Wednesday, August 17, 2022

Rolling out the cure: Wilmington vaccination process bumpy, providers still optimistic about results

New Hanover County has vaccinated more than 33,000 people to date. (Port City Daily/Courtesy New Hanover County)

WILMINGTON — From the earliest days of the Covid-19 outbreak, the most promising endgame for the pandemic was the development of an effective vaccine. Now, less than a year after the coronavirus began spreading like global wildfire, 10 vaccinations are available — including two in the United States — and many more are in the pipeline.

The rollout has hit plenty of bumps in the road, but spokespeople from local providers — New Hanover County Public Health, New Hanover Regional Medical Center, MedNorth, Wilmington Health — told Port City Daily it’s gone as well as they could have expected, considering the magnitude of the task.

Essentially, they have to get the life-saving vaccine injected into the arms of hundreds of thousands of people who want it — and as quickly as possible. Not to mention, the two vaccines approved for use in the United States, Pfizer-BioNTech and Moderna, require two doses three to four weeks apart.

Althea Johnson, CEO of Wilmington’s MedNorth Clinic, points to the lack of federal leadership of the early hurdles states — and, in turn — local vaccine providers such as MedNorth faced in establishing an efficient vaccination process. Johnson, whose clinic’s mission is to provide health care for underserved communities, also said there were legal issues at play that prevented advance work for providers to set up systems that would allow a smooth vaccination process. 

RELATED: Wilmington’s MedNorth eager to take Covid-19 vaccine to the people

“First of all, the vaccine had to be approved,” Johnson said. “They probably could have made some logistical arrangements, but they could not make any specific contractual arrangements until all of these things had been already approved and vetted.”

By all accounts, the development and approval timeline for the vaccines are unprecedented; the FDA gave Moderna and Pfizer emergency use authorization in about 11 months. The vaccines’ efficacy rate — 94%-95% protection against Covid-19 — are unparalleled. Often overlooked is the fact that minimal symptoms came from the 5% percent of people in the trials who were infected with the coronavirus after being vaccinated.

Johnson points out the emergency declaration from the federal government comes with legal concerns that filter down to the states — all of which were promised certain amounts of doses to be designated to local providers to administer.

“When you read the documents that you get from them (the state), they’re very, very specific” in vaccination requirements, Johnson said.

For example, the state requires a 20-plus question online form to be completed for each recipient.

“Unfortunately, this is such a litigious society that the state has to put all these safeguards in place for everybody” Johnson said.

Those requirements, regardless of need, inevitably slow down the process.

“I think that a lack of really good federal coordination has affected all states, really,” Johnson said. “You would think that perhaps a federal system would have been set up to vet your patients and track vaccinations, but I feel that (the Trump) administration was not focusing on that.”

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As an epidemiologist told National Public Radio recently, vaccines will not eliminate Covid-19, but they will make the disease manageable — fewer people will die or need to be hospitalized, and life eventually will get back to normal.

Epidemiologists say 70% of the 280 million Americans eligible need to be vaccinated to achieve widespread herd immunity. That would make it a dangerous but manageable disease, similar to an ordinary flu season.

Dr. Paul Kamitsuka, an infectious-disease specialist with Wilmington Health, compared battling Covid-19 to fighting a wildfire: The out-of-control spreading has to be contained before it can be effectively extinguished. 

Firefighters train for years to figure out the best way to put out a multitude of different fires. The Covid-19 pandemic is an uncontrolled fire that few people knew how to extinguish. Even when scientists and medical personnel offered instructions (masks, social distancing, etc.), many people refused to follow them.

Most pharmacists that people interact with are behind counters, filling prescriptions for blood-pressure medicine and antibiotics. They often don’t see how the patient has fared.

That’s not the case for Mike Melroy, pharmacy director at New Hanover Regional Medical Center, who has seen up-close the toll Covid-19 is taking on the region. Melroy and his colleagues have seen nearly 250 people die — 135 from New Hanover County — from Covid-19 at NHRMC, which serves several counties in southeastern North Carolina. 

Death is ubiquitous at hospitals, but most people die from maladies such as cancer and cardiac arrest, not infectious diseases. Influenza, for example, has killed fewer than 10 people in the entire state during the 2020-21 flu season. 

In a recent Zoom interview with Port City Daily, Melroy appeared weary. Like many healthcare workers, he can’t remember his last day off. The arrival of the life-saving vaccines is welcome fuel for Melroy and others who have had little ammunition to throw at the insidious virus.

While the vaccination rollout has not been smooth — appointments fill up as quickly as vaccines are received, phone lines are constantly busy and online scheduling systems jam — like Althea Johnson at MedNorth, Melroy believes the process is getting better as the state, NHRMC and other providers get more experience under their belts.

Both said upgrades have made the state’s database system easier to use, for example.

“We know that there’s an opportunity to improve” in how the vaccine is distributed, Melroy said. But the main obstacle remains the limited supply. 

“You know, because of our very limited supply, it just goes so quickly.”

Coming Monday, with an assist from Novant Health, Brunswick County took a different approach to the vaccination process.

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