BMC doctor discusses plans for distribution of the vaccine

Cassandra Pierre

Now that the Food and Drug Administration has authorized emergency use of the first Covid-19 vaccine in the United States, health care workers will be among the first to get the vaccine.

Dr. Cassandra Pierre, an infectious disease physician at Boston Medical Center who serves as the acting hospital epidemiologist, joined WBUR’s Sharon Brody on Dec. 12 to discuss how the hospital plans to distribute the vaccine, and how health care workers are feeling about receiving it.

On vaccine availability for BMC workers who care directly for coronavirus-positive patients:

“We do not anticipate that [frontline-facing health care workers will be unable to get the vaccine]. What we’re actually anticipating is that not everyone will be able to get their dose — their vaccine — within the first week or two weeks. It might be a month. It might be two months to get everyone actively vaccinated. It really depends on how much we get up front. But we do anticipate that we will be able to sufficiently cover everyone who is frontline-facing, who is caring for patients — especially those who are caring for Covid-positive patients. I should say, we really want to get everyone who is caring for patients, period, covered in the next few months.

“... But more than that, this is really about health care personnel, not just people who are providers or nurses. This is also very much about our support staff, certified nursing assistants, medical assistance, but also our environmental service workers, our food service workers. All of us have some risk of ... getting Covid.

On concerns about side effects and whether they might temporarily incapacitate health care workers:

“This is actually one of our biggest concerns. We know that — having looked at the data — the vaccine is safe. But up to maybe, even up to 50 percent of people combined in the Moderna and the Pfizer trials, have experienced these side effects, which are common among people who get vaccines in general.

“Of course, we’re concerned about the severe allergy that has been reported in the UK. But other than that, we’re not as concerned... The concern, obviously, is the overlap in between the symptoms, the adverse events that you could be seeing as a normal course of having received a vaccine, and symptoms for Covid. So that’s the fever, the body aches, the fatigue. So we have set up a system where ... we’re... educating our staff, that if you develop a fever, if you develop maybe severe symptoms, we do want you to take some time off and we want you to get tested for Covid. So clearly that could quickly destabilize the workforce.

“In order to avoid that, hopefully, we are planning on staggering the doses. So not everyone in the same work group gets vaccinated at that certain time: that would be a recipe for disaster. [We’re] trying to get people to get vaccinated right before they go off service or before the weekends so that people have time to recover and get over those side effects before they have to come back to work.

On hospital workers expressing anxiety about the vaccine:

“You know, I think that the decision to vaccinate health care workers first is really essential for three reasons. I mean, obviously, we want to make sure that we maintain our health care worker force, that we preserve their safety and their health, that they don’t become infected with Covid during this critical period when we need them to take care of our patients. We also want to make sure that our patients are aware this is a safe place to come. The majority of health care workers have been vaccinated. You are safe to come into the space. But the third important reason, that kind of gets to what you’re talking about, is we want our health care workers to serve as both indirect and direct spokespeople for the safety and efficacy of this vaccine, to show Americans, ‘Yes, we believe in this so much that we ourselves are getting vaccinated to show you that it is safe and we believe in this.’ And part of that is making sure that we can promote vaccine confidence among our own health care workers.

“And just as a sidebar, we know that many of the people in the hospital, like myself, are Black or belong to Black and brown communities, belong to communities that have been marginalized. And so we reflect our patient population.

We want to make sure that we also can speak to the lived experience of [being] a part of a group that has been experimented on, who has been marginalized, that has been disenfranchised for medical care, but [who want] to ... ensure our safety — our own individual safety and the safety of our communities — and speak with knowledge, and speak with confidence to the fact that this is something that is going to safeguard our communities this year and for years to come.”

On the most fair and helpful way to distribute the vaccine:

“Yeah, I think this is something we’ve been struggling with. I think one of the things that we have been hoping to use to our advantage is this concept of a vulnerability index that the CDC has conceived and utilized to identify where the hot spots will be. So that social or community vulnerability index really refers to a set of factors that might leave a community vulnerable to Covid or really any other health disparities.

“What is the density of housing in one area? Are people living in multigenerational households? What are the percentage of people that work in the essential fields that mean that they cannot quarantine safely at home? What are the language barriers? What is the percentage of people who live below the poverty line?

“We know the factors that put people at risk, not just for Covid, but for other kinds of chronic diseases and health disparities. How can we use that index to more effectively target those areas or those individuals who are going to really benefit the most?

This story was published by WBUR 90.9FM on Dec. 12. The Reporter and WBUR share content through a media partnership.