by Marissa Lorenz
Grand County Public Health Director Brene Belew-LaDue administered the county’s first dose of Moderna’s COVID-19 vaccine to Grand County Medical Director Dr. Darcy Selenke at the Denver Health Alpine Clinic early Wednesday morning.
Numerous Public Health staff, other health care workers, Grand County staff, County Commissioner Rich Cimino, and members of the media were present in the socially-distanced room to observe the momentous event.
Cheers and applause were heard, following the otherwise routine vaccine injection. And Dr. Selenke noted, “It’s an honor that they chose me. I’m working in the [Emergency Room] today with people from Texas, Florida–all over the US. It feels safer to be going to work with the vaccine.”
After months of hopeful waiting, Grand County received a total of 400 doses of the Moderna COVID-19 vaccine on Tuesday afternoon, December 22. Grand County Public Health (GCPH) received 100 doses, and Middle Park Health (MPH) received 300 doses. Shipments arrived without notice, though both entities had applied for and been told that they would be receiving vaccine early this week, following the US Food and Drug Administration’s (FDA) emergency use authorization of the Moderna product on December 18.
Grand County will be administering the Moderna vaccine, although another vaccine produced by pharmaceutical company Pfizer was approved December 11, due to the easier transport and storage needs for the Moderna product. While the Pfizer vaccine requires ultra-cold storage of -70 degrees Celsius–something none of Grand County’s major health providers can currently provide–the Moderna vaccine can be stored in a “regular” vaccine freezer, according to Public Health Nurse and Vaccine Coordinator Ellen Parri.
The doses administered by Public Health on Wednesday were thawed overnight. The vaccine must be utilized within six hours of a vial being opened, says Parri, and Public Health is working diligently to ensure that there is no unused, or wasted, vaccine.
Vaccine administration will be in phases
Vaccine administration throughout the county is being conducted according to a phased schedule devised by the Colorado Department of Public Health & Environment (CDPHE) and the Office of the Governor.
A revised schedule released on Wednesday describes Phase 1A as being for health care workers in high-risk settings who come into contact with COVID-19 for more than 15 minutes in a 24-hour period and residents/staff of congregate living facilities; Phase 1B for health care workers in moderate risk settings with less direct contact with COVID-19 patients; Phase 2 for health care workers who provide no direct patient care, other frontline workers, those 65 and older, and those who are immunocompromised; and Phase 3, for the rest of the general population.
GC Public Health is indicating a general time frame for each phase, indicating that they do not know how much vaccine will be made available when. Wednesday began the Phase 1 implementation, with Public Health having scheduled about a dozen healthcare workers to receive the vaccine at the Alpine Clinic in Fraser and planned afternoon administration at Silver Spruce and Grand Living Senior Apartments in Kremmling and Granby respectively.
Alexis Kimbrough, Deputy Director of Emergency Management, states that Phase 1B is expected to also take place in winter 2020/2021, Phase 2 is expected to occur in winter/spring 2021, and Phase 3 should be offered to the general public by summer 2021.
Middle Park Health received 300 doses of COVID-19 vaccine Middle Park Health staff opened their first shipment of the vaccine just hours later at their Granby facility. MPH vaccinated between 50 and 60 people on Wednesday and will prioritize their own highest-risk health care professionals, Grand County EMS personnel, and residents/staff of Cliffview Assisted Living with their first shipment of vaccine.
For those who have had COVID-19, a natural immunity is assumed for about 90 days following recovery. The Cliffview outbreak was first reported on September 27, putting those residents and staff near the end of the assumed natural immunity period. However, because of the small amount of data available on long-term effects of COVID-19, this natural immunity period is not definitive at this time.
Both the Moderna and Pfizer vaccines require two doses for maximum efficacy, shown to be 94-95% effective in study
trials. Recipients must receive both doses from the same type of vaccine. The second dose of Moderna vaccine is recommended at 28 days after the first dose.
Colorado is setting aside the second dose of vaccine for every dose they send to local providers and that a second shipment will be sent as that four-week date nears. All vaccine information is recorded in the digital Colorado Immunization Information System and reported to the federal government, so all medical providers will have access to who has received which vaccine and when.
Herd immunity still far off
However, for the county to reach an adequate level of long-term herd immunity, between 60% and 80% of the county population would need to be inoculated, according to Public Health Deputy Director Abbie Baker.
“Herd immunity” is the term used for the point at which a general population becomes immune to an infectious disease, either through natural long-term antibodies or vaccination, thus minimizing disease transmission. Previous vaccine efforts have been responsible for this effect in such diseases as measles, mumps, and smallpox, to the point that the latter was declared eradicated by the World Health Organization in 1980.
But at what point is there general immunity within a population? The Mayo Clinic website indicates that “94% of the population must be immune to [measles] to interrupt the chain of transmission” of that disease.
On resistance to receiving the vaccine, Baker notes that there is always a portion of the population that is opposed to vaccination. She indicates that between 40% and 60% of Grand County residents receive the flu vaccine on an annual basis.
“I don’t know if we’ll see the same resistance to this as we do with flu vaccine,” Baker said, “but the recommended level of herd immunity is 80% [for COVID-19].”
She indicates that, in a community of 15,000-plus people, about 12,900 residents would have to be vaccinated to achieve that 80%.
“We would be satisfied to achieve 60% of herd immunity,” Baker continued. “It would make a difference. 9,300 people–itwould make a huge difference.”
Both currently authorized vaccines were developed as Messenger RNA (mRNA) vaccines, a newer technology in vaccinology but one which has been studied for decades for such diseases as Zika, flu, and rabies. The COVID-19 vaccines are the first mRNA vaccines to be authorized for human use.
According to the US Centers for Disease Control (CDC), while “many vaccines put a weakened or inactivated germ into our bodies to trigger an immune response, mRNA vaccines teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.”
“mRNA vaccines have been held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States,” reads the CDC website. “The only COVID-19 vaccines the Food and Drug Administration will make available for use in the United States (by approval or emergency use authorization) are those that meet these standards.”
For more information on COVID-19 in Grand County, go to co.grand.co.us/COVID19. To learn more about COVID-19 in general, herd immunity, and/or mRNA vaccines, visit www.cdc.gov.
Grand County Public Health and local medical providers assure that there will be a concerted communication effort to notify citizens of when the County has moved into the later phases of the vaccine administration.
As a condition of distributing these vaccines being supplied by the federal government, vaccine providers cannot charge individuals for the vaccine at this time. It is anticipated that public or private insurance companies will cover any administrative fees that
may be attached to COVID-19 vaccine administration.