Large hospital systems are grappling with how best to decide which health care workers will be vaccinated first for COVID-19, a daunting task when it's unclear which shots they'll get, how many and when they'll arrive.
The first COVID-19 vaccine could be cleared for U.S. use as soon as next month, with Pfizer Inc. and BioNTech SE's candidate already under review and Moderna Inc.'s shot not far behind. Federal officials, meanwhile, have signaled that health care workers and older Americans at high risk should be vaccinated as step one in what could set off months of fraught decisions involving other key priority groups.
But following those initial guidelines could prove difficult. With 21 million health care workers in the U.S., there almost certainly won't be enough doses to reach them all at once. That's forcing hospitals to categorize their workers based on best-guess distribution estimates, a task made even more complex for some systems by a patchwork state-by-state approach.
Minnesota's Allina Health system, which employs 15,600 workers who have direct contact with patients in Minnesota and Wisconsin, is estimating it could get 3,000 to 4,000 doses initially. The plan: Prioritize those that interact directly with coronavirus patients by listing each worker by their job type and the units they work in.
"We're looking at all employees, where they work, what their roles are and what their exposure risk is," said Ryan Else, a doctor who is overseeing the coronavirus response in Allina Health's hospitals.
Health systems that operate across state lines face an even bigger challenge. While states are taking cues from federal guidelines, they are developing their own priority lists, creating a situation where some employees in one state might get vaccinated before their peers in another.
"How fair does that feel to people in the same system?" said Amy Compton-Phillips, a doctor and chief clinical officer at Providence, which operates 51 hospitals, as well clinics and medical offices across seven states.
Like Allina, Providence also plans to vaccinate workers based on their roles in an attempt at fairness. The health system will notify workers when it's their turn to get vaccinated. It is also creating an appeal process if people think groups were misclassified. "When things are in short supply, you make really hard decisions. They don't feel good," Compton-Phillips said.
Federal officials plan to initially send 6.4 million doses across the country, according to Gus Perna, Operation Warp Speed's chief operating officer. More doses will then be sent out on a weekly basis with the goal of distributing 40 million doses by the end of the year, Perna said on a call with reporters Tuesday.
Shipments will be divvied up across states based on the size of their adult populations, and not in response to any virus surges, U.S. Department of Health and Human Services Secretary Alex Azar said on the call.