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Maryland’s vaccine plan calls for two phases

First to get shots: elderly, first responders, health care providers

A woman receives an injection during phase 3 testing in September for the Janssen Pharmaceutical-Johnson & Johnson vaccine in the United States. On Friday, Oct. 2, 2020, a U.S. advisory panel made recommendations for who should be first in line to get COVID-19 vaccine, including a plea for special efforts by states and cities to get the shots to low-income minority groups. (Johnson & Johnson via AP)

Gov. Larry Hogan Tuesday released the state’s plan for administering a COVID-19 vaccine when it becomes available. The two-phase plan prioritizes the elderly, first responders and health care workers. (Johnson & Johnson via AP)

First responders and the elderly will be the first to receive a vaccination against the coronavirus — when one becomes available — under a plan released Tuesday by Gov. Larry Hogan.

The two-phase plan would prioritize those more likely to be exposed or who are more likely to suffer from the most severe effects of the virus. State officials said the segmented approach is also needed to build public trust in the safety and efficacy of the vaccine.

“In anticipation of a COVID-19 vaccine, Maryland stands ready to order, distribute, and administer it effectively and rapidly as soon as a vaccine becomes available,” Hogan said in a statement. “The State of Maryland’s plan for this historic undertaking will immediately make the vaccine available to Marylanders at highest risk of developing complications from COVID-19 as well as our critical front-line health care workers and essential workers in public safety and education.”

The plan prioritizes health care workers, first responders and nursing home staff and residents as well as teachers, public safety workers and others living in group living situations. Vaccinations for the broader public would occur later.

No decision has been made about exactly who would be eligible for the first round, but the state estimates that 14% of Maryland’s roughly 6 million people will fall into the phase one category.

Currently, there are no vaccines available and it could be months before the Federal Drug Administration authorizes any for emergency use.

The state plan relies, in part, on the federal government supplying kits that include 100 doses of the vaccine as well as syringes, alcohol swabs and personal protection equipment needed to operate the clinics and record cards for patients.

The 68-page draft for Maryland — the state’s first public version — anticipates that a limited supply of the vaccine would be available this fall.

Even so, once a vaccination is available, it may be limited to no more than 10o million doses nationwide, if that, according to some projections. The initial amount would not be enough to provide every person with a dose.

Most who receive the vaccination will require two doses. The state plan calls for a notification system that will remind patients to schedule that second dose at 21- or 28-day intervals.

Many of the vaccines will require specialized handling, including ultra-cold storage. Some vaccines under development must be stored at minus 70 degrees celsius — three times colder than a standard home freezer.

The state’s plan anticipates a high demand for the vaccine from a portion of the state population.

“However, current surveys indicate a high degree of vaccine hesitancy. A segmented approach sensitive to social and cultural nuances of Marylanders will be necessary to gain vaccine trust,” according to a draft of the plan. A recent Goucher Poll found that Marylanders were almost evenly split when asked their willingness to have a COVID-19 vaccine shot.

The state plans to hire an outside firm to creating a marketing strategy to build confidence in the vaccine and the program.

“With the rapid development and licensing of COVID-19 vaccines, there will be concerns as to the safety and efficacy of the vaccine,” according to the report. “Messaging will need to instill confidence in the vaccine and describe the process for reporting vaccine adverse events.”

Marketing efforts would begin prior to the availability of the vaccine and focus on educating the public on how vaccines are developed, approved, and monitored for safety and efficacy. The campaign also would explain the difference between the FDA’s emergency authorization process and the approval and licensing process.

The second phase of the state plan would likely not begin before Maryland has an ample supply of the vaccine and it has reached its targets for vaccinations of groups in the first phase.

Once goals in both phases are reached, the state could then move to a routine vaccination strategy.

The state is already in the process of recruiting doctors, clinics, pharmacists and hospitals to help in the vaccination process.

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