EXPRESS SESSIONS: The Experts Join The Express News Group To Talk About Vaccines

A panel of local lawmakers and health professionals joined the Express News Group and dozens of virtual attendees of last week’s Express Sessions forum on Thursday, January 25, to explore analyze the frustrating first six weeks of the COVID-19 vaccine distribution effort in New York and the prospects for shots reaching the East End sooner.

“I think the Titanic had a better rollout than the vaccine had in New York State,” quipped state Assemblyman Fred W. Thiele Jr. to start off the discussion. “It’s very convoluted. The criteria should be your age, it should be your risk factors, not who has the better access to a computer.”

But despite the anger and frustration that have been directed at the overwhelmed appointment scheduling systems put in place by the state, the panel members said that the real problems all come back to lack of supply and the state’s weekly allocation of just 300,000 doses or fewer.

Asked if the county were handed 100,000 doses next week would it be able to distribute them quickly, Suffolk County Executive Steve Bellone said: “Short answer — yes.”

“We can do 50,000 a week and we’re doing a little more than 1,000 to 2,000 at this point,” he said. He said the county already has agreements to set up vaccination “pods” at Hampton Bays High School and the Montauk School, as soon as there are allocations of doses that make them feasible to open. The easternmost vaccination site now is at Suffolk County Community College in Riverside, which only opened last week.

As state officials have said amid a deluge of criticism, Mr. Bellone said that the county has quickly ramped up its preparedness to administer shots but the supply of doses coming from the federal allocation system and then down to the county through the state is still only a relative trickle.

The breadth of the eligibility list has set off a frenzy for appointments that has sowed anger and frustration from those at most risk from the disease.

“They are hurting, they are scared, they want the vaccine,” said Dr. Fredric Weinbaum, the chief medical officer at Stony Brook Southampton Hospital, “and we want to get it to them, but supply is the limiting factor.”

East Hampton Supervisor Peter Van Scoyoc said that his town will have its own distribution site ready to roll by the end of this week, and is eager to start distributing vaccines and should be given a proportion of shots to do so.

“East Hampton is 5 percent of the population of Suffolk, so just send me 5 percent [of doses],” Mr. Van Scoyoc said. “Let me start distributing that in my community. We know who the people are in our community that need it the most.”

The town has a very large senior population, he noted, and a large population of very poor families, many of whom live in multi-family or multi-generational homes because of the region’s high housing costs. And the easternmost town on Long Island finds itself at a particular handicap under the current distribution system which is relying primarily on large vaccinations sites on western Long Island. Even the county’s easternmost location, the newly opened pod at Suffolk County Community College in Riverside, is more than an hour’s drive for some East Hampton residents, and winter weather can make that an even more impossible journey.

Mr. Thiele echoed his sentiment.

“I think that’s exactly one of the failures of the rollout: you have these big mass distribution facilities … and that’s great if you are near a city and you’re 10-15 minutes away, but one size does not fit all,” he said. “In a densely populated area, you can have a central location. In a rural area … you have to bring it into the community. It’s not often that we can learn from the state of West Virginia, but we should here. They got the vaccines to their pharmacies and their local healthcare providers and into their communities.”

The federal government has been selling vaccines directly to the CVS and Walgreens pharmacies, but to date the doses have been spread very far. Only two CVS pharmacies in the state have gotten allocations, Mr. Thiele said, one in Center Moriches and the other in rural upstate Erie County. Mr. Bellone said that as more pharmacies get allotments, residents who are not contacted directly by the pharmacy may have no way to find out that doses are available.

The only instances of locally available vaccines other than the allotments that Stony Brook Southampton Hospital was given to vaccinate medical workers have been flash-in-the-pan appearances of small numbers.

A pharmacy in Westhampton Beach that appealed directly to the state and secured a small allotment of doses, distributed them to eligible longtime customers. And Sun River Health, which has worked with Southampton Village on its testing efforts, secured 70 doses and reached out to Mayor Jesse Warren with an offer of administering them to village residents. Mr. Warren recounted on Thursday the scramble he and Village Hall employees undertook to identify and get seniors from the community and Southampton Fire Department firefighters to the Sun River clinic.

“We called all the 80- or 90-year-olds that we knew,” he said.

Dr. Weinbaum, whose hospital partners with Meeting House Medical Group network of local doctors, said that there has been no indication from the state when doses will start to be distributed to family practitioners. When they are, those doctors would be expected to distribute the shots to their patients, removing the necessity of having to navigate the overloaded state appointment system online or through the telephone.

Dr. Susan Donelan, an infectious diseases specialist and professor at the Stony Brook University Renaissance School of Medicine, said that the vaccination effort should evolve quickly in the next few weeks as the single-dose, more easily transported Johnson & Johnson vaccine is approved and begins mass distribution. The vaccine may not be as broadly effective as the Pfizer and Moderna vaccines are, but even at the lower 60 percent, she noted, it is more effective than the annual flu vaccines typically are, and can make a major impact in the spread of the virus and the severity of illness those who do contract it despite being immunized develop.

Dr. Donelan said she is also of the belief that all supplies of doses at this point should be dedicated to giving first doses to as many people as possible, to give them at least the partial immunity protection, and to worry about second doses as supply builds.

Asked when people might be able to expect to be safe in dialing back social distancing precautions, the medical experts said that only time and a close tracking of how the virus’s spread evolves as more people are vaccinated will tell.

Dr. Jeff Zilberstein, the new medical director at Peconic Bay Medical Center, said that the tracking of the effectiveness of the vaccines to this point has only be in reference to instances of “severe disease” suffered by those who have been immunized. There has not been clinical data collected on what percentage of immunized people may still contract the coronavirus and spread it, though he said the presumption is that vaccination probably protects most people from even contracting and being able to spread it.

“We don’t know whether it decreases spread, but we’re presuming that it will,” he said. “When prevalence goes down, that’s when we’ll be able to rip off our masks. Until that time, we don’t know what we don’t know.”

Also unknown is when the vaccine will be available to people younger than 16, who were not included in the first round of clinical trials. New trials are just getting underway that will include kids as young as 12, Dr. Weinbaum said.

Dr. Weinbaum said the one thing that is known is that the vaccines are safe for anyone to take. There have been only a small proportion of allergic reactions — about 11 people for every million who have taken it — and none of them have been so severe as to be life threatening. The vaccine itself carries no longterm potential impacts, he said, because it is not “alive” like in some other vaccines.

“It’s a synthetic messenger RNA, it’s not alive … it doesn’t go into your DNA, it’s not a retrovirus, nothing persists,” he said.

Dr. Donelan acknowledged that there is reticence among some to take vaccines in general and COVID-19 vaccines in particular, for a variety of reasons ranging from cultural distrust of government, to ideological stands about vaccinations to the taint of political self-interest that has stained the response to the pandemic nationwide. But as more people do take the vaccine, she said, the benefits should bear fruit in the eyes of at least some of the skeptics.

“I think now that people are seeing thousands of other people getting the vaccine and not getting sick,” she said, “people are going to be more enthusiastic.”