Vaccine rollout in rural Eastern Oregon and Idaho poses unique challenges

Less than a year after the coronavirus began its fatal spread in the United States, vaccines for the virus are now crossing the finish line in record time. Just a few days after the Food and Drug Administration authorized Pfizer and BioNTech’s COVID-19 vaccine for emergency use, tens of thousands of first doses of the vaccine have already arrived in the Pacific Northwest. Doses of Moderna’s COVID-19 vaccine, if authorized by the FDA, will soon follow.

In Oregon, Washington and Idaho, front-line health care workers and residents of long-term care facilities will be the first in line for receiving the vaccine. But wider distribution of the vaccine to the general population could still be months away. So health officials and medical professionals in the Northwest are beginning to think through some of the logistical challenges vaccine rollout will pose, particularly in more rural areas like Eastern Oregon.

Dr. Steven Nemerson is the chief clinical officer for the St. Alphonsus Health System, which operates two hospitals and dozens of clinics in Eastern Oregon. He is based in Boise, where the first doses of the vaccine arrived Monday. Doses arrived in Ontario, Oregon, a day later.

“We’ve got a schedule established to be able to administer it to front line healthcare providers as soon as we possibly can, and then we expect to expand that vaccination throughout our system in our Oregon facilities,” Nemerson said.

Nemerson joined OPB’s Crystal Ligori to talk more about how the process of vaccinating people in Oregon and Idaho will work. Here are some highlights of the conversation:

Crystal Ligori: How will the first vaccines impact the work doctors and nurses are doing right now, as Oregon and Idaho experience a surge of the virus?

Dr. Steven Nemerson: I think there are two points that are of paramount importance. The first one is, our health care providers are protected within the four walls of our facilities, and we have essentially no disease transfer between patients and health care providers. Although we certainly want to augment that protection, and this vaccine will do so. The second thing is that our health care workers don’t live within the four walls of facilities, and so their risk of contracting the virus is equivalent to someone that protects themselves properly, but is going about their business in the real world. And that’s where this disease is being transmitted. So our goal is to protect our colleagues from getting the virus in the community by vaccinating them. By protecting them from acquiring COVID, they’ll continue to be able to work. One of the biggest problems that we’ve had, frankly, is that health care providers are getting this virus out in the real world, and then they’re sick for a minimum of 10-14 days; they need to be quarantined or isolated before they could come back to work. And that’s really harming us.

Ligori: Are health care workers who’ve received the vaccine so far experiencing any side effects?

Nemerson: We received our first tray [on Monday] in Idaho, and we vaccinated promptly, starting at 4 p.m., quite a number of people. By anecdotal reports [Tuesday] morning, they’re doing well, and I don’t know that we’ve had a single person that’s called in sick. It’s generally after that second dose, which will occur in three weeks, where people will get mild flu-like symptoms for about the next day if they get anything at all. And so we’re prepared to adjust staffing to be able to accommodate that, and in fact, our scheduling of our own colleagues is such that we make sure that a limited number of people in each area are receiving the vaccine at any one time, so we don’t have a problem.

(Editor’s note: since this interview was recorded on Tuesday, St. Alphonsus also began vaccinating health care workers on Wednesday morning at its hospital in Ontario.)

Ligori: What logistical challenges does St. Alphonsus anticipate when wider distribution begins in Oregon and Idaho, including rural and sometimes remote areas?

Nemerson: For the Pfizer vaccine, which is the first to be approved, and [which] we’ve received in Eastern Oregon, that requires ultra-cold storage and temperature monitoring; that creates some logistical issues. It’s not like getting a frozen pizza sent to you from Chicago in a Styrofoam box. However, we expect the Moderna vaccine to be approved this week or next. That does not require the ultra-cold storage and as a result, will be more easily distributed to rural areas. And part of our strategy is going to be to use the Moderna vaccine in the more remote locations, and the Pfizer vaccine in the areas that are closer to our distribution hub, as it were ... we’re coordinating with [the Oregon Health Authority] to make sure that we get the vaccine to the right people at the right time.

Ligori: What’s your message to people who may have doubts about the vaccine?

Nemerson: Well, I would say this is an incredibly safe, and one of the most highly effective, vaccines developed, and therefore people should get it as soon as it becomes available to them, based on the criteria that are established by the federal government, the state government, and the places that are going to be administering it. And in fact, I will also tell you that I personally intend to get this vaccine as soon as my place in line comes up, as well as my own family members.

Listen to the full conversation with Dr. Steven Nemerson of the St. Alphonsus Health System by clicking play on the audio player at the top of this article.