As we begin Phase 2 of the Massachusetts COVID-19 vaccine rollout plan, we, your local leaders in infectious diseases, reaffirm our commitment to working together to help bring an end to this pandemic. We now face the massive and complex undertaking of ensuring access to COVID-19 vaccination for all of our residents.
We applaud President Biden’s decision to utilize all measures, including the Defense Production Act, to ramp up the production of vaccines and the supplies necessary for administration. We also fully anticipate the Food and Drug Administration and Centers for Disease Control and Prevention will continue to do everything in their power to expedite the review of additional COVID-19 vaccine candidates as soon as adequate data are available to ensure vaccine safety and efficacy.
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As the Commonwealth focuses its efforts on widespread public vaccination, we offer the following outline of the key challenges in this process and suggestions for how we can address these issues together.
Federal and state officials should act to do the following:
▪ Improve the transparency and predictability of vaccine supply. While we expect that the vaccine supply chain may remain fragile and unpredictable for a period of weeks to months, we ask that our leaders at all levels of government do their best to improve the transparency of vaccine supply and the predictability of the allocation of supply to vaccine clinics. Any additional insight that can be provided will aid in ensuring optimal communication and utilization of limited resources.
▪ Eliminate vaccine underutilization and waste. Federal and state leadership should ensure that all vaccination clinics utilize vaccine supply as soon as feasible; no vaccine should be left unused or in storage. They should also ensure administration of all doses prior to expiration, including the “extra dose” in vials as has become standard practice. While we support maintaining patient prioritization, all remaining doses should be given to anyone meeting emergency use authorization criteria to eliminate waste.
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▪ Ensure equity in vaccine access. Vaccination clinics must be located in areas that will ensure access to our vulnerable patients, including communities of color and those with limited access to a primary care physician. We must also ensure methods of patient outreach are equitable. Many vaccination clinics will use the Internet, e-mail, or text-based scheduling tools to achieve large-scale communication quickly. However, these tools will probably be less effective for people with limited English proficiency or those without reliable access to the Internet, a cell phone, or e-mail. Additional strategies such as mobile vaccine strategies and walk-in clinics must be developed. As soon as vaccine supply allows, we also recommend that clinicians on the ground be given the appropriate flexibility to vaccinate caregivers or family members who accompany patients to appointments if they may otherwise not be able to return or are at risk of limited access to vaccine. Reporting on vaccine doses delivered by language as well as race and ethnicity will help to ensure we hold ourselves accountable to this goal.
▪ Prioritize our most impacted communities in each phase. As we expand vaccination, we must ensure that communities hardest hit by COVID-19 are prioritized for vaccine distribution alongside those individually at greatest risk of severe COVID-19. These include towns and cities that do not have affiliations with major hospital systems.
▪ Employers must support vaccination. We request that federal and state officials consider requiring that employers support our vaccine efforts by allowing for paid time off for vaccination. No one should be prevented from receiving a vaccine because they are fearful of losing their job or critical income.
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In addition to federal and state leaders, Massachusetts residents have a role in ensuring widespread vaccination success too. When it’s your turn, get vaccinated as soon as possible and encourage your family, friends, and neighbors to do the same. All of the COVID-19 vaccines currently available in the United States have been shown to be safe and effective at preventing COVID-19 and may also help protect the people around you.
It’s common for vaccinations to cause side effects like fatigue, sore muscles, or a mild fever. These side effects are a good sign and mean that the vaccine is working to develop protection against the virus. Get the second shot even if you have side effects after the first one, unless your doctor tells you not to do so. This way the vaccine will have the best chance of keeping you and potentially others safe.
It takes time for vaccines to do their job to help your body build protection against the virus, and it’s possible to become infected with COVID-19 even after your first dose of vaccine. Continue to wear a mask, physically distance, and wash your hands regularly to stay safe until public health officials say it’s safe to stop, which will be possible once community transmission rates are suppressed.
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We remain here with you and will continue to work tirelessly to do our part to end this pandemic. The start of COVID-19 vaccination in our communities gives us optimism that we will soon see better days.
Dr. Tamar Foster Barlam is chief of the Section of Infectious Diseases at Boston Medical Center. Dr. Helen W. Boucher is chief of the Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center. Dr. Kalpana Gupta is associate chief of staff and chair of the Infectious Diseases COVID Response Team at Veterans Affairs Boston Healthcare System. Dr. Daniel Kuritzkes is chief of the Division of Infectious Diseases at Brigham and Women’s Hospital. Dr. Mary LaSalvia is interim chief of the Division of Infectious Diseases at Beth Israel Deaconess Medical Center. Dr. Matthew R. Leibowitz is chief of Infectious Diseases at Newton-Wellesley Hospital. Dr. Katherine McGowan is chief of Infectious Diseases at Brigham and Women’s Faulkner Hospital. Dr. Louise Ivers is interim chief of the Division of Infectious Diseases at Massachusetts General Hospital. Dr. Kenneth M. Wener is chair of the Division of Infectious Diseases at Lahey Hospital and Medical Center.
