As a group of groups for vaccines, here’s how Alaska will decide who is next in line


The vaccines of pharmaceutical companies Pfizer and Moderna are being coined as a game-changing weapon in the battle against COVID-19, which has infected more than 180 Alaskans and thousands more.

But for the next several months, far fewer vaccine doses will be available than those who wish to receive them. And it presents the difficult question of who gets the shot first.

According to his administration officials, GOP Gov. Mike Dunleavy has the ultimate right to decide. But so far, the state has made recommendations from a new advisory committee, largely made up of health care providers, that they said are best suited to consider the science and data surrounding the vaccine.

The committee’s initial work to allocate vaccines to various groups of health care workers was narrow, and has drawn relatively little scrutiny from the general public as the first consignment of 35,000 doses comes from pharmaceutical companies Pfizer and BioNotech.

But its work is now entering a more delicate phase as additional doses become available. And the letters are underlining the stakes of difficult dilemmas that some committee members did not feel they would be asked to consider.

Those seeking to ensure their place in Alaska’s vaccine line include nonprofits, trade unions, and even state agencies.

State legislature leaders want lawmakers and staff to be named essential workers, citing their importance to the state’s economic recovery and the aging Capitol Building’s reputation as a “petri dish” for communicable diseases .

Those represent requests that the committee has received so far, and it is set to give more public testimony at a meeting later this month.

Alaskaites should know that the committee is acting with humanity and honesty, said Mark Carr, a regional strategist with Providence Health and Services Alaska and one of the committee’s 24 members. He emphasized that members are not making value judgments or implementing some sort of “ethical algorithm”.

“Northing may be ahead of the truth,” he said. “We are going to identify a certain part of our structural system that we must keep going, so that we have a society left, so that we have a structure that allows groceries to be on the shelf and people Allows to drive to the hospital. “

Not what they signed up for

A separate federal committee first recommended residents of facilities such as front-line health care workers and nursing homes to get the vaccine, known as “Phase 1A”.

But the state wanted advice on how to implement Alaska’s recommendations, and helps ensure that health care workers should go first, because there was not enough vaccine for all of them.

Members of the committee include hospital officials, doctors, nursing home administrators, Fred Meyer pharmacists and leaders of Alaska’s tribal health care providers. He eventually recommended, and Dunley’s administration agreed, to begin with two levels of vaccination within Phase 1A.

Residents and employees of First Tier Nursing Home, plus hospital-based front-line health care workers, are “most at risk”. The second tier consists of emergency medical responders, vaccines and people providing community health support.

In a meeting on Sunday, the Federal Advisory Committee voted that the next phase, 1B, consisted of 19 million Americans and people over the age of 75, as well as 30 million front-end locations in places such as schools, grocery stores, prisons and public transportation. The line will include the necessary worker. Network. It also stated that Phase 1c would include a second, broader group of essential workers, adults with pre-existing medical conditions, and those aged 65–74.

Alaska’s allocation committee will now have to consider translating those national guidelines into state-specific recommendations.

Among the many committee members recently reached by phone, everyone except Carr was declined to be interviewed. Cosin said this is likely because the group’s role is taken on a much higher profile than many of its volunteer volunteers originally anticipated.

“People didn’t necessarily sign up for it, nor did we pursue it,” Cousin said. “It is people who are circling hospitals, caregivers in nursing homes, everyday physicians and others who have jobs that are simply coming together to help and advise the public good. “

Navigating the “impossible task”

Now that the vaccine has arrived in Alaska, the committee has received two dozen letters about the allocation, according to the list provided by Cousin. Advocates from various organizations also spoke on the public testimony of the first round of the committee on Thursday evening.

Among them, part of Dunley’s administration was the Office of Children’s Services, which wants its employees to be considered first responders. Meanwhile, the Alaska Branch of the American Civil Liberties Union has said that inmates will be given priority, citing a massive COVID-19 outbreak in state correctional buildings.

Then there is the Coastal Villages Area Fund, a nonprofit company that owns Bering Sea fishing rights, which pays for social and economic programs in 20 Southwest Alaska rural villages – some of which have led to COVIDs in large numbers Have seen -19 infections.

The CVRF has asked the allocation committee to recognize the unique challenges in the area, such as dense multi-family housing, some health clinics and the lack of piped water and sewer systems at some locations. The idea is not without precedent: In Tennessee, the state’s draft vaccination plan called for a 5% dose separation for areas that scored highly on the CDC, the “Social Vulnerability Index.”

CVRF Chief Executive Officer Eric Deakin said that perhaps, residents of rural southwest Alaska should be vaccinated around the same time as Alaskans put COVID-19 at a higher risk of serious illness.

“I think most of our communities are at risk,” Deakin said in an interview. “We do not think that population centers should have priority in rural areas when they deliver this vaccine.”

Carr, an ethicist, said committee members are mindful of the challenges facing rural Alaska. The allocation dilemma is particularly macabre because Alaska and other Americans are not used to competing with scarce resources, he said.

“This is not what we do. It’s not who we are, “Carr said. “Alaskans believe that our resources are absolutely unlimited.”

The committee is trying to avoid using the term “priority”, as it suggests that members value certain groups over others, Carr said. Instead, the broader goal of the allocation process is maximizing Alaska’s health and well-being, with Alaska’s chief medical officer Drs. Anne Zinc said.

This is one of the reasons that the initial phase of the vaccine is going to those who keep Alaska’s hospitals operating, and to facilities like nursing homes, Gink said.

It is not that those workers and residents in the health care system are more valuable than others, she said.

It is such that if hospitals are drowned because the staff is sick, deaths among the general public start climbing very rapidly, Gink said. Vaccination to nursing home residents means fewer of them will end up seriously ill and burdened hospitals, and it will allow the state to shift its virus-testing efforts away from those facilities and toward places like schools and restaurants Will allow, he said.

However, Zink acknowledged that many Alaska state allocation decisions are unlikely to be satisfied.

“I wish I had better words to comfort the Alaskans, to say that we are trying to do this as objectively and equitably as possible. But it is an impossible task, and I know that it is very important for many. Won’t be fair, “he said.” I’m completely sympathetic to that, and can understand why people would feel that way. But I can’t separate myself from looking at data and science about it, and whatever it is Trying to be as transparent as possible. “

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