Legislature(2019 - 2020)BY TELECONFERENCE
12/17/2020 09:30 AM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Statewide Covid-19 Vaccination Plan | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
December 17, 2020
9:35 a.m.
MEMBERS PRESENT
Representative Tiffany Zulkosky, Chair
Representative Ivy Spohnholz, Vice Chair
Representative Matt Claman
Representative Harriet Drummond
Representative Geran Tarr
Representative Sharon Jackson
MEMBERS ABSENT
Representative Lance Pruitt
OTHER LEGISLATORS PRESENT
Representative Sara Hannan.
COMMITTEE CALENDAR
PRESENTATION(S): STATEWIDE COVID-19 VACCINATION PLAN
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record.
WITNESS REGISTER
ANNE ZINK, MD, FACEP, Chief Medical Officer
Central Office
Division of Public Health
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Co-provided a PowerPoint presentation,
entitled "Alaska COVID-19 Vaccine Task Force."
TESSA WALKER LINDERMAN, DNP, RN, Nurse Consultant
Office of Substance Misuse and Addiction Prevention
Alaska Department of Health & Social Services
Anchorage, Alaska
POSITION STATEMENT: Co-provided a PowerPoint presentation,
entitled "Alaska COVID-19 Vaccine Task Force."
ROBERT ONDERS, MD, Medical Director
Community & Health Systems Improvement
Alaska Native Tribal Health Consortium
Anchorage, Alaska
POSITION STATEMENT: Co-Provided a PowerPoint presentation,
entitled "Alaska COVID-19 Vaccine Task Force."
MATTHEW BOBO, Director
Alaska Immunization Program
Division of Public Health
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Co-provided a PowerPoint presentation,
entitled "Alaska COVID-19 Vaccine Task Force."
HEIDI HEDBERG, Director
Division of Public Health
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the presentation.
ACTION NARRATIVE
9:35:22 AM
CHAIR TIFFANY ZULKOSKY called the House Health and Social
Services Standing Committee meeting to order at 9:35 a.m.
Representatives Claman (via teleconference), Drummond (via
teleconference), Spohnholz (via teleconference), Tarr (via
teleconference), and Zulkosky (via teleconference) were present
at the call to order. Representative Jackson arrived (via
teleconference) as the meeting was in progress.
^PRESENTATION(S): Statewide COVID-19 Vaccination Plan
PRESENTATION(S): Statewide COVID-19 Vaccination Plan
9:36:25 AM
CHAIR ZULKOSKY announced that the only order of business would
be a presentation on the statewide COVID-19 vaccination plan by
the Department of Health and Social Services (DHSS).
9:37:42 AM
ANNE ZINK, MD, FACEP, Chief Medical Officer, Central Office,
Division of Public Health, Department of Health and Social
Services, drew attention to slide 2 of the PowerPoint
presentation, entitled "Alaska COVID-19 Vaccine Task Force,
which read as follows [original punctuation provided]:
Agenda
? Opening Remarks (Dr. Anne Zink)
? Overview of Vaccine Candidates (Dr. Anne Zink)
? Alaska COVID-19 Vaccine Task Force
(Tessa Walker Linderman)
? ANTHC Partnership, Tribal Health Partner Work
(Dr. Bob Onders)
? Phases & Allocations (Tessa Walker Linderman)
? Ordering, Receiving, and Distribution (Matt Bobo)
? Community Planning (Tessa Walker Linderman)
? Vaccine Confidence (Dr. Anne Zink)
? Questions from the Committee
DR. ZINK offered that all the vaccine candidates have undergone
rigorous study for safety and efficacy. She then drew attention
to slide 4 of the presentation, which read as follows [original
punctuation provided]:
Vaccine Candidates Pfizer
? Authorized by FDA under an Emergency Use
Authorization
? Final analysis 170 confirmed cases of COVID-19 were
evaluated, with 162 observed in the placebo group
versus 8 in the vaccine group; 95% effective against
COVID-19 7 days post dose 2
? Efficacy was consistent across age, gender, race and
ethnicity demographics; observed efficacy in adults
over
65 years of age was over 94%
? 43,000 participants; no serious safety concerns
-70 degrees Celsius storage
DR. ZINK added that distribution of the vaccine is closely
monitored on an ongoing basis and recalled that there was a
report of a single adverse reaction recorded in Alaska. She
added that the ultra-cold temperature storage requirement
provides logistical challenges, and that the vaccine may only be
stored under refrigeration for up to five days.
DR. ZINK explained that additional information is available and
contained in publications and drew attention to slide 5 of the
presentation, which read as follows [original punctuation
provided]:
Publications for reference:
The FDA issued an emergency use authorization (EUA)
for the Pfizer
COVID-19 vaccine on Dec 11, and the Advisory Committee
on
Immunizations Practices (ACIP) voted to recommend the
use of the
Pfizer COVID-19 vaccine for those 16 and older.
Publications of note
include:
Official MMWR release of "The Advisory Committee on
Immunization Practices' Interim Recommendation for Use
of Pfizer-BioNTech COVID-19 Vaccine United States,
December 2020"
? Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for
Recipients
and Caregivers
Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for
Healthcare
Providers
? Pfizer-BioNTech COVID-19 Vaccine EUA Letter of
Authorization
DR. ZINK cited the publication on slide 5 as including the
Advisory Committee on Immunization Practices (ACIP) which is the
advisory entity to the Centers for Disease Control and
Prevention (CDC) and makes recommendations on who should receive
the vaccine first.
DR. ZINK noted that additional vaccines are scheduled to become
available, and referred to slide 6 of the presentation, which
read as follows [original punctuation provided]:
Vaccine Candidates Moderna
? Submitted for Emergency Use Authorization;
discussions
happening this week
? Interim analysis 95 cases included 90 cases in
placebo
group and 5 cases in vaccine group; vaccine efficacy
against COVID-19 was 94.1% 2 weeks post dose 2;
vaccine efficacy against severe COVID-19 was 100%
? 30,000 participants; no serious safety concerns
? On December 2, Moderna announced that it would soon
begin testing its coronavirus vaccine in children ages
12
through 17
-20 Celsius storage
? Information from manufacturer press release
DR. ZINK added that the Pfizer and Moderna vaccines are similar
to one another and are both Messenger Ribonucleic Acid (mRNA)
type vaccines, which require neither a live virus nor an
attenuated virus, but rather uses a small segment of Ribonucleic
Acid (RNA) which produces a cleaner response with fewer adverse
effects to date. She added that, although mRNA vaccines have
not been widely used, they have been long studied.
DR. ZINK highlighted the information contained in slide 7, which
read as follows [original punctuation provided]:
No steps are skipped during the clinical trial process
for COVID19 vaccine. Manufacturing and trials can
happen at the same time, which speeds up the timeline
for vaccines to reach Alaska should once authorized by
the FDA.
DR. ZINK went on to explain the three phases of preclinical
trials. Phase 1 tests the safety [of the vaccine candidate] in
a small number of people; phase 2 tests hundreds of people for
safety and effectiveness; and phase 3 consists of testing the
safety and efficacy among tens thousands of people. She noted
that Phase 3 had proceeded more quickly than anticipated due to
the high number of the population already exposed to the
pandemic.
9:44:05 AM
DR. ZINK drew attention to the information contained in slide 7,
which read as follows [original punctuation provided]:
Vaccine Candidates
Safety is a top priority:
? FDA scientists review all Vaccine
Adverse Event Reporting System
(VAERS) reports classified as
serious
? CDC scientists will review VAERS
reports for adverse events of
special interest (AESI)
? CDC and FDA coordinate on
analysis of VAERS data and both
agencies conduct data mining
DR. ZINK recounted a recent adverse reaction as a working
example of the successful cooperation between clinicians, the
Food & Drug Administration (FDA) and the CDC to monitor the
event for safety and reporting.
DR. ZINK directed attention to slide 9, which read as follows
[original punctuation provided]:
Vaccine Candidates
According to current federal government estimates,
Alaska's initial
allocations of vaccines could include:
? Pfizer: 35,100 doses
? Moderna: 26,800 doses
These vaccine doses will be distributed statewide
among public, private
and Tribal health systems.
The current authorization for the vaccine is under an
EUA, which is
different than a normal vaccination authorization
under a biological
license. There are specific rules related to an EAU
that arguably limit
the ability of an employer to mandate a vaccination.
? Complex Question we do not provide legal advice to
non-state
agencies, individuals
? Governor Dunleavy has indicated that he will not
mandate a
vaccination for Alaskans
DR. ZINK explained that Alaska is coordinating with Operation
Warp Speed to obtain the state's entire December 2020 vaccine
allocation, rather than on a weekly basis, due to the unique
logistical challenges posed in Alaska. She noted that these
allocations are decided by the federal government and include
those allocated through the Indian Health Service (HIS). She
added that tribes are allowed to choose to work either with the
HIS or the state and are partnering with the state for
distribution logistics. She added that the vaccine is approved
for use under an Emergency Use Authorization (EUA) rather than a
full authorization due to the status of the pandemic.
9:47:43 AM
TESSA WALKER LINDERMAN, DNP, RN, Nurse Consultant, Office of
Substance Misuse and Addiction Prevention, Alaska Department of
Health & Social Services, drew attention to slide 11 which
depicts the organizational structure of the Alaska Covid-19
Vaccine Task Force. The Task Force consists of eight teams co-
led by the Alaska Department of Health and Social Services
(DHSS) and the Alaska Native Tribal Health Consortium (ANTHC):
planning, operations, software solutions, payers, pharmacy,
education, data, and liaisons. She noted that the full team
consists of approximately 50 individuals.
9:49:09 AM
ROBERT ONDERS, MD, Medical Director, Community & Health Systems
Improvement, Alaska Native Tribal Health Consortium, applauded
the efforts of the task force in its coordinated efforts with
the Indian Health Service, the State of Alaska, ANTHC, and
regional tribal associations to begin vaccine distribution in
Alaska communities. He noted that many anticipated challenges
with logistics and government-to-government coordination were
mitigated through existing infrastructure such as the Vaccines
for Children Program and proactive communication and advocacy on
the part of the task force.
9:52:00 AM
MS. WALKER LINDERMAN referred to slide 14, entitled "Vaccine
Availability Phases," which depicts the current status of the
vaccine as having gone from the phase of "No Vaccine" to "Very
Limited Availability" and the ultimate future goal of "Widely
Available". She then directed attention to slide 15, which read
as follows [original punctuation provided]:
Vaccine Allocation Federal
? CDC Advisory Council on Immunization Practices
(ACIP)
approved the following recommendation by majority
(13-1) vote at its December 1, 2020 emergency meeting
When a COVID-19 vaccine is authorized by FDA and
recommended by ACIP, vaccination in the initial phase
of the
COVID-19 vaccination program (Phase 1A) should be
offered to
both 1) health care personnel and
2) residents of long-term care facilities
? More information:
https://www.cdc.gov/vaccines/acip/index.html
MS. WALKER LINDERMAN shared with the committee the information
contained on slide 16, which read as follows [original
punctuation provided]:
Vaccine Allocation Federal
Further CDC Advisory Council on Immunization Practices
(ACIP)
Recommendations:
? Healthcare personnel (HCP) with direct patient
contact
-Unable to telework
-Including those who work in inpatient, outpatient,
or community settings
-Provide services to patients or patients' family
members
-Handle infectious materials
? HCP working in residential care or long-term care
facilities
? HCP infected with COVID-19 within the preceding 90
days may
choose to delay vaccination for other HCP more
susceptible to
infection
? No current data to inform recommendations for
pregnant or
breastfeeding women
MS. WALKER LINDERMAN continued with the presentation of
information depicted on slide 17, which read as follows
[original punctuation provided]:
Vaccine Allocation Federal
Further CDC Advisory Council on Immunization Practices
(ACIP) Recommendations:
? Long-term care facility resident sub-groups
-Skilled Nursing Facilities
-After Skilled Nursing Facilities:
?Assisted living facilities
?Intermediate care facilities for individuals with
developmental disabilities
?Residential care facilities
?State Veterans Homes
9:54:53 AM
MS. WALKER LINDERMAN explained that the Task Force has
communicated to stakeholders with an analogy depicted on slide
18, which read as follows [original punctuation provided]:
Vaccine Allocation Analogy
Decisions on who gets initial COVID-19 vaccine are
like
nesting dolls. Each layer builds on the previous
layer, and
no layer stands on its own.
The Alaska COVID-19 Vaccine Task Force is working with
federal, state, Tribal, military, and community
partners to
plan for Alaska's needs.
MS. WALKER LINDERMAN explained that in order to meet Alaska's
unique needs, federal guidance on vaccine distribution was taken
into consideration and tailored to those needs as described on
slide 19, which read as follows [original punctuation provided]:
Vaccine Allocation Alaska
The Alaska COVID-19 Vaccine Allocation Advisory
Committee meets regularly. It unanimously determined a
portion of the people that will be included in Phase
1a:
? Hospital based front-line health care workers at
highest
risk for COVID-19 infection
? Long-term care facility residents and staff (also
includes
Skilled Nursing Facilities, Assisted Living Homes, and
Department of Corrections infirmaries providing care
that is similar to assisted living)
? EMS/fire personnel
? Community Health Aides
? Individuals who are required to perform vaccinations
Input for the committee may be submitted: Alaska
COVID19 Vaccine Allocation Advisory Committee meetings
(PDF)
9:56:53 AM
MATTHEW BOBO, Director, Alaska Immunization Program, Division of
Public Health, Department of Health and Social Services, drew
attention to the map graphic on slide 21 which depicts receiving
locations for vaccines which consist of the existing Vaccines
for Children Program and the Alaska Vaccine Assessment Program
infrastructures.
MR. BOBO shared slide 22 with the committee, which read as
follows [original punctuation provided]:
Ordering, Receiving and Distributing Vaccine
COVID-19 vaccination providers may enroll in the CDC
COVID19 Vaccination Program administered by the Alaska
Immunization Program, a program within the Alaska
Department of Health and Social Services:
http://dhss.alaska.gov/dph/Epi/id/Pages/COVID19/Vaccin
eProviders.aspx
As of December 11, 342 health care providers are fully
enrolled.
MR. BOBO added that 360 providers are enrolled in the Vaccines
for Children Program. He shared the information on slide 23,
which read as follows [original punctuation provided]:
Ordering, Receiving and Distributing Vaccine
Integrated IT systems both public and private, as
well as new
and existingare needed to ensure successful vaccine
allocation, distribution, administration, monitoring,
and
reporting.
MR. BOBO explained that there exists Fast Track, an immunization
information system, and additional systems are being implemented
for scheduling and data tracking.
MR. BOBO explained that there are 64 federal vaccine
jurisdictions, and the CDC has provided the guidance for
jurisdictions detailed on slide 23, which read as follows
[original punctuation provided]:
Ordering, Receiving and Distributing Vaccine
Jurisdictions are not advised to purchase ultra-cold
storage
equipment at this time:
? Ultra-cold vaccine will be direct shipped from the
manufacturer in coolers that are packed with dry ice
? Direct shipments to the vaccination provider site
will be in
975-dose increments on a real-time, day to day basis
Ultra-cold vaccine arriving at Alaska Native Medical
Center:
https://www.youtube.com/watch?v=PPjhAH1Az7g&feature=y
outu.be
10:00:38 AM
MS. WALKER LINDERMAN introduced the community planning item on
the agenda. She explained that the Technical Assistance
Advisors (TAAs)on slide 26 consist of the focus areas of
hospitals, long term care facilities, pharmacies, and community
health centers, and they provide assistance in preparing to
receive the vaccine. She shared the responsibilities of TAAs as
outlined on slide 27, which read as follows [original
punctuation provided]:
Community Planning TAA
Technical Assistance Advisor (TAA) Responsibilities:
Assess planning progress
Provide individualized outreach and support
Provide updated information
Assist with problem solving, provide resources
Engage in regular communication
Support THE COMMUNITY's planning efforts
MS WALKER LINDERMAN shared the list of community entities with
whom the task force and TAAs are coordinating on slide 28, which
read as follows [original punctuation provided]:
Community Planning TAA
Technical Assistance Advisors (TAA's) Serve as
Task Force Point-of-Contact for the Following
Entities:
Public Health Center Pharmacies
Regional Emergency Preparedness Home Health/In Home
Care Agencies
Emergency Management Law Enforcement
Local Government Leadership Agencies Serving
Individuals with Disabilities
Tribal Leadership EMS
Hospitals Agencies Serving People Experiencing
Homelessness
Community Health Clinic (FQHCs, etc.,.) Long Term Care
Facilities
Tribal Health Organizations Agencies Serving People
65+
Critical Industry Partners
MS WALKER LINDERMAN then listed the identified community
planning TAA regions as Southcentral, Interior, Southeast,
Northern, and the Municipality of Anchorage.
10:03:45 AM
DR. ZINK introduced the final agenda item listed in the
presentation on Vaccine Confidence. She suggested that while an
efficacious may be available, any vaccine will only be effective
if the State is able to distribute it safely and people are
willing to take the vaccine. She emphasized the importance of
information and outreach efforts. She referred to slide 31 as
an example of a public service announcement to aid in
appropriate messaging. She directed attention to slide 32,
which read as follows [original punctuation provided]:
http://Covidvax.Alaska.gov
? Regular updates: Learn about vaccine availability
? Communications tools: Weekly updated written
messages
you can use to discuss COVID-19 vaccine in your
community
? Learning opportunities: Weekly Thursday 2 PM
publicly-available virtual learning opportunity to
stay informed about
planning, distribution and vaccine science
? Planning resources: Healthcare stakeholder and
community
partner resources
10:05:55 AM
CHAIR ZULKOSKY referenced slide 19, entitled "Vaccine Allocation
Alaska" and asked how the task force has accommodated rural
communities, stating that there is a lack of professionally
trained personnel to perform vaccinations.
10:06:54 AM
MS. WALKER LINDERMAN answered that in addition to the people
listed on the slide as included in Phase 1A, allocation is made
to tribal organizations, and she suggested that the analogy of
nesting dolls on slide 18 depicts the multiple levels that will
be engaged in vaccine delivery and distribution. She
acknowledged that many unique circumstances exist throughout
rural communities and those will continue to be taken into
consideration.
10:08:06 AM
CHAIR ZULKOSKY sought to clarify regarding vaccine allocation if
the vaccine received by hospitals will be distributed with
flexibility considering the availability of trained personnel.
MS. WALKER LINDERMAN noted that the task force is requesting
facilities to follow federal and state guidelines with the
understanding that the circumstances are continually changing
and stated that, for example, additional doses of the Pfizer
vaccine were found to be available in the vials, and the task
force recommended that communities evaluate and distribute the
extra doses based on what is best for their own communities
while taking into consideration the prescribed guidelines.
10:09:39 AM
CHAIR ZULKOSKY inquired when the recommendations for Phase 1B,
expected to result from a meeting of the CDC Advisory Committee
on Vaccination Practices scheduled to take place December 19,
2020, should be implemented by the State.
10:10:03 AM
DR. ZINK indicated that they would be implemented as soon as
possible, considering supply and what groups should be served.
She noted that the tiered approach to prioritizing groups is
regularly reevaluated. She allowed that the circumstances are
challenging due to limited supply.
CHAIR ZULKOSKY asked whether the Phase 1B implementations should
take weeks, or longer.
DR. ZINK conceded that it may require weeks to implement the
recommendations and will depend on the clarity of guidance that
emerges from the CDC and how it should comport with the
circumstances in Alaska, and considering science, data, equity,
and logistical feasibility. She added that people's interest in
receiving the vaccine is increasing and, accordingly, the supply
would be diminished.
10:13:11 AM
CHAIR ZULKOSKY asked whether the task force's allocation
committee was taking into consideration, regarding vaccine
allocation during Phase 1B, certain economic disparities in very
rural locations, such as multigenerational crowded homes and the
lack of running water and sewer which, when compounded,
negatively impact communities struggling to combat a viral
pandemic outbreak.
DR. ZINK acknowledged that Alaska Native populations are
disparately affected by the virus with hospitalizations and
deaths. She added that previous pandemics and epidemics have
also disproportionately affected these populations.
Furthermore, in addition to ethnic disparity, data reveals
disparity exists among socio-economic and healthcare access
across the country. She stated that access to clean water is
healthcare. She stated that disparities that exist are
acknowledged prominently throughout the national and local
conversations and that the hope and the intent is to mitigate
these disparities.
10:15:55 AM
REPRESENTATIVE DRUMMOND asked whether vaccine lots shipped in
975 dose packages could be broken down and redistributed
according to the plan for communities with fewer than 975
residents. She asked also whether doses in excess of the tiered
priority groups may be distributed to other members of a
community.
10:17:16 AM
MS. WALKER LINDERMAN stated that the packages can and are being
broken down to appropriate sizes for the communities receiving
them and reminded the committee that there is a five-day
refrigeration storage window also taken into consideration
during distribution.
10:18:42 AM
CHAIR ZULKOSKY added that she had observed communities
functioning as regional hubs and that chartered aircraft are
being deployed to ensure that the fragile vaccine is delivered
strategically and timely.
10:19:16 AM
REPRESENTATIVE DRUMMOND applauded the coordinated efforts and
the clear answer to her question.
10:19:47 AM
REPRESENTATIVE TARR asked how broader distribution would be
funded and whether it would be equally available to all those
who wish to receive it.
10:20:44 AM
HEIDI HEDBERG, Director, Division of Public Health, Department
of Health and Social Services, stated that coordination among
communities, DHSS, and the Division of Homeland Security and
Emergency Management will be required and broader distribution
will vary depending on community resources available. She
stated that some of the logistical and clinical costs may be
reimbursable and that the vaccine itself is available at no
cost.
10:21:58 AM
REPRESENTATIVE TARR added that the annual flu vaccination is an
example of successful free vaccine distribution.
10:22:42 AM
REPRESENTATIVE SARA HANNAN, Alaska State Legislature, stated
that populations in infirmaries are listed in the distribution
tiers and asked where the congregate populations, such as
prisoner populations, are listed in the tiered distribution
scheme.
10:23:28 AM
DR. ZINK acknowledged the importance of addressing congregate
populations including those in multigenerational homes. She
stated that the staff and patients in correctional and other
facilities are listed in the distribution tier that is currently
underway and that congregate populations are among those
demographics being considered for prioritization in the ongoing
distribution scheme.
10:24:33 AM
REPRESENTATIVE SPOHNHOLZ expressed concern that there is
sufficient supply in the first batch to fully vaccinate Phase
1A. She asked how many people in Alaska meet the criteria to
be vaccinated under Phase 1A and what the vaccination schedule
would be for the next batch available.
10:25:07 AM
MS. WALKER LINDERMAN explained that Phase 1A consists of two
tiers, and a third tier is in the process of being defined and
identified. She stated that tiers one and two consist of
approximately 25,000 people. She added that 35,000 doses of the
Pfizer vaccine include the 11,000 tribal allocation and that the
Moderna vaccine should be available next week. She stated that
the Pfizer and Moderna vaccine supply should accommodate tiers
one and two and that following the vaccination of tiers one and
two, distribution for tier three could potentially begin.
10:26:33 AM
REPRESENTATIVE JACKSON asked whether the cost of the vaccine is
known and noted that new medications typically cost more when
they initially become available.
10:27:15 AM
MS. HEDBERG stated that the federal government has purchased the
vaccine and ancillary supplies on behalf of the states and the
cost occurs with transportation and logistics on the
distribution of the vaccine. She added that some clinical costs
may be reimbursable through the Federal Emergency Management
Agency (FEMA). She explained that a primary goal is to make the
vaccine available at little to no cost.
REPRESENTATIVE JACKSON asked whether data concerning those who
have been tested, those who are awaiting test results, those
awaiting vaccine, and those who have received the vaccine could
be cross referenced.
10:29:20 AM
MR. BOBO stated that VacTrAK is the data management system in
place and that data can and will be shared with other systems.
REPRESENTATIVE JACKSON followed up by noting that there may be
individuals awaiting results and if there exists the ability to
access that data.
MR. BOBO answered that when data is available, cross reference
is possible.
10:31:04 AM
DR. ZINK added that individuals are not required to be tested
prior to immunization. She added that vaccination produces a
more effective immune response than natural infection and that
individuals who have contracted the virus are encouraged to
receive the vaccine. She added that the data systems are not
configured specifically to lookup and compare data and that
personally identifying information does not accompany the data
and is submitted voluntarily.
10:31:50 AM
CHAIR ZULKOSKY asked Dr. Zink to dispel myths pertaining to
adverse reactions, to provide details of the recently publicized
adverse reaction of a vaccine recipient in Juneau, and to
provide information on what causes adverse reactions.
DR. ZINK stated that an allergic reaction occurred in Juneau and
two other similar reactions occurred in England. She explained
that the CDC is monitoring and providing guidance for monitoring
for adverse reactions. She explained that while the exact cause
of adverse reaction is still under investigation, preliminary
thoughts postulate that nanoparticles that surround the mRNA
contains structures that protect the mRNA itself, and
individuals may react to those. She stated that the only
complete contraindication for anyone to receive the vaccine
would be for individuals with known reactions to components of
the Pfizer vaccine, which consists solely of the mRNA and the
nanoparticles afore mentioned. She added that individuals with
known reactions to injectable medications such as other
immunizations are monitored for a longer period of time
following the injection to screen for anaphylaxis or other
reactions. She noted that the single reaction in Juneau is the
only severe adverse reaction reported across the entire country.
She added that another reaction resulted in swelling of an
individual's eye that was successfully treated with Benadryl.
She noted that state and federal organizations and members of
the healthcare community are in close and timely communication
to share experiences and report on any adverse reactions. She
stated that to her knowledge, there have been only the three
significant adverse reactions that occurred in Alaska and in
England.
10:35:27 AM
CHAIR ZULKOSKY asked how many doses have been distributed
nationally over the last few days.
DR. ZINK replied that data is available to track vaccinations in
Alaska; however, national data is not yet available.
10:36:22 AM
REPRESENTATIVE DRUMMOND asked when teachers and school faculty
and staff will be vaccinated considering schools are attempting
to reopen safely. She stated that Mt. Edgecumbe High School, a
boarding school in Sitka, has been open since approximately
August and has effective testing and mitigation strategies in
place for approximately 400 students, and she expressed concern
for other schools at which students coming and going may be at
higher risk for an outbreak.
DR. ZINK stated that the task force has a designated liaison
working directly with schools and districts to assist them in
planning, testing, and mitigation strategies to safely reopen
schools. She acknowledged that teachers and school staff are
classified as critical infrastructure and are not currently
scheduled for vaccination. She stated that the vaccine is
approved for use in children age 16 and up. She added that
after the first tiers of vaccination recipients receive the
vaccine, testing and other mitigation resources may be
redistributed. She added that vaccination is one tool among
several in public health to help control outbreaks and the
spread of the virus, and redistribution of testing and
mitigation resources and supplies would have positive effects
among high-risk groups that are not yet scheduled for
immunization.
10:39:51 AM
REPRESENTATIVE TARR expressed her concern that the public may
become overconfident that the vaccine is available and cease
critical public health measures, particularly due to the holiday
season and people participating in gatherings. She asked for
guidance and clear messaging on the same.
DR. ZINK expressed that there have been many cases and many
deaths throughout the country and in Alaska. She urged
patience, cooperation, and compliance with measures such as
masking and maintaining physical distance. She drew the analogy
of the pandemic as like the dark Alaska winter and that, with
time, both will end.
10:41:40 AM
CHAIR ZULKOSKY stated that her region has had disproportionately
high incidences of infection due to factors such as lack of
water and crowded, multigenerational households. She asked
whether those specific factors will be considered ongoing
through the allocation development process.
DR. ZINK stated that the Alaska COVID-19 Vaccine Allocation
Advisory Committee is actively discussing these important
factors not solely regarding vaccination but also regarding
other public health measures. She noted that there have been
identified delays in testing and treatment options and the
vaccine is a critical tool in the overall management of the
pandemic. She expressed gratitude for the cooperation of the
officials in the region and expressed her delight at the long-
awaited arrival of the vaccine.
CHAIR ZULKOSKY shared her concern of observing hospital and
health care workers administering care with limited resources
and many basic needs unmet and expressed appreciation that the
vaccine has arrived. She asked for an explanation of the status
of the epidemiological curve, noting that the Yukon-Kuskokwim
Delta region has stayed in the "exponential growth" stage for
some time. She asked where the state overall is on the curve,
taking into consideration the hope of the vaccine and the risks
associated with people wishing to gather for the holidays.
10:45:01 AM
DR. ZINK stated that hospitalization and death rates are still
unacceptably high; however, there has been a decrease in the
infection growth rate, the data for which is under scrutiny to
ensure its accuracy prior to publicly acknowledging the fact.
She attributed the slowed rate to individuals maintaining
distance and wearing masks and, conversely, when those measures
are not followed, growth rates increase. She expressed hope
that Alaskans remain patient and committed to slowing the growth
rate through individual actions. She noted that the
reproductive rate of the virus has dropped to below 1 for the
first time in multiple months, but the drop in the rate is
fragile and depends on individuals' voluntary compliance.
10:46:54 AM
CHAIR ZULKOSKY asked Dr. Onders for an update on capacity issues
in Alaska Native Medical Center (ANMC).
10:47:10 AM
DR. ONDERS stated that the ANMC critical care unit (CCU) has
been expanded by bringing in additional staff and equipment. He
indicated that the daily patient average is slightly lower. He
added that higher acuity patients exceed the number of CCU beds
available. He noted that the pediatric CCU capacity is not
exceeded and can be used for treatment of younger adults if
needed. He expressed his cautious optimism and hope that
individuals continue the mitigation strategies including masking
and social distancing, to help stop the spread of the virus
because the vaccine alone will not stop community spread.
10:50:39 AM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 10:51 a.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 12.17.2020 COVID Vaccine DHSS House HSS Presentation.pdf |
HHSS 12/17/2020 9:30:00 AM |
House HSS 12/17/2020 |