Vaccines on the way to LRH

Tuesday, December 15, 2020

COVID-19 mitigation still encouraged

Officials with Lakes Regional Healthcare announced Thursday the hospital expects to receive 300 doses of a COVID-19 vaccine developed by pharmaceutical company Moderna. The vaccines are anticipated to arrive the week of Dec. 21, and the first round of vaccinations might be given to local healthcare workers around Christmas, according to Dickinson County Public Health Director Katy Burke.

Priorities for the first doses

Burke said the state health department is initially supplying each county with enough vaccines to cover about 30 percent of their health care work forces. She said Dickinson County has around 850 healthcare workers but, because the Moderna vaccine is shipped in increments of 100, Dickinson County was allotted an even 300 doses. LRH Chief Medical Officer Jeremy Bolluyt said the vaccines won't be given exclusively to providers within the hospital. He said dentists, optometrists and other health care workers in the community may also be included in the first round of vaccinations. Burke said subsequent shipments of the vaccine will be used to vaccinate the remaining health care professionals in Dickinson County, and partnerships with national pharmacies will help in administering the vaccines to other locations like long-term care facilities.

Of the 3,340 COVID-19 related deaths recorded by the state of Iowa as of Tuesday, 1,134 were among long-term care facilities, according to the state's coronavirus tracking website. The data also showed about 139 outbreaks of COVID-19 in long-term care facilities across the state. Only one such outbreak was listed in Dickinson County at Accura Healhcare of Milford. The state data showed 42 total cases at the local facility, but only one case was recorded in the past 14 days. The state website also listed 12 individuals had recovered at Accura.

Iowa Department of Public Health Director Kelly Garcia said earlier this month she expects vaccines will be available to the general public by mid 2021, if projections hold. Bolluyt said he expects vaccine shipments will become more regular after the initial supply arrives at LRH later this month.

"The two pharmaceutical manufacturers of the COVID vaccine Pfizer and Moderna are on track to make 2.3 billion doses combined over the next year," Bolluyt said. "So we hope to be able to vaccinate most of the community by this summer."

Burke said, when the vaccines are available to the general public, health officials plan to inform Lakes Area residents through news releases and social media. Both of the vaccines need to be given in two doses 21 days apart for the Pfizer vaccine and 28 days apart for the Moderna vaccine. Burke said local patients will likely have their follow-up appointments scheduled when they receive their first dose.

"Vaccine recipients will be encouraged to keep their vaccination card and show it at their follow-up vaccination appointment to ensure the second dose of vaccine is the same brand/manufacturer as the first dose received," Burke said. "Both doses need to be the same brand."

Vaccinations recommended

Dickinson County Public Health is encouraging Lakes Area residents to be vaccinated against COVID-19 for three main reasons, according to Burke. She said the vaccine could substantially decrease the chances of an individual being infected with the virus a second time LRH physician Zach Borus said in late November he was aware of patients who had recovered from COVID-19 and later been reinfected. Burke said, if a person does happen to be infected with the virus again, a vaccine would help keep the second case from becoming as severe. She also said vaccinations among the general public will help stop the virus from spreading to populations like the elderly who are at an increased risk of serious complications.

Still, she said vaccination won't be cause to suddenly stop current efforts to minimize the spread of the virus within the community.

"While experts learn more about the protection that COVID-19 vaccines provide under real life conditions, it will be important for everyone to continue using all the tools available to help stop this pandemic, like wearing masks, washing hands often and social distancing," Burke said. "Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on mask use. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision."

She said the U.S. Centers for Disease Control are still not sure, at this point, how much of a given population will need to be vaccinated to achieve herd immunity against COVID-19 the ratio varies by disease, according to the CDC.

Dickinson County had 154 active cases as of late last week, according to data from local health officials. About 1,385 of the county's 1,554 total cases were listed as recovered, but 15 Dickinson County residents have now died because of COVID-19 the second time the reported deaths have increased by two in as many weeks. The county's two-week rolling average of positive tests has continued to dwindle from about 19 percent on Dec. 4 to about 17 percent the next week.

"We saw a peak in November, and our numbers are going down fortunately," Mike Ehret, Dickinson County Emergency Management coordinator, said. "The thing to remember is that the hospitals don't typically see their peak until a few weeks after the numbers peak after everything kind of filters through. Hopefully they're past their peak and they'll start seeing their numbers decline."

As of Friday's report, nine patients at LRH were positive for COVID-19. The hospital has admitted 94 COVID-19 patients since March.

Research and development

Information from Iowa State University said both the Pfizer and Moderna vaccines are part of a new class of vaccines called mRNA vaccines. David Verhoeven, an assistant professor of veterinary microbiology and preventative medicine at ISU, has expertise on mRNA vaccines, according to the university. He said, while traditional vaccines prompt viral immunity within cells, mRNA vaccines seem to spur immunity in a patient's bodily fluids as well as their cells.

As of Monday, Burke said local health officials weren't sure if they'll be receiving vaccines from both Moderan and Pfizer in the future. The two vaccines require different storage temperatures. Pfizer's needs to be ultra-frozen or stored with dry ice. Burke said LRH has one ultra-frozen unit hand, and she said the Moderna doses can be stored in her department's normal freezer and refrigeration units.

Research teams at both Iowa State University and the University of Iowa are developing needle-free, single-dose nanovaccines that would not require refrigeration. Iowa State's Nanovaccine Institute received $2 million in federal funding as part of the Coronavirus Aid, Relief and Economic Security or CARES Act, according to information from the university. Information about the project said the nanoparticles about 300 billionths of a meter wide are made with biodegradable polymers and would be used in a nasal spray to trigger an immune response.

"While it is wonderful that there are several first generation COVID-19 vaccines that will become available soon, there are multiple opportunities for improved next generation vaccines, in terms of their ability to induce long-lived protective immunity, prevent transmission and be stored at room temperature for long periods of time," Balaji Narasimhan, director of the Nanovaccine Institute, said. "Nanovaccines can provide these important advancements in the next phase of our fight against COVID-19."

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