Hawaii health officials estimate 25,000 people rolled up a sleeve to receive the first dose of the coronavirus vaccine before the close of a difficult year in which COVID-19 sickened more than 21,000 island residents and left nearly 300 people dead.

Overall, the state has given about a third of its vaccine doses — mainly to health care workers and the staff and residents of long-term care homes.

“You’re not going to get vaccines on a Monday and put them in arms on a Monday,” said Brooks Baehr, a spokesman for the state Department of Health. “There is going to be some lag time, maybe 48 to 72 hours, because we really want to ensure that the vaccine gets here before we go and invite people to come down to a location to get the vaccine.”

Josh Green, COVID-19, coronavirus, vaccine, pfizer, moderna, pandemic, shot, immunization
Lt. Gov. Josh Green administered about 500 COVID-19 vaccines to health care workers and first responders on Windward Oahu on Tuesday. Courtesy: Lieutenant Governor’s Office

COVID-19 vaccines are being rolled out in phases, and health care workers who are at the top of the priority list are expected to be the easiest group to vaccinate because they work in the hospitals and medical offices where the vaccines are stored.

Lt. Gov. Josh Green, who oversees Hawaii’s vaccination rollout plan, said the shots are being given at a deliberate pace to ensure that every one of the delicate vials is stored and administered properly.

“It’s a complicated process — it’s not going to be like waving a magic wand,” Green said.

The complications range from ensuring that vaccine distribution sites have enough ultra-cold storage space to setting up a system to remind people when it’s time to receive their second dose.

“It’s going to take a long time to vaccinate people so I hope they can be really patient,” Green said. “This is the largest public health endeavor we’ve ever had to make so it’s going to start slowly so that we don’t make mistakes.” 

Vaccine Rollout Slower Than Expected

The pace at which the state can inoculate residents also greatly depends on how quickly Hawaii can acquire more doses of the vaccines by Pfizer-BioNTech and Moderna.

The federal effort to deliver the COVID-19 vaccine across the country — popularly known as Operation Warp Speed — is already taking longer than expected.

The state received a total of 65,250 doses of the Pfizer-BioNTech and Moderna vaccines in 2020, down from the 81,825 doses it expected to get. The rest of the vaccine doses will arrive on a delayed schedule sometime after Jan. 1.

“We’re at even greater risk than we’ve been in recent months.” — Dr. Janet Berreman

According to the state’s vaccination plan, an estimated 46,000 people in Hawaii will be offered the vaccine in the first phase, including hospital and nursing home workers, first responders and others who work in settings that put them at a higher risk for coming into contact with bodily fluids or aerosols.

The next group will include people of all ages with health conditions that make them more vulnerable to severe bouts of COVID-19, followed by thousands of elderly Hawaii residents who live in communal settings.

It will likely be at least six months before Hawaii has a sufficient supply to offer vaccines to 70% of the state’s 1.4 million population — the benchmark that officials intend to reach.

“I know people have the opportunity to see either the glass half full or the glass half empty, but if I told you that we were going to vaccinate thousands of our health care workers before the new year just a few months ago no one would have believed me,” Green said. 

Every Hawaii resident who gets vaccinated is asked for age, address, gender, race, primary care physician, vaccination history, allergy history, health status and email address.

After receiving the first dose, Green said people will receive multiple reminders by email to get their second shot. He said the state will also likely solicit feedback on their vaccination experience, including whether they felt any side-effects.

“Right now the most important objective is to get people both of their shots, but over time we will be able to go back and review whether there was a significant drop-off in disease in areas with high rates of vaccination,” Green said.

The goal is to inoculate a large enough portion of the population for the state to achieve herd immunity. State officials say about 70% of Hawaii residents will need to get vaccinated against COVID-19 to greatly reduce the likelihood that even those who are not vaccinated will catch it.

Health Officials Warn Of ‘A Dual Threat’

A new strain of COVID-19 that scientists say is more contagious — but no deadlier — than earlier strains of the virus has not yet been discovered in Hawaii, state health officials announced on Thursday.

The state lab has so far tested about 700 COVID-19 samples from the community and has not found any sign of the new strain, which was first detected in the United Kingdom and since been discovered in numerous U.S. states, said State Laboratories Division Administrator Edward Desmond.

Desmond said it’s a matter of when, not if, it will reach Hawaii.

Dose #1 of Pfizer-BioNTech COVID-19 vaccine in syringes during press event held at Queen's Medical Center. December 15, 2020
Persuading enough Hawaii residents to roll up a sleeve for the vaccine for the state to achieve herd immunity is expected to be a challenge, health officials say. Cory Lum/Civil Beat/2020

Because the strain spreads more easily from person to person and is all but certain to reach Hawaii, Dr. Janet Berreman, the Kauai District Health Officer, said it’s now even more important that people in the islands adhere to mask-wearing and social distancing guidelines.

“We’re at a kind of very strange juncture right now where there’s reason for a lot of optimism around the vaccine and a tremendous readiness to move on,” Berreman said. “At the same time, disease rates on the mainland are the highest they’ve ever been and are continuing to rise. And now there’s this more transmissible virus.”

“So that’s a dual threat,” she said. “We’re at even greater risk than we’ve been in recent months.”

Until a significant portion of the Hawaii population gets vaccinated, Berreman said this elevated threat level is unlikely to change.

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