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COVID-19 COVID-19
VACCINES VACCINES

next for frontline essential workers, but rather focusing “on people for
whom there is strong and consistent evidence that COVID-19 makes
them more likely to become very sick or die.” Although this extensively
broadened the population for which the COVID-19 vaccine was in-
dicated, it also further exacerbated the COVID-19 vaccine supply and
demand inequity.
COVID-19 vaccines offer great promise in our battle against the
adverse health effects of this pervasive disease, but we still have several
immediate needs: we need more vaccine supply; we need more organ-
izations to enroll as vaccine providers to administer the vaccine; and
we need more clear communication regarding where those who are
recommended to receive the vaccine can do so. I have the privilege of
working with many dedicated leaders and professionals in our com-
munity who are committed to addressing these issues.
As of this writing, University Health has begun to offer the
COVID-19 vaccine to individuals in the Phase 1B category through
a large vaccination setting and other organizations are also finalizing
plans to provide immunizations to this vulnerable population. The
state of Texas is communicating that if vaccine providers administer
the vaccine they will get more, and so is strongly encouraging that
no doses be held in reserve. With the timing of the second dose of
approaching for those who were immunized early, and a larger eligi-
ble population, we need a consistent and growing supply of vaccine
to be provided.
Just recently, the COVID-19 vaccine developed by the University
of Oxford and AstraZeneca was authorized by regulators in the U.K.
and in India, bringing yet another weapon to the global fight against
this novel coronavirus. It is the most logistically forgiving of the
three major vaccines to date since it only requires refrigeration for
Vaccine Implementation gage in 9-1-1 emergency services like pre-hospital care and transport, storage, which opens up supply to a vast network of existing immu-
nization infrastructure. However, researchers are estimating that
staff in outpatient care settings who interact with symptomatic pa- FDA authorization of the Oxford AstraZeneca vaccine may not
tients, and healthcare workers in corrections and detention facilities. come until April 2021. Until then, we must maximize the availability
By Bryan Alsip, MD
On December 18, 2020, the FDA issued an emergency use author- and administration of both the Pfizer-BioNTech and Moderna vac-
ization for the Moderna COVID-19 vaccine, which demonstrated cines in the coming months.
similar safety and efficacy as the Pfizer-BioNTech version with some As more organizations in Bexar County enroll to become immu-
On December 11, 2020, the U.S. Food and Drug Administration ignated to receive the Pfizer-BioNTech vaccine. Therefore, week 1 al- logistical advantages. Although it is shipped frozen (between -13ºF nizers, more vaccine is provided by the state and federal governments,
(FDA) issued the first emergency use authorization for the Pfizer- locations of the COVID-19 vaccine in Texas went almost exclusively and 5ºF), the Moderna vaccine does not have the same ultra-low tem- and more venues become available to our community residents, we
BioNTech COVID-19 vaccine for the prevention of coronavirus dis- to hospitals. perature storage requirements. The Moderna vaccine also does not re- can protect more people against symptomatic COVID-19 disease. At
ease 2019 (COVID-19) caused by severe acute respiratory syndrome Those hospitals and health systems began immunizing their staff as quire dilution and, after being thawed, can stay refrigerated for up to a time when hospitalizations for COVID-19 patients in Texas are at
coronavirus 2 (SARS-CoV-2). From a public health standpoint, this recommended by both the CDC’s Advisory Committee on Immu- 30 days prior to use. This makes the vaccine easier to store and admin- an all-time high, this is more important than ever. If you or your or-
represented a significant turning point in our war against COVID- nization Practices (ACIP) and the Texas Expert Vaccine Allocation ister, which enables more organizations to play a role in offering the ganization traditionally offers immunizations, please become a part of
19, marking a deliberate shift in strategy from defense to offense. Hav- Panel (EVAP), but the supply of vaccine did not initially meet the de- vaccine. Week 2 allocations of the COVID-19 vaccine in Texas in- this endeavor. Enroll as a COVID-19 vaccine provider with the Texas
ing been on the defensive for over a year, that was a refreshing change. mand. Some hospitals did not receive enough doses, or even any vac- cluded the Moderna product and were shipped to a larger group of Department of State Health Services (DSHS) at https://enrolltexa-
The authorization of the Pfizer-BioNTech vaccine also brought its cine. Furthermore, Health Care Workers, as defined by the Texas immunization providers including physician offices, urgent care clin- siz.dshs.texas.gov/emrlogin.asp and immunize your staff and eligible
own challenges. Although praised for early data which suggest the vac- EVAP for Phase 1A, includes an extensive range of staff and providers ics, and pharmacies. Unfortunately, many of these allocations were patients as guidelines recommend. We need more community con-
cine is safe and effective, it has strict storage and handling require- working both inside and outside of the hospital setting. very small, with several locations receiving only the minimum supply tributors to expand our vaccination efforts and help make 2021 the
ments. Specifically, vials of vaccine must be kept frozen between As we have seen throughout this pandemic, our community found of 100 doses. year we turn the tide on this historic pandemic.
-112ºF and -76ºF, which requires an ultra-low temperature freezer not ways to collaborate. Several organizations that received initial alloca- During the same week, the Texas Department of State Health Serv-
readily available to most immunization providers. As federal and state tions began to share vaccine and to immunize others. University ices (DSHS) published their recommendations for Phase 1B COVID- Bryan Alsip, MD MPH FACPM is Executive Vice Presi-
governments made decisions regarding allocation, only those organi- Health partnered with the Southwest Texas Regional Advisory Coun- 19 vaccine allocation. As with several other states, these guidelines dent and Chief Medical Officer for the University Health Sys-
zations that had enrolled as vaccine providers and had indicated they cil (STRAC), the City of San Antonio, Bexar County, and other differed from those published by the CDC’s Advisory Committee on tem and is a member of the Bexar County Medical Society.
could meet the ultra-low temperature storage requirements were des- healthcare providers, to offer vaccinations to EMS providers who en- Immunization Practices (ACIP), by not recommending the vaccine

18 SAN ANTONIO MEDICINE • February 2021 Visit us at www.bcms.org 19