Vaccine rollout to prioritize those at higher risk

Officials working to vaccinate 60 to 70% of residents once a candidate is available

Ron Balajadia, the state Department of Health’s immunization branch chief, explains the state’s draft vaccination plan for COVID-19 during a news conference Thursday. Hawaii is preparing for a future rollout of a vaccine once it’s available.

Health officials are hoping to get 60 to 70 percent of Hawaii’s population vaccinated for COVID-19 once it’s available, though the state will likely face challenges of funding, wary residents and limited storage capacity on Neighbor Islands.

“Experts who study immunity tell us to break the chain of transmission of a virus, at least 60 to 70 percent of the population must develop immunity to the virus,” Gov. David Ige said. “A safe and effective vaccine is the best way to reach this level of immunity. Once we reach this level of protection, we can get more aggressive about reviving the economy, getting our keiki back to schools and allowing more normal social interactions and behaviors.”

The Health Department rolled out a preview of its vaccination distribution plan Thursday, which still needs to be vetted by the Centers for Disease Control and Prevention.

Ron Balajadia, immunization branch chief for the Department of Health, said the plan would give first priority to health care employees at hospitals, nursing homes, in-home care and others involved with direct patient care. First responders with a high risk for COVID-19 exposure would also be in the top priority group, as well as Hawaii residents of all ages who have underlying conditions and comorbidities like diabetes and heart disease, including those ages 65 and over who live in close-packed settings like long-term care facilities.

The second priority group would cover other essential workers, such as kindergarten to 12th-grade teachers and school staff; people with underlying health conditions that put them at moderate risk of catching COVID; people in homeless shelters or group homes with physical or mental disabilities and the workers who serve them; people in prisons, jails, detention centers and similar facilities as well as their staff; and all adults ages 65 and older. (When asked why prisoners would take priority over other groups, Balajadia said it was because of the facilities’ “congregate setting.”)

Lt. Gov. Josh Green said during a news conference Thursday that while not everyone may want the COVID-19 vaccine, it’s the job of policymakers to offer people the choice.

The third group would include young adults ages 18 to 22 years old, children ages 17 and younger and employees in industries or occupations not mentioned in previous groups that are considered essential and face increased risk of exposure.

Lastly, the fourth group would include all Hawaii residents who didn’t fall in the other priority groups.

“It’s important to start planning now so we’re ready when a safe and effective vaccine is available,” Ige said. “The best estimates at this point are that an FDA-approved COVID vaccine won’t be available for a few months. However, we want distribution structures and procedures in place.”

But the $800,000 provided by the federal government for vaccine distribution may not even come close to what Hawaii ultimately needs. The Health Department has been redirecting current staff to its vaccination program and used some of the funding to hire more people. However, Ige said the state will likely need to request more funding.

Balajadia said that based on past campaigns and the effort needed to transport, store and vaccinate people across the state through clinics and mobile teams could cost as much as $25 million. He said the CDC is working with manufacturers to get the vaccine delivered in an “ultracold setting” with dry ice in hopes of keeping them viable for five days.

“We are working really hard to try to determine the capacity for storage and also the capacity for dry ice here in the state of Hawaii,” he said. “And we also know that some of our Neighbor Islands may not have that capacity, so (we’re) really trying to incorporate and ensure that whatever it is that we’re planning is kept in mind with what the capacity for our Neighbor Islands are.”

When asked if some islands would get priority over others, Balajadia said that the vaccines “will be distributed to all islands based on the criteria.”

Lt. Gov. Josh Green said the vaccine could come in the form of two shots, four weeks apart, though final details will depend on the vaccinations that get approved. Green said he and his family would be taking the vaccine even though he already had the virus, as that doesn’t guarantee full immunity, though he understood people’s concerns “that this vaccination has been accelerated because of the global emergency.”

“Everyone has to make up their own mind,” said Green, who’s also a medical doctor. “Everyone has to know what their own risk is. As Ron was pointing out earlier, we feel that people who are most vulnerable will likely be the ones that want the vaccine the most. . . . Those individuals will have to make the hard decision about whether or not they want to take the vaccine early in its phase, but we’ll keep it available for people.”

The job of policymakers, Green said, is “to give people an option.” They also need to vet the data and make sure the studies and safety profiles have been good and that the people who went through the process didn’t have side effects.

“Having had COVID, you don’t want to get COVID if you can prevent it with a vaccination that’s safe. Take it from me,” Green said.

* Colleen Uechi can be reached at cuechi@mauinews.com.


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