Governor outlines preliminary state plan for distribution of a COVID-19 vaccine when it’s available

Gov. Andrew Cuomo outlined a preliminary COVID-19 Vaccination Program Sunday to address how the state will begin to distribute and administer a vaccine when one becomes available.

The plan brings together an independent task force of experts, including doctors from Stony Brook Medicine and Northwell Health, to review every COVID-19 vaccine authorized by the federal government to advise the state on its safety and effectiveness. Distributing a vaccine would ultimately begin with prioritizing those most at risk and frontline workers.

“We are coming up with a plan on many presumptions,” Mr. Cuomo said. “We don’t really know how many doses we’re going to get, we don’t know what vaccine we’re going to get, we don’t know when we’re going to get it.”

The plan features three priority levels, split between areas with high COVID-19 prevalence and areas with low prevalence. The top priority would go to high risk population and essential health care workers. Lower risk population and other essential workers would be next and the general population would be last.

More specific phases are also considered that would begin with health care workers in patient care settings, long-term care facility workers and the most at-risk long-term care facility residents. A second phase would add first responders, teachers and school staff, public health workers, other essential frontline workers that regularly interact with the public and other long-term care residents and those living in other congregate settings. Individuals in general population deemed particularly high risk would also be in Phase 2.

Phase 3 would include individuals over 65, Phase 4 would be other essential workers and Phase 5 includes everyone else.

He called it a “major undertaking” and said the state will use whatever resources are available, including possibly using National Guard members.

Mr. Cuomo noted the challenge and time it would take to administer a vaccine with as many as 40 million doses. He said most the vaccines under development seem to require two doses that are administered a few weeks apart. Even as New York leads the country in COVID-19 testing, the total number of tests done is currently 12.9 million — more than seven months into the pandemic.

“It gives you a scale of how daunting this task is,” Mr. Cuomo said.

There is currently no COVID-19 vaccine authorized or approved in the United States. Operation Warp Speed began when the pandemic started with a goal to produce and deliver 300 million doses of safe and effective vaccines with initial doses available by January 2021, according to the Centers for Disease Control and Prevention. The CDC is working in partnership with the National Institutes of Health, the Biomedical Advanced Research and Development Authority, the Department of Defense and many other private firms and federal agencies. Dozens of potential vaccines are currently in a Phase 3 trial.

The governor said there will be one statewide vaccination plan that local governments will follow as to not create hundreds of differing strategies.

He said it remains unclear how the federal government will introduce a plan for vaccines. He said the National Governors Association sent a letter to President Trump requesting to meet and discuss how implementation of a vaccine will work between federal and state governments. He said a letter from the NGA included 36 questions with a basic premise of “How does this work?”

Mr. Cuomo said the governors want to know who determines how many vaccines each state receives or if there will be a federal strategy.

“Can they tell us if they’re going to condition the release of vaccines,” he asked. “Are they going to turn around and say we won’t give you the vaccines, unless you do X, Y and Z?”

The CDC says “experts are working on how to distribute these limited vaccines in a fair, ethical and transparent way.” Vaccines at first may not be recommended for children, according to the CDC.

FDA Commissioner Stephen Hahn, M.D. and Peter Marks, M.D., the director of the Center for Biologics Evaluation and Research, issued a statement recently saying: “We are committed to expediting the development of COVID-19 vaccines, but not at the expense of sound science and decision making. We will not jeopardize the public’s trust in our science-based, independent review of these or any vaccines. There’s too much at stake.”

Mr. Cuomo added: “States cannot do this on their own. Period. This is a larger operation undertaking I would argue than anything we have done during COVID to date. We need the federal government to be a competent partner with this state and every state.”

Other logistical challenges await, such as storing vaccines, which Mr. Cuomo said would require a temperature potentially as low as minus 80 degrees Celsius. The financial cost also remains unclear. He said New York State is already facing a $50 billion deficit and federal relief has not arrived.

The CDC says “the federal government is committed to providing free or low-cost COVID-19 vaccines. Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccine providers will be able to charge administration fees for giving or administering the shot to someone.”

On Monday, Mr. Cuomo reported 998 positive COVID-19 tests for a 1.21% positive rate. Total hospitalizations climbed to 934 across New York. Hospitalizations across the state have been trending up for the past few weeks after holding steady throughout the summer.