Nearly 40 million vaccines could be needed to protect New Yorkers from COVID-19. Every state submitted to the federal government how they intend to distribute those vaccines to residents, whenever a vaccine becomes available. But the pharmacists who will actually be handling the injection say a lot is still left to be determined.
The Trump administration’s plan to roll out a COVID-19 vaccine required a public-private partnership between the federal government and big commercial pharmacies. That plan drew criticism from New York Gov. Andrew Cuomo.
He said the plan was “deeply flawed” and would create a bottleneck in the demand for the vaccine. It could take a year to vaccinate the entire population of New York against COVID-19 under the federal plan, meaning the state would have to keep some restrictions in place until then.
“Don’t tell us it’s the state’s responsibility without giving the state the resources to do the job,” Cuomo said.
Plus, those seeking the injection would have to visit a pharmacy to receive it, like they would for a flu shot.
“The president talks about CVS and Walgreens and the national chains. Sure. But they are mainly located in rich communities, not in poor communities,” he said. “My friends, we cannot compound the racial injustice COVID already created.”
Michael Bars, a spokesman for the White House, blasted Cuomo, saying the governor has missed 17 briefings over the last five months for state governments overseeing the vaccine development process.
“It’s no surprise that an absent Governor Cuomo is substantially behind and unprepared as states formulate their vaccine distribution plans," Bars said.
Now, Cuomo said a Biden presidency would help mom-and-pop drug stores, schools, community health centers and houses of worship where people of color would have better access to the injection.
And then, from there, the roll out is really in the hands of independent pharmacists who are embedded in communities to do the job, according to Howard Jacobson, who runs Rockville Centre Pharmacy on Long Island.
“We are going to make it happen. Sight unseen, we are going to make it happen,” Jacobson said. “We'll need to get the vaccine. We'll have to be trained, and we're going to have adequate storage.”
That’s going to be the largest hurdle: cold storage. Cuomo plans to set up central warehouses across New York to keep the vaccine refrigerated at sub-zero temperatures.
Jacobson is in a holding pattern until more information is released about: how the vaccine will reach the warehouses; who transports the injections to the distribution sites; and if they need to be super cold, how often will there be drop off?
“And if we need to hire more people, that's what we'll do,” he said. “If we need to change something in our workflow. We will do it in order to get this done.”
“There's definitely going to be a supply issue that people are going to have to stock up on and make sure they have,” said Thomas D’Angelo, president of the Pharmacists Society of the State of New York. He said the pandemic has put a strain on all aspects of the healthcare industry.
Rockville Centre Pharmacy is going to need way more syringes, unless the vaccines are pre-packaged with one. Masks and gloves will be needed and might have to be changed out more frequently. Drug stores will have to hire more professional staff to administer injections.
“That's going to be the biggest issue,” D’Angelo said. “I mean, I did hear that CVS was hiring 10,000 technicians to help. I don't know how that's going to help, because technicians can’t vaccinate in New York State.”
A spokesperson with CVS Health was unavailable for an interview, but the company said in a release that 70% of the U.S. lives within three miles of a CVS Pharmacy, and have easy access to professional pharmacy, nursing and technician staff for coronavirus vaccine when it becomes available.
Walter Markowitz, professor of health professions at Hofstra University and former 30-year administrator at Northwell Health, said it’s likely going to take a combination of licensed providers for an effective vaccination distribution. CVS rolls out 20 million flu vaccines a year across the U.S. New York needs twice that for COVID-19 in a much shorter period of time.
“40 million is an awful lot. Consider that only like 40% of people get the flu vaccine. And so, you know, I'm not a big believer in herd immunity. So you're really going to have to immunize a major portion,” Markowitz said. “The only vaccine in which we really eradicated the disease was smallpox.”
The rollout of the state’s vaccine plan prioritizes healthcare professions, then frontline workers and next people who are most susceptible to the virus.
Hossam Maksoud is CEO of Community Cares Rx, a pharmacy that serves long-term care facilities in the New York tri-state area. Maksoud said a major break in the national supply chain pitting states in a bidding war for possible injections, like they did for safety equipment, would make it difficult to protect their vulnerable nursing home patients.
“You have a conflict between state policy and the state rules and regulation versus the federal and which one really pharmacists should follow,” Maksoud said. He is most concerned that they’ll run out of vaccines — leaving a population unfairly exposed, whether they be senior, poor or a people of color. Because, he said, it happens.
“There is a huge shortage in New York and maybe the country for flu vaccines. We don't have flu vaccines. We ran out of flu vaccines. So, you know, there is a lot of catch up.”
Independent pharmacists say if Cuomo wants to engage the community where they live to get a vaccine, they will need supplies and support from all levels of government to make it happen.
