State health officials said they will need to double, if not triple, the pace of immunizations to vaccinate and protect about 70% of Washington’s adult population from the novel coronavirus.

Immunology experts use 70% as a rough target for herd immunity, the point at which enough of society is immune that the virus cannot readily spread between people. The state aims to reach its goal, among people 16 and older, in about seven months, said SheAnne Allen, the state’s COVID-19 vaccine director, during a meeting of the state’s Vaccine Advisory Committee.

Currently, the state is using about 15,000-20,000 doses of vaccine each day.

“We need about 45,000 doses in arms a day,” Allen said. “It’s a big goal.”

The goal illustrates the importance of picking up the pace of vaccination in Washington, and gives a rough approximation of when Washington residents’ lives might feel closer to normal.

Washington state will move to the next phase of coronavirus vaccination in the ‘coming days.’ Here’s what that means.
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Workplace clinics and pop-ups

State officials during the committee meeting also described their strategy to rapidly expand vaccination infrastructure, by helping support workplace clinics, mass vaccination clinics, mobile vaccination teams and pop-ups at community centers or places of worship to accelerate vaccination.

For now, state officials maintain that a consistent, reliable vaccine supply from the federal government remains a primary hurdle and said requests for doses from vaccine providers exceed what the state can direct to them.

As supply opens up, the state first hopes to assign more doses to pharmacies and expand capacity through a federal partnership program. Next, the state will look to supply employer-based clinics, which can handle vaccine logistics through employee health programs.

“In flu season, we know a lot of adults get vaccinated through their employer,” said Michele Roberts, the state Department of Health’s acting assistant secretary.

The state is finalizing contracts for companies to assist at mass vaccination sites and plans to involve the National Guard in that effort.

Mobile and pop-up clinics will help ensure people who are harder to reach in the medical system are not left behind.

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“We need to have those plans in place. We are working to develop them now, knowing that supply is still the limiting factor,” Roberts said. “We have to be ready when this switches from not enough vaccine to more vaccine.”

Data gaps

State officials told the advisory committee they are scrambling to figure out data problems that have left them unable to publicly explain large gaps between vaccine delivery and administration.

“This is absolutely the biggest challenge we have going on right now, besides vaccine supply,” Roberts said, saying the state needed better real-time data on administration and vaccine storage.

State officials said at least 201,660 doses of vaccine have been used in Washington state as of Jan. 11. Washington has received 624,975 doses as of Wednesday, meaning that a minimum of 32% of doses had been administered. The health department maintains the actual percentage is higher because of lagging administration data.

Roberts said those administering vaccines needed to submit data more quickly, and that health department workers were determining if there were problems in how the state compiles data.

“We, as a system of all of us, are not accurately telling the story to anybody on where are the doses, how many have been given,” Roberts said. “We need to be able to answer that question for the public.”

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Roberts said the state knew that more doses were being administered than are reported, because the health department is surveying vaccine providers separately and coming up with different statistics than what the state reports.

It isn’t realistic to continue the time-consuming survey efforts, Robert said.

Using a data-entry system to send immunization information to the state’s database is cumbersome, and it can take several data-entry clerks to submit information for a few hundred people, said Dr. Rachel Wood, health officer for Lewis County Public Health and Social Services.

Expanding access

State officials also told the committee they were considering changes to its prioritization plan after the Trump administration urged governors to expand vaccine access to anyone 65 and over or anyone with a comorbidity. No decision has been made.

“We are looking at that information, actively seeking more information, and quite frankly, waiting for what the Biden administration’s decisions are,” Roberts said. “They’re actually in charge next Wednesday.”

Some vaccine advisory committee members, including Dr. Susan Westerlund, of the Washington Academy of Family Physicians, urged state health leaders to update their phase guidance to find a place for those age 65-69 in the state’s priority plan.

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“It would be nice to have them listed somewhere. Otherwise, it looks like you’re not considering the … group,” Westerlund said. Committee members noted they had received a flood of questions from this group and others, trying to understand their places in the prioritization line.

The federal policy changes — which caught state leaders by surprise — have prompted outrage among some people in that age group, who see other states vaccinating their peers.

“The whole country seems to be saying 65, and Washington state seems to be saying, ‘don’t worry about those folks, throw them under the bus, they can wait until April or May,’ ” said Steve Hirsch, a 65-year-old in Seattle, during a Thursday interview. “I understand everybody is putting up their hand and saying, ‘Me, me, me.’ … That argument, we don’t have enough going around, it’s hard to make when they can’t use what they’ve got.”

Access, long lines and confusion have been a problem in some states that are offering the vaccine more widely, as demand far outstrips supply.

Roberts told the committee the state’s complex prioritization plan is designed to promote equity and to help protect workers who are more likely to contract the virus in addition to the most vulnerable.

Roberts also argued that the federal government’s announcement that it would no longer reserve booster shots and would send all available doses to states, had left the impression that supply was suddenly swelling.

“They were not very clear publicly, this announcement of more vaccine coming is in a couple weeks,” Roberts said. “It’s a huge public-relations nightmare.”