Second wave of COVID-19 vaccine distributions begins in Alaska as Moderna shipments arrive

The first shipments of the Moderna COVID-19 vaccine — the second to receive federal approval — arrived in Alaska on Monday as vaccinations that started last week extended into some of the state’s most remote regions.

Meanwhile, state and federal officials are trying to figure out why about a third of the half-dozen severe reactions to the vaccine officially reported in the U.S. so far have occurred in Alaska. Officials say reactions have been rare, and far more treatable than the virus can be.

The state’s first vaccine arrived a week ago: the start of 35,100 doses manufactured by Pfizer coming to the state in two pulses. As of Sunday, 5,674 doses had been administered, according to the state’s vaccine webpage, which tracks the statewide total slightly behind real-time.

Alaska expects to receive 26,800 initial doses of Moderna vaccine, public health officials said Monday. That number includes Indian Health Service allocations but not those for Veterans Affairs and the Department of Defense. The Alaska VA Healthcare System expects to receive 600 doses this week. A defense department spokesperson said the agency is not releasing specific numbers of vaccines administered to personnel for security reasons.

Health officials hope the less finicky Moderna vaccine will be a better fit for some of Alaska’s far-flung rural communities as compared to the Pfizer product, which requires ultra-cold storage.

By Monday, vaccine had traveled to cities, regional hub communities and small villages. Despite the strict temperature requirements, Pfizer vaccine distribution has gone mostly smoothly, state officials say.

A vaccine shipment to Ketchikan had to be thrown away last week because it got too warm during shipment. Twenty doses were lost, said Matt Bobo, a state immunization program director.

In the Yukon-Kuskokwim region, more than 180 medical providers in 37 villages have been vaccinated, health officials said. The region has experienced some of the highest case rates per capita in the state and country in recent months.

“So we did charter flights to the villages, and we called ahead and had everyone meet us on the runway,” said Dr. Ellen Hodges, a family medicine physician who serves as chief of staff for Bethel-based Yukon-Kuskokwim Health Corp. “We vaccinated in vehicles, we vaccinated in planes. We vaccinated a couple people on snow machines. It was truly a remarkable endeavor.”

In Galena, in the Interior, high-school senior Corbin Sommer and media teacher Paul Apfelbeck filmed the arrival of the first vaccine aboard an Air Arctic 10-seat twin-engine plane just before sunrise on Monday, the shortest day of the year.

“It’s so, so exciting to have the vaccine,” local family practitioner Dr. Tamera Huntingon tells the camera. “It’s so poetic that it’s the solstice, and maybe this is the darkest point of the pandemic.”

Tanana Chiefs Conference, the Fairbanks-based nonprofit tribal health organization, distributed the first doses in its service area to residents and staff at the Yukon Koyukuk Elders Assisted Living Facility. Some of the Interior’s eldest residents from five communities live full-time at the facility.

Virginia Johnston, a 93-year-old resident, got the very first shot. Health aide Nicole Gregory asks Johnson if she’s ready. “You’re going to feel a slight poke,” Gregory says.

Johnson, her hair in neat French braids, didn’t flinch.

Adverse reactions

Nearly all the state’s vaccinations so far resulted in no reports of serious problems. State protocols require anyone administering the shots have a medical response kit available. Recipients are monitored for at least 15 minutes following vaccination; 30 minutes for people with a history of allergic reactions.

But by Monday, 11 Alaskan health-care workers had reported some kind of adverse reaction after getting the shot, including two described as anaphylactic shock. One Bartlett Hospital employee suffered several waves of reaction and needed to be hospitalized overnight.

The Alaska Department of Health and Social Services announced six new cases at Bartlett on Monday. The state had already reported five adverse reactions in Alaskan health care workers as of Sunday.

None of the six new reactions was serious, state health officials said on a call with reporters Monday.

Alaska appears to be something of an anomaly. Only six people across the country reported anaphylactic reactions as of Friday, including two here, federal officials say.

An updated count wasn’t available Monday. A Centers for Disease control spokesperson said the agency is working on a plan for reporting adverse reactions to the COVID-19 vaccines.

A federal investigation is ongoing as to why Alaska has seen about a third of the total anaphylactic reactions nationwide, according to the state’s chief medical officer, Dr. Anne Zink. There are no clear answers yet.

“There have been an impressive number of emails and conference calls with the CDC and numerous immunology groups over the country since these first few cases,” Zink said, adding that multiple causes are being considered. “Everything is on the table.”

Health officials have speculated that one suspect for the bad reactions is polyethylene glycol, a chemical widely used in medicines, cosmetics and other household products, and is part of the vaccine.

They’ve stressed that allergic reactions to the vaccine have been both rare and treatable, and that the vast majority of vaccine recipients were fine.

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Anchorage Health Department registered nurse Wendy Williams draws a dose of the Pfizer-BioNtech COVID-19 vaccine during a vaccine clinic on Thursday, Dec. 17, 2020 in East Anchorage. The Municipality of Anchorage is beginning to vaccinate firefighters and first responders this week. (Loren Holmes / ADN)

A less fussy vaccine

Supplies of the vaccine are limited in Alaska and around the country, prompting federal and state-level priorities for the first shipments.

The first group to receive vaccine was hospital-based, front-line health care workers and long-term care facility residents and staff. The next tier of vaccination, which is also in progress, includes front-line EMS and fire service personnel providing medical services who are frequently exposed to COVID-19 patients including community health aides, as well as health care workers required to give shots.

Additional groups could start getting vaccinated as soon as Jan. 4, officials say, including additional health care workers who have direct patient contact or contact with infectious materials; provide services that can’t be offered remotely; provide service in a setting where postponing treatment could harm the patient; and need to be licensed and certified, such as lab technicians or workers performing COVID-19 testing.

A state allocation committee will decide which groups get priority as additional vaccine becomes available.

The Pfizer and Moderna vaccines are similar in that they both use messenger RNA technology, proved highly effective in clinical trials, and require two doses spaced apart, according to a state summary.

Storage temperatures provide a critical difference: Both vaccines must be kept cold but the Moderna vaccine can be shipped at -4 degrees Fahrenheit and is stable after thawing at refrigerator temperatures for 30 days and at room temperature for 12 hours. The Pfizer vaccine must be shipped at -94 degrees Fahrenheit but can only be stored at refrigerated temperature for five days.

State officials say a benefit of the Moderna vaccine is it provides extra flexibility for communities with less access to cold storage.

Hodges said a welcome shipment of Moderna vaccine is expected in the next day or two.

She said the additional doses from Moderna provided by Indian Health Services in addition to the state’s initial allotment have been a huge relief, and will allow vaccinations in the region to clip along faster than other parts of the state.

The health organization expects to finish with the first round of vaccinations — hospital-based, front-line health care workers and long-term care residents — by Wednesday. Next, people 65 and older.

“We’ll be starting our vaccinations of our elders this week,” she said.

Correction: This story has been updated to correct the spelling of Galena media teacher Paul Apfelbeck’s name.