Photo from Joseph Spector/USA Today

TOMPKINS COUNTY, N.Y.—The recent weeks of the coronavirus pandemic have been teeming with headlines bringing both the best news and the worst news of the last several months: a vaccine delivery appears imminent, but until it is made widely accessible to a variety of different populations, the public health crisis seems poised to keep worsening as it has nationwide over the last several weeks.

How New York will start its vaccination distribution program became a bit clearer on Wednesday, as Gov. Andrew Cuomo announced that distribution of the Pfizer vaccine would begin on Dec. 15. It will prioritize delivery to residents and workers in nursing homes, which have been among the hardest hit locations throughout the pandemic, as well as healthcare workers.

“The vaccination program is really the end-game here,” Cuomo said on Dec. 3. He’s repeatedly called it the “weapon that will win the war” against the coronavirus, even after saying that distribution wouldn’t start in New York State until the vaccine is approved by a state medical board subsequent to federal approval.

Tompkins County Public Health Director Frank Kruppa had previously stated that nursing home residents, staff and other frontline workers would be prioritized to receive the vaccination locally, in accordance with federal and state-set guidelines and likely with the help of Cayuga Health System. He said the county is still gathering information on how many doses would be necessary to satisfy the first prioritization of long-term care facility workers and residents.

If the vaccine delivery process begins on Dec. 15, Kruppa said the county would begin by identifying priority populations, which has already began, and would then establish “closed points of dispensing,” where the vaccination would be administered.

“It’s a set up that allows for the vaccination of an identified population,” Kruppa said. “The hospital would likely vaccinate their staff, and we would work with them and our long-term care facilities to get folks vaccinated in their facilities.”

Cuomo has emphasized repeatedly that the vaccine should be distributed fairly and without bias, particularly once the priority, high-risk populations are vaccinated. Plans are underway to make that a reality in Tompkins County, even though widespread distribution of the vaccine for “anyone who wants it” may not begin until spring or summer of 2021, according to Kruppa and federal officials.

“Here locally, we are committed to making sure that as we develop our points of dispensing, particularly when it becomes available to the general population, that we will have multiple avenues for people to access that so that it is equitably distributed,” Kruppa said. “The main focus is making sure that it’s available in different parts of the community. We have memorandums of understanding with multiple facilities that would allow us to set up (points of dispensing) in different parts of the community so that there would be access for everyone. The thing we don’t know yet is if that’s going to be our role.”

President Donald Trump has said he wants retail pharmacies to be included in the distribution and administration of the vaccine, which is why Kruppa isn’t sure how many or whether any of the county’s potential PODs would be utilized or not.

Though cases have begun to climb at a worrisome rate recently, the overall public health impact of the pandemic has been relatively less in Tompkins County than elsewhere, with only four deaths and just over 1,000 confirmed cases. That won’t preclude the county from receiving its initial vaccine supply when its being distributed to local municipalities in the coming weeks, though.

“I don’t think the prevalence of disease in our community is going to be a driver in when or how much of the vaccine we are going to get,” Kruppa said. “We would expect that New York State will get its allocation based on its population. Then, based on our estimation in the priority populations, we would get our portion of that.”

Exactly how many doses Tompkins County will need, or will receive, isn’t known yet. Kruppa said the county health department is still working with local long-term care facilities and medical care providers to determine the exact priority population number locally.

Kruppa said larger hospital systems may receive shipments of the vaccine first, mostly due to the “cold-chain” (or frigid, temperature-controlled) conditions necessary to safely transport and store the vaccines that have been developed so far. From there, they would likely be distributed farther out—but the state’s specific plan on that isn’t quite clear yet.

The Pfizer vaccine, which appears to be the option that will start being delivered on Dec. 15, requires a double dose of the vaccine 21 days apart. Those who receive the shots will not be actually vaccinated until they receive the second shot—Kruppa said that the first shot essentially readies the body’s immune system, while the second shot is what truly initiates immunization. That could make the vaccination process complex, Kruppa acknowledged, and the challenge of immunizing the community is magnified by the relatively prominent anti-vaccination sentiment in Tompkins County and, maybe more prominently, in Ithaca.

“We definitely have concerns about uptake of the vaccine,” Kruppa said. “We have an issue here in Tompkins County with vaccination of school-aged children being lower than we would like to see it in regular times. I imagine that will extend to this situation. We’ll certainly be putting out messaging about the vaccine, letting folks know that it’s necessary and that it’s safe. I think where that needle is really going to move is at the federal and the state level.”

Matt Butler

Matt Butler is the Education & Public Health Reporter at the Ithaca Voice. He can be reached by email at mbutler@ithacavoice.com