Hope and some uncertainty as Alaska prepares for first doses of COVID-19 vaccine to arrive

As health officials in Alaska prepare for the first doses of a COVID-19 vaccine that they say will likely ship out this month, some expressed hope and optimism — along with a few reservations about a vaccine developed in record time.

Dr. Anne Zink, Alaska’s chief medical officer, called the impending vaccine “incredibly hopeful and incredibly exciting” during a call with reporters this week.

But she also said she’s hearing some reluctance from health care providers around the state who still want to see more data on the newly developed vaccines before they get fully on board.

“Many health care providers are scientists by training,” she said Monday. “They want to know more, they want to see the studies, they want to see the data, and they want to understand it.”

For many, it has felt like a dizzying few weeks in the world of COVID-19 vaccine development as the country races toward approving and distributing a vaccine developed less than a year after a virus was first identified.

[The first doses of a COVID-19 vaccine could be distributed nationwide in just a few weeks. Here’s what we know so far about Alaska’s plans.]

On Monday, the drug company Moderna submitted an application for an emergency use authorization of their vaccine, just a week after Pfizer submitted theirs. Data presented by both companies show each vaccine to be more than 90% effective.

On Tuesday, a federal advisory committee with the CDC approved a series of recommendations that include prioritizing residents of long-term care facilities and at-risk health care workers for the very first doses of the vaccine, which officials say could be shipped out at the earliest by mid-December pending approval by the Food and Drug Administration. That approval could be given as soon as Dec. 10.

Vaccines will be in limited quantity initially, and probably won’t be available to the general public until May or June at the earliest, health officials say.

Alaska health officials on Thursday will discuss whether to adopt all of the federal recommendations, which they’re likely to do with a few potential adjustments, said Tessa Walker Linderman, co-lead with Alaska COVID Vaccine Task Force, on a call with reporters this week.

“We imagine this will mirror what (the Advisory Committee on Immunization Practices) puts out, but just understanding that Alaska has some unique challenges as well,” she said.

Some of the concern Zink often hears stems from how quickly the pace of the vaccine approval process seems to be accelerating. But the speed in and of itself isn’t necessarily a problem, Zink said.

“No steps were skipped in the process of this,” she said. Tens of thousands of people have participated in the leading drug companies’ vaccine trials. Scientists have also been able to build on an existing body of research and technology, which has sped up the timeline, she said.

“Just like your phone gets faster as we have more technology to build on, the process of understanding and making vaccines gets faster the more we understand the vaccine process,” she said.

Barbara Bigelow, an administrator with South Peninsula Hospital Long Term Care in Homer, said her team is currently surveying nursing staff to get a sense of who will feel comfortable getting a vaccine.

“Health care workers as a rule are not 100% in their acceptance of vaccinations, so I kind of think the COVID vaccination is going to look like the flu vaccination in most settings,” she said. The U.S. Centers for Disease Control and Prevention estimates that last year, about 80% of health care workers received the flu vaccine.

When the COVID-19 vaccine is ready, Bigelow said she’ll likely get it.

“I’ve always been pro-vaccination for myself and my family,” she said. “I think the risk of everything else we do in life are thousands of times greater than the one-in-a-million chance you’re going to have a reaction to a vaccine.”

Dr. Jay Butler, the CDC’s deputy director for infectious diseases, called the news of potentially more than one highly effective vaccine “pretty darn amazing” during a call with health providers in Alaska on Wednesday.

But he said too that while most of the news that has come out about the vaccines is very hopeful so far, it’s important to wait for the upcoming results of an independent review of the vaccine’s clinical trials before making determinations about safety and efficacy — which the FDA will review too.

Butler previously served as a health commissioner in Alaska, and before that he was the state’s chief medical officer.

He said that there are also some unanswered vaccine questions and gaps in knowledge that are important to find answers to soon.

One is whether the COVID-19 vaccines work to prevent asymptomatic spread, he said.

“This is really crucial,” he said. “Whether the vaccine will prevent infection (as well as illness caused by the virus) so that transmission can truly be interrupted.”

Knowing the answer will help determine travel risk, how personal protective equipment should continue to be used in health care settings and whether a post-exposure quarantine is still necessary, he said.

Another pressing concern is what the recommendations should be for vaccinating pregnant women and breastfeeding mothers, a group that has not been included in the vaccines’ clinical trials.

About three-quarters of health care workers are women, and it’s estimated that up to a third of a million could be pregnant or postpartum while providing care, Butler said. This group is also at a higher risk for developing a more severe illness from the virus.

A final question is whether those who have been previously infected with COVID-19 should get vaccinated. The answer is likely yes, but not right away.

The CDC has said that is likely that immunity to the virus lasts for about three months after infection. But it’s not definitely known.

“We’re talking about an infection that has only been around for about nine months,” Butler said. “So we really don’t know the answer to that question.”

Reinfection does occur, but it is not known how rare or common it is, Butler said.