KANSAS CITY, Mo. — Missouri presented its rollout plan for when a COVID-19 vaccine is available on Thursday to the Centers for Disease Control and Prevention for feedback.
The state said 25 working groups and more than 100 state employees have been working on a plan since July 9, incorporating the CDC’s guidance that was released in late August.
Missouri also worked with stakeholders from hospitals, nursing homes and the federal government in developing its 111-page plan.
“It does not have to be approved and will not be approved, but there will be feedback,” Missouri Department of Health and Senior Services Director Dr. Randall Williams said.
The state expects to receive that feedback from the CDC by Oct. 26 with Williams saying he’s hopeful the first phase of vaccinations will be available by late November or early December, though some in the medical community believe that’s an overly optimistic timeline.
Williams added that vaccinations for the general public aren’t likely to be available until April at the earliest.
“The vaccine will not be available for children or pregnant women, because those phase-three trials have not been done as of now," Williams said.
A key element of Missouri’s COVID-19 Vaccination Plan is the prioritization of who gets first access to the vaccine, which will likely be in a limited supply initially as production ramps up.
“Our North Star is always individual patients and our second North Star is always preventing spread in the community,” Williams said.
Missouri’s top priority, dubbed Phase 1A, will be vaccinating “unpaid and paid healthcare [sic] workers,” especially staff at nursing homes and other long-term care facilities along with other health care workers who have direct patient contact.
The bulk of COVID-19 deaths in Missouri have come from outbreaks at long-term care facilities, so preventing employees from bringing the virus into those facilities in the first place is considered critical.
Next in line, dubbed Phase 1B, will be all additional health care workers along with “critical infrastructure workers and Missourians at higher risk for COVID-19 disease identified by the CDC established comorbidities for COVID-19,” according to the plan.
Critical infrastructure workers is a broad term that includes first responders — including EMS, law enforcement, fire and corrections personnel — along with child care workers and teachers/school staff.
The group also includes public utility workers, employees involved in manufacturing deemed essential for national security, food processing and production plant employees, and employer-defined essential workers.
Individuals over age 65 or diagnosed with health conditions that put them at high risk for severe complications are included in Phase 1B. Underlying conditions include obesity, chronic kidney disease, asthma and other chronic lung diseases, diabetes, hypertension, and chronic heart disease.
Missouri estimates there are 1.075 million residents over age 65 and 1.295 million with high-risk conditions, while the state estimates 925,000 are employed in the above-defined essential jobs — though there’s likely some crossover among those groups.
While the vaccine will be free of charge to all Missourians — along with the syringes and safety equipment worn by health care providers — there may still be a fee involved.
“You are allowed to charge to administer it,” Williams said.
Currently, there are four vaccines in domestic development — three are two-stage vaccinations and require cold storage, which presents a logistical challenge for distribution. One of the vaccines is a single injection and no cold storage.
Parson, who was in Kansas City earlier Thursday to tout a new saliva-based rapid COVID-19 test, said he will not mandate that any Missouri residents get vaccines.
That is in line with his refusal to mandate masks be worn in the state, suggesting Wednesday that social distancing and avoiding large gatherings are more important than masks.
Williams said that the state is encouraging all Missouri residents to get flu shots.
He also stressed that during the vaccine rollout it will remain important to prevent community transmission through hygiene measures — wearing masks, social distancing and washing hands — to reduce strain on the health care system.
“We are committed to making sure that it is safe,” Williams said of vaccine safety.
He added that a broad vaccination program “is our best chance and our best pathway to get to a better place.”
The MIssouri National Guard — which has helped administer COVID-19 tests, transported medical supplies to hospitals, provided food bank support, assisted with the state’s data entry efforts and staffed phone banks among other aspects of the pandemic response — will remain central to the state’s logistical efforts in implementing the vaccination program, according to Major General Levon Cumpton.
“The Missouri National Guard will continue to support our interagency teammates as long as we are needed,” he said.
Cumpton said the Missouri National Guard has been impacted with positive COVID-19 tests among service members, but he’s not authorized to provide details about the scope of any outbreaks.
Missouri has seen its mortality rate from COVID-19 infections drop from more than 7% early in the pandemic to less than 2%.
That improvement is due partly to the shifting demographics of the pandemic, which has skewed younger during the summer and fall.
Williams also credited the state’s “box-in” testing strategy at long-term care facilities for improving COVID-19 mortality in the state.