Thread by @JeffJacksonNC

Here's the vaccine situation in North Carolina:

- overall supply

- your place in line

- how quickly the line might move

/thread/ (not short) #ncpol #covid

This week, North Carolina got 85,000 doses of the Pfizer vaccine.

Next week, that will drop to 60,000.

Some of you saw the headlines about Pfizer vaccine shipments being reduced, for reasons that are still unclear. That appears to have happened across the board.

So, while we were originally expecting to get another 85,000 Pfizer doses, now it looks closer to 60,000.

But that doesn’t apply to the Moderna vaccine.

Next week, our state will be getting 175,000 doses of the Moderna vaccine - which just became FDA-approved last night.

Both vaccines need to be administered with a first and second shot. The shots must be 21 days apart for Pfizer and 28 days apart for Moderna.

And you can't mix a Pfizer with a Moderna vaccination - you need two doses of the same kind.

These estimates are very rough, but it’s safe to say that within the next six weeks North Carolina will be getting hundreds of thousands (but likely not millions) of doses.

But, keep in mind, everyone needs two doses. So, for example, if we get one million doses by the end of January, that means 500,000 immunizations.

For context, that’s less than 5% of our state.

Many sources, including Dr. Fauci, say that herd immunity kicks in once 75 to 85% of the population is immunized.

However, he says that once 50% of the population is immunized we should start to see an effect on slowing community spread.

Hitting 50% could take months.

We may very well end up with much more supply than the current rate, but that’s less likely to happen in the next couple months than in the months that follow.

Dr. Fauci, for instance, says we should have greater supply starting in late March or early April.

That means that for purposes of controlling the overall rate of infection for the next few months - which will be crucial - the vaccine *may not be* a major counterweight.

HERE’S WHERE THE VACCINES ARE HEADING WITHIN OUR STATE RIGHT NOW

First, we’re shipping to all the hospitals.

We have 116 hospitals in our state.

In the first week, we only had enough vaccine to ship to 53 of them, and some of them only received a small number of vaccines.

The 53 hospitals that were chosen for the first shipment all have ultra-cold freezers.

Novant, for example, had to quickly buy 20 new freezers to get the shipment.

Once the vaccines are unloaded from their ultra-cold delivery box they must be put in a freezer within 5 minutes.

Due to how the vaccine is packaged, the smallest number of Pfizer vaccines that a hospital can receive is 975.

You can’t sub-divide that number due to packaging.

The Moderna vaccine is different.

It doesn’t require ultra-cold storage, just regular freezer storage.

That means it can ship in batches of 100.

While supplies are still scarce, this makes the Moderna vaccine more well-suited for rural hospitals and smaller providers.

*Important Note*: Nursing home distribution works differently.

The federal government wanted to give states some flexibility in deciding where vaccines would go *except* when it comes to nursing homes, which they wanted to ensure were a priority.

They also wanted to make sure that the administration of the vaccine in nursing homes was handled with particular care.

So the approach they came up with was to contract with Walgreens and CVS to use their medical staff to administer the vaccine to nursing homes.

And the deal is the federal government will pay for that *as long as* your state allocates at least 50% of the Moderna vaccine to nursing homes.

NC has complied with that, so nursing homes will have the benefit of a large number of trained medical staff to handle vaccination.

This does not, however, apply to all forms of long-term care facilities. Right now, this is specifically for nursing homes due to their highly elevated risk.

HERE’S HOW THE PHASES WORK (I.E., “YOUR PLACE IN LINE”)

The CDC established guidelines for how states should prioritize vaccine distribution.

North Carolina has adopted those guidelines.

1a: Health care workers specifically dealing with COVID and residents/staff of long-term care facilities.

1b: Adults with at least two chronic conditions that put them at severe risk, and front-line workers at high risk of exposure.

2: Adults over 65, adults under 65 with at least one chronic condition, and front-line workers.

3: College students, K-12 students (when a vaccine is approved for children under 16, which hasn’t happened yet), and essential workers at lower risk of exposure.

4: Everyone else.

The most recent estimate is that we may reach group 1b by mid-January. It depends entirely on whether we continue to receive the vaccine at the rate we expect.

1b is a vastly larger pool of individuals than 1a, so it will likely take much longer to get through.

BOTTOM-LINE

The big variable here - how quickly we get more vaccine - is hard to predict.

That said, at this point it appears the baseline scenario is that it could be months before we've immunized enough people for it to become a major limiting factor for community spread.

That means this is still largely up to us, as individuals. We still owe it to each other to keep infection chains as short as possible.

*Our vigilance is the bridge to the vaccine.*