60% to 70% of any given population will need to have immunity for daily economic, educational, and social activities to resume with relative safety. Ige said that means roughly 700,000 to 800,000 people in the state of Hawai‘i will need to be vaccinated, which he described as a “monumental task.”

The state currently has $800,000 set aside for vaccine distribution, though Green said the cost will be in the millions, with Ige adding that Hawai‘i will go back to the federal government to seek more funding in the days ahead.

Vaccine injections will be provided to members of the public free of charge, save for a minor fee implemented by the state to pay for the staffing and equipment necessary to vaccinate upwards of 1 million people. The most likely format for a vaccine will be two shots administered four weeks apart, Green said.

Rolling out a vaccine

Once a vaccine is approved, Hawai‘i’s goals include procuring it as quickly as possible, distributing it to the highest-priority individuals first, and creating a communications network to “report on any adverse events associated with vaccine administration.”

Three phases of the vaccination rollout plan are as follows:

• Phase 1: Potentially limited doses available.
• Phase 2: Large number of doses available, supply likely to meet demand.
• Phase 3: Likely sufficient supply, slowing demand.

Critical target populations will be prioritized during the first phase of distribution. This will include high-risk health workers and first responders, people with underlying conditions that put them at higher risk, those over 65 years of age, and people living in crowded settings.

K-12 teachers and school staff, critical-risk workers in high-risk settings, people at moderately higher risk due to health concerns, homeless individuals, and those people confined to prisons or employed in such physical spaces will be the next groups prioritized.

Decisions on who will receive the vaccine, and when, will be informed by standards established via the National Council of Medicine.

Planning ahead

Jurisdictions were engaged on Sept. 16, 2020, by the Centers for Disease Control and Prevention (CDC) to develop a plan over the coming month that would allow for the safe and expedited distribution of a vaccine.

The plan, titled Operation Warp Speed, issued the lofty goal of delivering 300 million doses of “safe and effective vaccine” by New Year’s Day 2021. While that timing no longer seems feasible, Hawai‘i has done significant work toward putting together what is not yet a finalized plan.

The state Department of Health has formed a core planning team with representatives from local, state, and federal levels along with private sector partners. The Disease Outbreak Control Division Immunization Branch will function in a leadership role and lists the following priorities in the executive summary.

• Priority 1: Establish a robust and effective operational structure to support vaccination program efforts.
• Priority 2: Engage a broad group of stakeholders to support planning and readiness efforts to include vaccination providers and representatives from critical population categories.
• Priority 3: Establish and implement a pro-active vaccination communications program.

A vaccination core planning team and a vaccination program implementation committee will support the rollout, along with standing and ad hoc workgroups, according to the summary. To access the state’s PDF outlining its plan, click on the following link: Vaccination Plan.

Balajadia said the state is expecting an increase in COVID-19 infections over the fall and winter months, which means any new surge would be simultaneous with flu season. He encouraged everyone in Hawai‘i to get a flu shot, adding that children should continue to received their routine vaccinations through this period.