State health officials must ensure that COVID-19 vaccines are distributed effectively and efficiently, particularly early on when supplies are limited, and ensure that they are seen as trusted tools in the fight against the illness.
That was the message Monday from Dallas public health physician John Carlo, MD, in Texas Medical Association testimony on the state’s plan to distribute COVID-19 vaccines when they become available.
During a virtual public meeting of the Department of State Health Services (DSHS) Task Force on Infectious Disease Preparedness and Response, Dr. Carlo said the state should stress to patients the importance of registering for ImmTrac2, the state’s vaccine registry, before vaccines become available, and ensure that it is easily incorporated into electronic medical records (EMR) systems.
“We must absolutely avoid the repeat of manual entries, overwhelming volumes, and backlogged data,” said Dr. Carlo, a member of the TMA COVID-19 Task Force. He is former medical director for Dallas County Health and Human Services and former chair of the Texas Public Health Coalition.
The state also should further study which high-risk groups – including physicians and other health care professionals – should be among the first to receive a vaccine, Dr. Carlo said.
“For example, among high-risk workers in health care facilities, those providing direct care to COVID-19 patients in emergency departments and COVID-19 units will be at highest risk,” Dr. Carlo said. “Considerations should also include prioritizing high-risk workers, such as geriatricians or intensive care unit physicians, who care for patients who are over 65 years of age, obese, diabetic, or immunocompromised and have a higher risk of severe complications with COVID-19.”
During the meeting, DSHS Commissioner John Hellerstedt, MD, named a panel of 16 Texas lawmakers, officials, and physicians – including seven TMA members – who will advise DSHS on the distribution COVID-19 vaccines. TMA director of Public Health, Christina Ly, PhD, also will serve as a consultant to the rapid response panel. See the full list below.
The panel faces a lot of work because there are so many unknowns tied to the COVID-19 vaccines, including when they will be ready for public use.
“The biggest question we have are quantities,” Dr. Hellerstedt told the task force. “We have no idea what quantities there will be at first.”
So far, no COVID-19 vaccine has been licensed in the U.S. by the Food and Drug Administration. But health authorities have said one could be licensed as early as November, and a limited number of doses may be available soon, Imelda Garcia, panel chair and DSHS associate commissioner for laboratory and infectious disease services, told Texas Medicine Today earlier this month.
Dr. Carlo’s recommendations Monday included communicating to Texans the benefits of a vaccine and details on the allocation process, including who is responsible for developing the distribution plan.
“Polls have already indicated some public distrust of the COVID-19 vaccine, illuminating a need to invest in message development, formative research, and focus groups to best address public concerns and strengthen vaccination uptake,” Dr. Carlo said. “Distrust of the medical community and treatments have long been documented in minority populations; therefore, TMA encourages the plan to prioritize countering the distrust by developing culturally and language appropriate messaging, using community champions and health workers, as well as tying in the voices and expertise of the physicians these communities do trust.”
Texas physicians already can sign up to distribute COVID-19 vaccines. Find more tools, resources, and information on TMA’s COVID-19 Resource Center, which is continually updated.
The advisory panel consists of:
- Imelda Garcia, panel chair and associate commissioner for laboratory and infectious disease services, DSHS
- Sen. Lois Kolkhorst (R-Brenham)
- Sen. Eddie Lucio, Jr. (D-Brownsville)
- Rep. Stephanie Klick (R-Fort Worth)
- Rep. Senfronia Thompson (D-Houston)
- David Lakey, MD, vice chancellor for health affairs and chief medical officer, University of Texas System
- Gerald Parker, MD, associate dean, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University
- John Zerwas, MD, executive vice chancellor for health affairs, University of Texas System
- W. Nim Kidd, chief, Texas Division of Emergency Management, Texas A&M System
- Stephen Williams, director, Houston Health Department
- Casie Stoughton, director of public health, City of Amarillo
- Paul McGaha, DO, University of Texas Health Science Center at Tyler and local health authority, Smith County
- David Gruber, associate commissioner for regional and local health operations, DSHS
- Manda Hall, MD, associate commissioner for community health improvement, DSHS
- Stephen Pont, MD, state epidemiologist, DSHS
- Jennifer Shuford, MD, infectious disease medical officer, DSHS
- Ryan Van Ramshorst, MD, chief medical officer, Medicaid and Children’s Health Insurance Program, Texas Health and Human Services Commission