Hawaii officials still have many wrinkles to iron out in their plan to distribute COVID-19 vaccines when a vaccine is approved for use, documents show.

The Department of Health will spearhead the effort to coordinate the distribution of vaccines to 121,000 people who meet eligibility as critical populations within four weeks of the vaccine’s availability, according to a copy of its plan — in its first iteration — which is now available for viewing online.

The Department of Health initially had refused to release a full copy of the draft.

Several vaccines are inching closer to earning federal safety approval, and most of them require two doses within 21 to 28 days. Those vaccines could be shipped to Hawaii as early as December, yet there is much work to do to prepare. It will be a massive undertaking, requiring a swift deployment and expansion of existing vaccination resources about 16 times the size of the state’s annual influenza campaign that reaches about 50,000 people every year.

Department of Health Director Dr. Elizabeth Libby Char.
Health Department Director Dr. Libby Char says the distribution of COVID-19 vaccines will be an “enormous” undertaking. Cory Lum/Civil Beat/2020

“The more I learn about it the more I realize the enormous task this is going to be,” Department of Health Director Dr. Libby Char told Civil Beat. “I think we will pull it off but it’s going to be a collaborative effort.”

The state will work with pharmacies and other vaccine providers that have been involved with seasonal vaccine drives in the past, the Stop Flu at School (SFAS) program and others who served as vaccination providers during the 2009 H1N1 pandemic.

The federal government will allocate vaccine doses based on each state’s population. An estimated 44,000 people in Hawaii would meet priority criteria in the first phase, including first responders, health workers and kupuna. It will likely be at least six months until Hawaii has a sufficient supply to offer vaccines to 70% of Hawaii’s 1.4 million population — the benchmark that officials intend to reach.

There are an estimated 35,000 health workers deemed to be at most risk for COVID-19 who will be among the first group to be vaccinated. Hawaii’s estimated 22,000 teachers and school staff won’t receive vaccines until the second phase of the rollout. 

The first group to receive the vaccine will include an estimated 35,000 high-risk health workers and 11,000 first responders.  The second cohort includes people of all ages with health conditions that make them more vulnerable and susceptible to COVID-19 — an estimated 40,000, along with another 35,000 kupuna older than 65 who live in communal settings.

Then, in Stage 2 of the vaccination plan, another 136,500 kupuna will have the opportunity to get vaccinated, along with teachers and school staff, people who live in homeless shelters or group homes, prisons, jails or detention centers.

About 214,000 keiki under the age of 17 and nearly 89,000 young adults between 18 and 24 are set to receive vaccines in Stage 3 of the plan, as well as at least 100,000 others.

The state is still working on finalizing its communications plan. Officials write that they plan to “present information in culturally responsive language and available in languages that represent communities within Hawaii.”

The plan maps out where critical populations live and will use census data and the Centers for Disease Control and Prevention’s Social Vulnerability Index to allocate vaccines across all islands. The team writes that it intends to partner with public and private agencies, such as community health centers and elderly care homes.

In order to be successful with the vaccination plan, we need to be able to dedicate the appropriate time and personnel and resources to work on it so we have a good package ready to roll,” Char said. 

In the document, Hawaii health officials say they anticipate supply chain issues just as there were when attempting to purchase personal protective equipment, but it’s not clear how they’ll get around that.

Hawaii’s hospitals currently do not have enough ultra-cold storage space but are scrambling to purchase freezers and enough supply of dry ice.

Elliot Parks, the president and CEO of Hawaii Biotech, which is developing a COVID-19 vaccine of its own locally in the islands, said the plan seemed “well-conceived.”

Still, there is data missing about how safe and effective vaccines will be for certain groups, such as the very young or old. Most of the data collected in initial stages from leading vaccine candidates show vaccine safety among the healthy adult volunteers who participated in early clinical trials.

“In a perfect world, we would have sufficient safety data for the elderly, children, and other specific groups by the time that the plan projects vaccinating these groups,” he said. “When we will have sufficient safety data from clinical studies on each of these groups remains unclear.”

Read the full draft plan here:

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