Legislature(2019 - 2020)ANCH LIO DENALI Rm

12/07/2020 10:00 AM HEALTH & SOCIAL SERVICES

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10:01:03 AM Start
10:02:19 AM Presentation: Department of Health and Social Services Statewide Covid-19 Vaccination Plan
11:30:49 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Presentation: Department of Health and Social
Services: Statewide COVID-19 Vaccination plan
**Streamed live on AKL.tv**
-- Testimony <Invitation Only> --
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         ANCHORAGE LIO                                                                                        
                        December 7, 2020                                                                                        
                           10:01 a.m.                                                                                           
MEMBERS PRESENT                                                                                                               
Senator David Wilson, Chair                                                                                                     
Senator Natasha von Imhof, Vice Chair                                                                                           
Senator Cathy Giessel (via teleconference)                                                                                      
Senator Mike Shower (via teleconference)                                                                                        
Senator Tom Begich (via teleconference)                                                                                         
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
OTHER LEGISLATORS PRESENT                                                                                                     
Representative Harriet Drummond (via teleconference)                                                                            
Representative Bryce Edgmon (via teleconference)                                                                                
Representative Sara Hannan (via teleconference)                                                                                 
Representative Delena Johnson (via teleconference)                                                                              
Representative Andi Story (via teleconference)                                                                                  
Senator Elvi Gray-Jackson (via teleconference)                                                                                  
Senator Jesse Kiehl (via teleconference)                                                                                        
COMMITTEE CALENDAR                                                                                                            
Presentation: Department of Health and Social Services Statewide                                                                
COVID-19 Vaccination Plans                                                                                                      
     - HEARD                                                                                                                    
PREVIOUS COMMITTEE ACTION                                                                                                     
No previous action to record.                                                                                                   
WITNESS REGISTER                                                                                                              
DR. ANNE ZINK, Chief Medical Officer                                                                                            
Division of Public Health                                                                                                       
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT: Delivered  a presentation  on the  statewide                                                             
COVID-19 vaccination plan.                                                                                                      
TESSA WALKER LINDERMAN, Nurse Consultant                                                                                        
Division of Public Health                                                                                                       
Alaska Department of Health and Social Services and                                                                             
DHSS Lead                                                                                                                       
Alaska COVID-19 Vaccine Task Force                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered question  related to  the statewide                                                             
COVID-19 vaccination plan.                                                                                                      
DR. ROBERT ONDERS, Medical Director                                                                                             
Alaska Native Tribal Health Consortium                                                                                          
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT: Described  the tribal  partnership component                                                             
of the Alaska COVID-19 taskforce.                                                                                               
MATTHEW BOBO, Immunization Program Manager                                                                                      
Section of Epidemiology                                                                                                         
Division of Public Health                                                                                                       
Department of Health and Social Services (DHSS)                                                                                 
POSITION  STATEMENT: Answered  questions  about the  availability                                                             
and distribution of the COVID-19 vaccine in each phase.                                                                         
LORI WING-HEIER, Director                                                                                                       
Alaska Division of Insurance                                                                                                    
POSITION  STATEMENT: Stated  that the  taskforce has  worked very                                                             
hard  to  make the  vaccine  available  to  Alaskans as  soon  as                                                               
ACTION NARRATIVE                                                                                                              
10:01:03 AM                                                                                                                   
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee  meeting to order 10:01  a.m. Senators Giessel                                                               
and  Begich  were present  via  teleconference,  and Senator  von                                                               
Imhof  and Chair  Wilson were  present in  person. He  noted that                                                               
Senators  Kiehl  and  Gray-Jackson, and  Representative  Drummond                                                               
were also listening via teleconference.                                                                                         
^Presentation:   Department  of   Health   and  Social   Services                                                               
Statewide COVID-19 Vaccination Plan                                                                                             
10:02:19 AM                                                                                                                   
CHAIR  WILSON  stated that  the  purpose  of  the meeting  is  to                                                               
receive  an overview  from the  Department of  Health and  Social                                                               
Services on  the state's COVID-19  vaccination plan. He  said the                                                               
intent is  to disseminate  information and  learn how  the public                                                               
can  be involved  and  get more  information.  He identified  the                                                               
individuals online  to present and  answer questions as  Dr. Anne                                                               
Zink, Heidi  Hedberg, Tessa Walker  Linderman, Matthew  Bobo, Dr.                                                               
Robert  Onders,  and  Lori  Wing-Heier.  He  clarified  that  the                                                               
committee is not  taking a stance in support of  or opposition to                                                               
getting the vaccine.  That is a personal  choice that individuals                                                               
should make in consultation with their health care professional.                                                                
CHAIR WILSON  welcomed Dr.  Zink to deliver  the overview  on the                                                               
statewide COVID-19 vaccination plan.                                                                                            
10:04:57 AM                                                                                                                   
DR. ANNE ZINK, Chief Medical  Officer, Division of Public Health,                                                               
Department  of  Health  and Social  Services  (DHSS),  Anchorage,                                                               
Alaska,  reviewed the  agenda for  the  presentation outlined  on                                                               
slide 2.  She said she will  provide opening remarks and  a brief                                                               
discussion  of   the  vaccine  candidates.  Next,   Tessa  Walker                                                               
Linderman will talk about the  Alaska COVID-19 Vaccine Task Force                                                               
followed  by Dr.  Robert Onders  who will  talk about  the tribal                                                               
health partner  work. Ms.  Walker Linderman  will go  through the                                                               
phases and  allocations followed by epidemiologist  Matt Bobo who                                                               
will  discuss  ordering,  receiving,   and  distribution  of  the                                                               
vaccine,   then  back   to  Ms.   Walker  Linderman   to  discuss                                                               
communication  and community  planning.  Dr. Zink  said she  will                                                               
conclude   the  presentation   with  a   discussion  on   vaccine                                                               
confidence and answer any remaining questions.                                                                                  
10:05:56 AM                                                                                                                   
At ease.                                                                                                                        
10:06:48 AM                                                                                                                   
CHAIR WILSON reconvened the meeting.                                                                                            
DR. ZINK continued the presentation  on slide 3 advising that the                                                               
vaccine candidates  are expected  in Alaska  in the  near future.                                                               
The  Pfizer vaccine  is expected  to  arrive first.  It has  gone                                                               
through  all   three  stages  that  ensure   vaccine  safety  and                                                               
efficacy,  including Phases  1, 2,  and 3.  The vaccine  has been                                                               
tested in over 43,000 participants  and has been submitted to the                                                               
Food   and   Drug   Administration  (FDA)   for   emergency   use                                                               
authorization.  The  FDA  is currently  reviewing  the  data  for                                                               
safety and efficacy  and the state is  awaiting their conclusion.                                                               
The  initial  data showed  170  confirmed  cases of  COVID-19.  A                                                               
comparison of  the placebo group  versus the group  that received                                                               
the  vaccine showed  that  the efficacy  of  the vaccine  against                                                               
COVID-19 was  95 percent [seven  days] after the second  dose was                                                               
administered  and 94  percent  in  those over  age  65. This  was                                                               
consistent across ages, gender, race, and ethnicity.                                                                            
DR.   ZINK  described   the   Pfizer   vaccine  as   logistically                                                               
challenging because it  has to be stored at  -70 degrees Celsius.                                                               
She said  the task force team  has been working around  the clock                                                               
to ensure that that part of the distribution is successful.                                                                     
10:08:41 AM                                                                                                                   
DR. ZINK advised  that the Moderna vaccine is  expected to arrive                                                               
in  Alaska soon  after the  Pfizer vaccine.  She noted  that they                                                               
both use the messenger RNA (mRNA) platform.                                                                                     
She  said the  Moderna vaccine  was  tested on  more than  30,000                                                               
participants  and  no serious  safety  concerns  were found.  The                                                               
vaccine was  94 percent  efficacious two  weeks after  the second                                                               
dose  and 100  percent against  severe COVID-19.  She noted  that                                                               
efficacy is how well a  vaccine works in a controlled environment                                                               
whereas effectiveness is how well it works in the real world.                                                                   
DR.  ZINK said  the  Moderna data  was submitted  to  the FDA  on                                                               
December  2,  2020  and additional  testing  of  the  coronavirus                                                               
vaccine is  starting in children  ages 12 through 17.  The Pfizer                                                               
vaccine was only tested in people age 18 and older.                                                                             
She said the  Moderna vaccine is not  as logistically challenging                                                               
as the Pfizer  vaccine because the storage  requirements are just                                                               
-20 degrees Celsius.                                                                                                            
10:09:48 AM                                                                                                                   
DR. ZINK  displayed slide  6 that depicts  the three  test phases                                                               
for  the vaccine  candidates. She  emphasized  that the  clinical                                                               
trial process for  the COVID-19 vaccines did not  skip any steps.                                                               
The  vaccines that  have been  submitted  are built  on years  of                                                               
technology. The process  to develop mRNA vaccines  have been long                                                               
underway. They have been found to be very safe and efficacious.                                                                 
She  explained  that  the  vaccine  candidates  from  Pfizer  and                                                               
Moderna  have  completed the  three  test  phases illustrated  on                                                               
slide 6.  Phase 1 is the  preclinical study phase that  tests for                                                               
safety in  10-100 people. Phase  2 tests hundreds of  people with                                                               
different  characteristics  such  as  age and  health  status  to                                                               
ensure  that   the  effectiveness  and  side   effects  are  well                                                               
understood.  Phase 3  tests thousands  of people  to assess  both                                                               
safety and  effectiveness. All three  phases have  been completed                                                               
for both  vaccine candidates and  are being submitted to  the FDA                                                               
for approval.                                                                                                                   
DR.  ZINK suggested  watching Dr.  Jay  Butler's presentation  to                                                               
learn more  about clinical trials  and other  vaccine candidates.                                                               
The YouTube link is on the bottom of slide 7.                                                                                   
10:11:18 AM                                                                                                                   
DR.  ZINK displayed  slide 8  that shows  the federal  government                                                               
currently   estimates  that   Alaska's  initial   allocations  of                                                               
vaccines could include 35,100 doses  from Pfizer and 17,900 doses                                                               
from Moderna. She noted that  the doses from Moderna are expected                                                               
to change  early this week,  particularly with the  Indian Health                                                               
Service  (IHS)  distribution.  She informed  the  committee  that                                                               
because  of   the  geographic  challenges  of   distributing  the                                                               
vaccine, Alaska has selected to  receive its allocations up front                                                               
for the  month rather than  week-to-week. She clarified  that the                                                               
initial allocations  are for the  first of two doses.  The second                                                               
doses  will  be  shipped  later. She  also  highlighted  that  in                                                               
addition  to  the FDA,  the  Advisory  Committee on  Immunization                                                               
Practices (ACIP) is also looking at the information.                                                                            
DR. ZINK  deferred to  Tessa Walker Linderman  to talk  about the                                                               
task force and how it is structured in Alaska.                                                                                  
10:13:10 AM                                                                                                                   
CHAIR WILSON  stated that Senator  Shower had joined  the meeting                                                               
via  teleconference, and  that Representatives  Hannan and  Story                                                               
were listening to the meeting via teleconference.                                                                               
10:13:18 AM                                                                                                                   
SENATOR  VON  IMHOF  asked  if  the  state  contracted  with  the                                                               
University of  Alaska, Fairbanks (UAF)  to help with  storing the                                                               
vaccine at the required ultra-cold temperature.                                                                                 
10:13:50 AM                                                                                                                   
DR.  ZINK   replied  the   department  has   worked  extensively,                                                               
including  with  UAF, to  be  able  to  store the  vaccines.  She                                                               
deferred to Ms. Walker Linderman for more detail.                                                                               
10:14:22 AM                                                                                                                   
TESSA  WALKER LINDERMAN,  Nurse  Consultant,  Division of  Public                                                               
Health,  Department of  Health and  Social  Services (DHSS),  and                                                               
DHSS Lead, Alaska COVID-19 Task  Force, said Pfizer has developed                                                               
a shipping  container that can  maintain the  required ultra-cold                                                               
temperatures for up to 20 days  if it is replenished with dry ice                                                               
every  five  days. Also,  the  task  force  has talked  with  the                                                               
university, the Alaska  Department of Fish and  Game (ADF&G), and                                                               
the  Alaska Sea  Life  Center to  locate  ultra-cold freezers  in                                                               
different communities  statewide and  determine whether or  not a                                                               
source of dry ice is readily available.                                                                                         
10:15:39 AM                                                                                                                   
SENATOR SHOWER referred to the statement on slide 8 that read:                                                                  
          Vaccines made available via an Emergency Use                                                                          
        Authorization cannot be required or mandated by                                                                         
     governments and businesses.                                                                                                
He  asked if  the  vaccine could  be mandated  once  the EUA  has                                                               
10:16:16 AM                                                                                                                   
DR. ZINK replied the state has  no plans at this point to mandate                                                               
any  vaccine  and  private   business  can't  mandate  individual                                                               
vaccines until  there is full  authorization, which  won't happen                                                               
for about two years.                                                                                                            
SENATOR SHOWER  said he asked  because in some  professions one's                                                               
job can  be jeopardized  by taking a  vaccine that  is authorized                                                               
through  an EUA.  He cited  the example  of the  FAA saying  that                                                               
pilots who take the vaccine  in this circumstance will lose their                                                               
10:17:50 AM                                                                                                                   
MS. WALKER LINDERMAN  turned to the organizational  chart for the                                                               
Alaska  COVID-19 Vaccine  Task Force  depicted on  slide 10.  She                                                               
said that when the group was  convened in August 2020, it quickly                                                               
became clear that it would be  important for DHSS to partner with                                                               
the  Alaska Native  Tribal Health  Consortium (ANTHC).  She noted                                                               
the co-leads  within each of the  eight teams and that  each team                                                               
is further  broken down into  sub-teams. She said the  task force                                                               
has 50 people that meet daily.                                                                                                  
She deferred to Dr. Onders to discuss the tribal partnership.                                                                   
10:19:35 AM                                                                                                                   
DR. ROBERT ONDERS, Medical Director,  Alaska Native Tribal Health                                                               
Consortium  (ANTHC),  expressed  appreciation to  the  state  for                                                               
involving ANTHC  early in the  planning process.  The partnership                                                               
has worked well and has been  instrumental in helping to plan for                                                               
distribution to the more challenging  areas of the state. He said                                                               
that with  more than 180  village clinics and  multiple hospitals                                                               
throughout  the state,  ANTHC probably  has more  opportunity for                                                               
vaccine  administration than  any  other entity.  They serve  not                                                               
only Alaska Natives, but also  other people in those communities.                                                               
ANTHC has  helped to coordinate  discussions with  their regional                                                               
tribal  health partners  and  tribes  and the  state  to use  the                                                               
state's  existing infrastructure  for vaccine  administration and                                                               
immunization coordination. This will  help facilitate the process                                                               
working well across the state.                                                                                                  
10:21:27 AM                                                                                                                   
MS.  WALKER LINDERMAN  turned  to slide  13  and paraphrased  the                                                               
timeline for December. It read as follows:                                                                                      
     Expect dates to change as we find out more                                                                                 
     December  1:  CDC   Advisory  Council  on  Immunization                                                                    
     Practices (ACIP) met and voted  on a recommendation for                                                                    
     who gets the vaccine first                                                                                                 
     December   3:  Alaska   Allocation  Committee   met  to                                                                    
     recommend  prioritization  and distribution  model  for                                                                    
     December  4-7:  Vaccine   shipment  details  (including                                                                    
     estimated  doses) reported  to  hospital leadership  or                                                                    
     hospital vaccine planners                                                                                                  
     December 10: FDA meeting  on Pfizer vaccine. Additional                                                                    
     CDC  guidance is  expected.  If  EUA approved,  vaccine                                                                    
     shipment may begin.                                                                                                        
Technical difficulty                                                                                                            
     Mid  December:  Pfizer   vaccine  shipments  arrive  in                                                                    
     Mid-End December:  Moderna vaccine shipments  arrive in                                                                    
     Alaska Expect regular  shipments to continue throughout                                                                    
     Expect regular shipments to continue throughout 2021                                                                       
10:22:45 AM                                                                                                                   
At ease.                                                                                                                        
10:28:07 AM                                                                                                                   
CHAIR WILSON reconvened the meeting  and apologized the technical                                                               
10:28:37 AM                                                                                                                   
SENATOR BEGICH asked what the time  gap will be between the first                                                               
and second  dose of either the  Pfizer or Moderna vaccine  and if                                                               
the second  dose is  necessary to achieve  the efficacy  that was                                                               
DR. ZINK replied  both are two-dose vaccines;  the Pfizer vaccine                                                               
is split 21  days apart and the Moderna vaccine  is split 28 days                                                               
apart.  The efficacy  picks up  after the  second dose  so it  is                                                               
important that people plan to get  the second dose of the vaccine                                                               
they received initially.                                                                                                        
MS. WALKER  LINDERMAN read the  last two  points on slide  13 and                                                               
confirmed Dr.  Zink's earlier statement that  Alaska will receive                                                               
the vaccine  doses up-front for  the month rather than  in weekly                                                               
10:31:05 AM                                                                                                                   
MS. WALKER LINDERMAN reviewed the  phases of vaccine availability                                                               
depicted  on  slide 14.  She  said  there  will be  very  limited                                                               
availability  of  the  vaccine   in  Phase  1A/1B.  More  regular                                                               
shipments  will  occur  in  Phase 2,  but  availability  will  be                                                               
limited. In Phase 3, the vaccine  will be widely available to the                                                               
entire population. She said the  timeline for the three phases is                                                               
undefined at this point but Phase 1A is potentially a week away.                                                                
10:32:02 AM                                                                                                                   
MS. WALKER LINDERMAN paraphrased slide 15 that read as follows:                                                                 
     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                                                                    
     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:                                                                                                        
10:33:06 AM                                                                                                                   
CHAIR WILSON asked if all or just critical front-line health                                                                    
care personnel will receive the vaccine in the initial phase.                                                                   
10:33:25 AM                                                                                                                   
MS. WALKER LINDERMAN replied the next two slides address the                                                                    
question. She paraphrased slides 16 and 17 that read as follows:                                                                
     Vaccine Allocation  Federal                                                                                              
     Further CDC Advisory  Council on Immunization Practices                                                                    
     (ACIP) Recommendations:                                                                                                    
     ?  Healthcare  personnel   (HCP)  with  direct  patient                                                                    
          -Unable to telework                                                                                                   
          -Including   those   who    work   in   inpatient,                                                                    
          outpatient, or community settings                                                                                     
          -Provide services to patients or patients' family                                                                     
          -Handle infectious materials                                                                                          
     ?  HCP working  in residential  care or  long-term care                                                                    
     ? 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                                                                                            
     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                                                                                                 
10:35:33 AM                                                                                                                   
MS. WALKER LINDERMAN displayed slide 18 that uses nesting dolls                                                                 
to describe the vaccine allocation. The notion is that each                                                                     
layer builds  on the previous one.  None of the layers  stands on                                                               
its  own  and there  is  prioritization  within each  layer.  She                                                               
explained that  the largest nesting  doll represents  the federal                                                               
recommendations  and   the  next   doll  represents   the  Alaska                                                               
Allocation Committee. Within that is  how a community or hospital                                                               
might prioritize the vaccine. The  decisions move down ultimately                                                               
to the  individual level where  Alaskans make the  decision about                                                               
the vaccine for themselves.                                                                                                     
10:36:28 AM                                                                                                                   
MS. WALKER LINDERMAN paraphrased slide 19 that read as follows:                                                                 
     Vaccine Allocation  Alaska                                                                                               
     On  December  3,  Alaska  COVID-19  Vaccine  Allocation                                                                    
     Committee met  and unanimously determined a  portion of                                                                    
     the groups  that will  be included  in Phase  1A. These                                                                    
     groups include:                                                                                                            
       ? Hospital based front-line health care workers at                                                                       
     highest risk for COVID-19 infection                                                                                        
     ? Long-term care facility residents and staff                                                                              
     ? EMS/fire personnel                                                                                                       
     ? Community Health Aides                                                                                                   
     ? Individuals who are required to perform vaccinations                                                                     
       The committee will reconvene to discuss additional                                                                       
     groups to include in Phase 1A Thursday, December 10.                                                                       
MS.  WALKER  LINDERMAN  said   front-line  hospital  workers  and                                                               
residents and  staff at  long-term care  facilities are  tier one                                                               
and  EMS/fire  personnel,  community  health  aides,  and  people                                                               
giving vaccinations are tier two in Phase 1A.                                                                                   
10:37:39 AM                                                                                                                   
CHAIR WILSON  asked how many  hospital workers will  be immunized                                                               
in Phase 1A.                                                                                                                    
MS. WALKER LINDERMAN replied the  hospitals have identified about                                                               
8,000 critical workers and about 14,000 staff overall.                                                                          
10:38:46 AM                                                                                                                   
SENATOR VON  IMHOF asked if  she would recommend that  people get                                                               
the vaccine  if they  have either  had COVID-19  or have  taken a                                                               
test that shows they have antibodies in their system.                                                                           
MS. WALKER LINDERMAN deferred the question to Dr. Zink.                                                                         
10:39:30 AM                                                                                                                   
DR. ZINK  said the department  has been  waiting for the  CDC and                                                               
APIC to provide  additional guidance, but the  initial data shows                                                               
that  immunity from  the vaccination  generally is  stronger than                                                               
natural immunity. They anticipate  that people who have recovered                                                               
from COVID-19 will  get the vaccine if they choose  to do so. The                                                               
vaccine will  be offered to  people in tier  1 and tier  2 within                                                               
Phase 1A, including those who  have recovered. People will not be                                                               
asked  about  antibody testing  prior  to  receiving the  vaccine                                                               
because  there  is  a  lack  of  data  to  show  it  demonstrates                                                               
10:40:32 AM                                                                                                                   
SENATOR VON IMHOF said, based on  her reading, it is too early to                                                               
say whether  the vaccine or  natural immunity is  more effective.                                                               
She  added  that  she likes  the  prioritization  the  department                                                               
outlined  and the  caveat that  front line  workers who  have had                                                               
COVID-19 are able to delay getting  the vaccine if they choose to                                                               
do so.                                                                                                                          
10:41:53 AM                                                                                                                   
SENATOR  BEGICH asked  if access  to excess  vaccine that  may be                                                               
available in Phase  1A will be made available  to law enforcement                                                               
and other  first responders. If  not, he  asked if they  could be                                                               
10:42:30 AM                                                                                                                   
DR. ZINK answered that the  department is watching the scientific                                                               
data very  closely and  will continue  to work  with the  CDC and                                                               
APIC to  ensure that the  distribution of the  vaccine, including                                                               
any  excess,   is  science-based,  equitable,   and  logistically                                                               
feasible. The idea  is to work through those  three pillars while                                                               
ensuring  that no  vaccine  is  wasted and  that  the health  and                                                               
wellbeing of Alaskans is protected.                                                                                             
10:43:44 AM                                                                                                                   
SENATOR  BEGICH recalled  that nursing  home populations  fall in                                                               
Phase  1B  of the  distribution,  and  asked where  the  homeless                                                               
population falls in the process.                                                                                                
DR.   ZINK  clarified   that  nursing   homes,  long   term  care                                                               
facilities, and skilled nursing  facilities fall within Phase 1A.                                                               
To the question about when  the homeless population would receive                                                               
the vaccine, she  said that is being discussed right  now but the                                                               
challenge with  that group is  that the  vaccine is given  in two                                                               
SENATOR  BEGICH asked  her to  keep  his office  informed on  the                                                               
progress to offer the vaccine to the homeless population.                                                                       
DR. ZINK  said she would  make sure that  the task force  and the                                                               
physician dedicated  to COVID challenges  keeps his office  up to                                                               
10:45:09 AM                                                                                                                   
CHAIR  WILSON  recognized  that Senator  Stevens,  Representative                                                               
Edgmon, and  Representative Johnson  were listening  and watching                                                               
via teleconference.                                                                                                             
SENATOR GIESSEL  asked what data  the U.S. is following,  what is                                                               
known about the specific variety  of COVID-19 that is circulating                                                               
in the country,  and if there are different  strains in different                                                               
DR.  ZINK  replied the  department  is  monitoring the  different                                                               
clades of SARS-CoV-2  that cause COVID-19 and  has submitted some                                                               
genomic  sequencing  to  the  genetic  sequencing  data  bank  in                                                               
Fairbanks. Six  of the  seven major  clades, or  variations, that                                                               
are circulating  in the  U.S. have  been seen  in Alaska  but the                                                               
shape and  function of the  protein spike seems to  be consistent                                                               
between the  clades. The vaccines  appear to target  that protein                                                               
spike, which  is how  the virus  enters the  human cell,  so they                                                               
should remain  effective as  the virus  continues to  change. She                                                               
said the department will continue to watch that closely.                                                                        
She  said information  about  the side  effects  of new  vaccines                                                               
comes  after about  two months  and how  long the  immunity lasts                                                               
will come  after about six months  of data or during  the Phase 3                                                               
trials.  More data  is also  coming out  about the  fact that  it                                                               
appears that the  virus that causes COVID-19  affects both innate                                                               
immunity and  responsive immunity. That will  be followed closely                                                               
to  ensure that  healthcare providers  and the  people of  Alaska                                                               
have that information.                                                                                                          
10:49:29 AM                                                                                                                   
CHAIR  WILSON asked  for more  information on  who might  fall in                                                               
Phase  2 and  Phase 3  and where  teachers, public  officials who                                                               
have been diagnosed  with the virus, and  other essential workers                                                               
might fit in the phases.                                                                                                        
10:50:20 AM                                                                                                                   
MATTHEW  BOBO, Immunization  Health Program  Manager, Section  of                                                               
Epidemiology,  Division of  Public Health,  Department of  Health                                                               
and  Social Services  (DHSS), recounted  that healthcare  workers                                                               
and residents in  long term care facilities will  fall into Phase                                                               
1A.  Teachers and  other workers  in the  critical workforce,  as                                                               
defined  by federal  guidelines, will  fall into  Phase 1B.  This                                                               
will be mapped  out by the Allocation Committee. Phase  2 will be                                                               
spent  working  through  the  critical  workforce  and  into  the                                                               
general population. The vaccine will  be readily available to the                                                               
general public in Phase 3.                                                                                                      
CHAIR WILSON asked  when interested people in  the general public                                                               
would  be  able to  provide  input  to the  Allocation  Committee                                                               
regarding who  might be essential  workers and what  residents go                                                               
into each phase.                                                                                                                
10:51:55 AM                                                                                                                   
DR.  ZINK  said  people  are  welcome  to  send  letters  to  the                                                               
Allocation Committee but it is  important to understand that they                                                               
are a group of scientists  and clinicians who represent a diverse                                                               
range of expertise and experience  in both urban and rural areas.                                                               
They will  look at the  information with the pillars  of science,                                                               
logistics, and statewide equity.                                                                                                
CHAIR  WILSON asked  if the  information  on how  to contact  the                                                               
Allocation Committee is on the DHSS website.                                                                                    
DR. ZINK answered yes, and  additional information sources are at                                                               
the end of the presentation.                                                                                                    
10:53:34 AM                                                                                                                   
SENATOR  SHOWER asked  if the  vaccine eliminates  the chance  of                                                               
getting COVID-19  and infecting others  or if it just  reduce the                                                               
severity of  the symptoms  if someone were  to come  into contact                                                               
with the virus post vaccination.                                                                                                
DR. ZINK  answered that the  initial data looked at  symptoms and                                                               
severity of the symptoms, which  is where the efficacy was found.                                                               
The  data is  still under  review on  whether somebody  could get                                                               
COVID-19 and transfer it to others.                                                                                             
SENATOR SHOWER commented  on the moving goal  posts for reopening                                                               
the economy  and asked  when the medical  benefit of  keeping the                                                               
economy closed isn't worth the devastation to the economy.                                                                      
10:56:34 AM                                                                                                                   
DR. ZINK  answered that the mission  of DHSS is the  physical and                                                               
mental  health  and wellbeing  of  Alaskans  and they  know  that                                                               
economic  health is  tied to  both. She  said the  tools DHSS  is                                                               
using to  reduce the spread  of the virus  are the tools  to keep                                                               
businesses  open;  to  keep  people  healthy,  safe,  and  moving                                                               
forward;  and to  keep government  systems open  and functioning.                                                               
This  means   schools  open,   hospitals  functioning,   and  law                                                               
enforcement doing its  job without people being sick  or any part                                                               
of the system  being overwhelmed. She said the  team continues to                                                               
look at all  the components both within and  outside of COVID-19.                                                               
She offered  her perspective that  the goal post is  ensuring the                                                               
health and wellbeing of Alaskans and that has not changed.                                                                      
SENATOR SHOWER asked if she  could give a definitive timeline for                                                               
opening all sectors of the economy.                                                                                             
11:00:22 AM                                                                                                                   
DR. ZINK  answered that she  has been describing the  vaccine and                                                               
its  distribution  like  the  sun.  There  is  not  a  noticeable                                                               
difference  between  December 21  and  December  22, but  by  the                                                               
spring  equinox there  will  be more  vaccine  available and  the                                                               
world will  be different. She said  the caveat is that  there are                                                               
no associated production and distribution challenges.                                                                           
DR. ZINK continued to say:                                                                                                      
     Honestly, from my seat in  this position, it feels like                                                                    
     watching a  man land  on the moon.  To see  the science                                                                    
     coming together [in] such quick  time over vaccines and                                                                    
     to see the hope and  inspiration right now, I feel like                                                                    
     we can see the runway up  ahead. It's going to be a lot                                                                    
     of work  but I think  this spring and summer  are going                                                                    
     to feel like very different  places. Not because of any                                                                    
     rules or  regulations, but because  we're not  going to                                                                    
     be having  as many people  sick and infected  by COVID-                                                                    
     19,  which  is  directly  impacting  their  ability  to                                                                    
     function and  work and keep businesses  open and moving                                                                    
11:02:11 AM                                                                                                                   
MR.  BOBO  continued  the  presentation   with  a  discussion  of                                                               
ordering,  receiving,   and  distribution  of  the   vaccine.  He                                                               
directed attention to the map  on slide 21 that shows color-coded                                                               
locations to illustrate Alaska's  existing system to get vaccines                                                               
from  the larger  airports  to increasingly  rural  parts of  the                                                               
state. Specifically,  it depicts the sites  that DHSS distributes                                                               
vaccines for  the federal Vaccines  for Children Program  and the                                                               
Alaska Vaccine Assessment Program.                                                                                              
11:02:59 AM                                                                                                                   
MR. BOBO displayed slide 22 and read the following:                                                                             
     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:                                                                    
     As of December  4, 265 health care  providers are fully                                                                    
MR. BOBO displayed slide 23 and read the following:                                                                             
     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.                                                                                 
11:04:19 AM                                                                                                                   
SENATOR BEGICH asked  if precautions were being  taken to prevent                                                               
the  state's   IT  systems  from  being   hacked  and  disrupting                                                               
distribution of the vaccine.                                                                                                    
MR.  BOBO answered  yes; the  security plan  for the  vaccination                                                               
tracking  system  is  behind  firewalls  and  is  being  assessed                                                               
throughout the process. Furthermore,  the state security officers                                                               
are holding these conversations with their federal partners.                                                                    
11:05:05 AM                                                                                                                   
SENATOR BEGICH asked if DHSS  is communicating about the recently                                                               
reported IT breach and receiving real-time data about the hack.                                                                 
MR.  BOBO  said  he  was  unclear about  the  specific  case  but                                                               
security protocols  are being  followed and the  system is  up to                                                               
date to ensure there are no  hacks. There have been none to date,                                                               
he said.                                                                                                                        
11:05:46 AM                                                                                                                   
MR. BOBO paraphrased slide 24 that read as follows:                                                                             
     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                                                                                                                  
11:06:44 AM                                                                                                                   
MS. WALKER  LINDERMAN turned  to slide 26  and explained  that in                                                               
terms of community  planning, the DHSS task force  has focused on                                                               
planning  for Phase  1A  so  that communities  can  focus on  the                                                               
subsequent  phases.  To  accomplish  this,  the  task  force  has                                                               
developed  a team  of  public  health nurses  who  will serve  as                                                               
regional  technical assistant  advisors (TAAs)  in the  different                                                               
areas of the state.                                                                                                             
She  displayed slide  27  and  explained that  the  TAAs will  be                                                               
responsible  for: assessing  the  community's planning  progress,                                                               
providing individualized outreach  and support, providing updated                                                               
information,  assisting   with  problem  solving   and  providing                                                               
resources;  engaging in  regular  communications, and  supporting                                                               
the  community's  planning  efforts   for  subsequent  phases  of                                                               
vaccine distribution.                                                                                                           
MS. WALKER  LINDERMAN displayed  the list  of entities  for which                                                               
the TAAs serve as the task  force point of contact. She said this                                                               
shows the  robust planning that  the task force hopes  to support                                                               
on  the  community  level.  She  said the  TAAs  will  serve  the                                                               
following regions:  Southcentral, Interior,  Southeast, Northern,                                                               
and the Municipality of Anchorage.                                                                                              
11:09:17 AM                                                                                                                   
DR.  ZINK  expressed appreciation  that  the  committee held  the                                                               
hearing  to  receive information  and  answers  to questions  the                                                               
public may have posed about the  vaccine. She said the goal is to                                                               
be transparent and provide timely  and accurate information about                                                               
vaccines  to Alaskans  and Alaska  decision-makers on  an ongoing                                                               
basis.  She said  there may  be  efficacious vaccines  but to  be                                                               
effective it has to get out to people.                                                                                          
She directed  attention to slide 31  that has a link  to a recent                                                               
public service announcement from  the Centers for Disease Control                                                               
(CDC) that talks about testing  and production. She said the task                                                               
force is  also working to  produce local announcements  to ensure                                                               
that direct questions are answered.                                                                                             
11:10:13 AM                                                                                                                   
DR. ZINK reviewed slide 32 that read as follows:                                                                                
     ? 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                                                                    
        ? Planning resources: Healthcare stakeholder and                                                                        
     community partner resources                                                                                                
DR. ZINK said the last  few slides have additional resources that                                                               
the committee and public may  find helpful. She offered to answer                                                               
11:11:08 AM                                                                                                                   
CHAIR WILSON asked what the cost  of vaccine is and who is paying                                                               
for it.                                                                                                                         
MR. BOBO explained that the  federal government is paying for the                                                               
vaccine through  Operation Warp  Speed. There is  no cost  to the                                                               
public, but providers may charge  a fee to administer the vaccine                                                               
and insurance companies will pay.                                                                                               
CHAIR WILSON asked how long the funding is expected to last.                                                                    
MR. BOBO  said his  understanding is that  the funding  will last                                                               
through all  three phases of  administering the vaccine.  He said                                                               
he didn't know what would happen after Phase 3.                                                                                 
11:12:32 AM                                                                                                                   
SENATOR  SHOWER  asked  Dr.  Zink if  someone  who  received  the                                                               
vaccine  and  still  contracted   COVID-19  would  be  considered                                                               
DR.  ZINK  said the  science  and  data  is insufficient  to  say                                                               
whether  or not  this  vaccine  will prevent  the  spread of  the                                                               
disease, but the hope is that  an answer will be forthcoming very                                                               
CHAIR  WILSON  asked if  someone  who  gets COVID-19  after  they                                                               
receive the first vaccination should  go ahead and get the second                                                               
DR. ZINK answered that the  expectation is that the emergency use                                                               
authorization  (EUA)  will  provide  more clarity  on  that,  but                                                               
people are generally discouraged  from getting vaccines when they                                                               
are sick because their immune system is fighting the disease.                                                                   
11:15:27 AM                                                                                                                   
SENATOR  BEGICH asked  if the  resource materials  listed on  the                                                               
last few slides  were available in languages  other than English.                                                               
He  noted that  over 100  languages  are spoken  in his  district                                                               
MS. WALKER  LINDERMAN replied the task  force communications team                                                               
is working  to make  translated materials  available and  the CDC                                                               
already has documents available in different languages.                                                                         
SENATOR SHOWER  asked Dr. Zink  to comment  on the notion  that a                                                               
certain percent of  the population must be  vaccinated within six                                                               
months  to achieve  broad immunity,  and how  that might  work in                                                               
Alaska.  He   also  asked  if   there  will  be   exemptions  for                                                               
individuals who do not wish to get the vaccine.                                                                                 
11:18:13 AM                                                                                                                   
DR. ZINK  reiterated that the  state has no intention  to require                                                               
anybody to  take the vaccine.  With regard to the  question about                                                               
herd immunity,  she said somewhere  between 60 and 70  percent of                                                               
the population needs  to have robust immunity  to prevent ongoing                                                               
transmission of  the virus across  the population as a  whole. As                                                               
to  how long  the  vaccine will  last, she  said  there isn't  an                                                               
answer to that question at this  time. Six months into the trials                                                               
is  about the  time it  takes to  see if  the body  builds innate                                                               
immunity that  it holds onto  for a  longer period as  opposed to                                                               
having to  renew the vaccine on  a regular basis. She  said there                                                               
is not  a lot of  concern about  mutations because the  virus has                                                               
been fairly stable to this point.                                                                                               
DR. ZINK stated  that the goal is to efficiently  provide as much                                                               
vaccine  as possible  to those  who want  to take  it, given  the                                                               
limitations  of   production,  allocation   to  the   state,  and                                                               
distribution within the  state. She said the data  and science on                                                               
the immunology is very reassuring at this point.                                                                                
11:20:30 AM                                                                                                                   
CHAIR WILSON  asked if  there is a  percentage of  the population                                                               
the department would like to see immunized.                                                                                     
DR. ZINK said herd immunity is  achieved when 60 to 70 percent of                                                               
the population has a significant  degree of immunity. The vaccine                                                               
is a significant tool to  achieve that immunity and therefore the                                                               
goal of the health and wellbeing  of Alaskans. She said a lot has                                                               
been  learned  about  the  immunology of  this  disease  and  the                                                               
department will continue to monitor it closely moving forward.                                                                  
SENATOR BEGICH said  he, too, has heard concerns  about a vaccine                                                               
mandate  and he  wanted to  point out  that even  President-elect                                                               
Biden  indicated  that there  would  be  no mandate,  but  people                                                               
should  "do  the  right  thing."  He  suggested  all  legislators                                                               
reassure constituents  that there is  no mandate but  that people                                                               
take a vaccine to stay safe.                                                                                                    
11:23:13 AM                                                                                                                   
CHAIR  WILSON reiterated  that  the committee  is  not taking  an                                                               
official  stand  on   the  vaccine  but  is   trying  to  provide                                                               
He asked  Dr. Zink to  respond to  the concern about  whether the                                                               
vaccine will in some way alter a person's DNA.                                                                                  
DR. ZINK  emphasized that the  vaccine will not alter  a person's                                                               
DNA. She  explained that DNA  is transcribed into RNA  that makes                                                               
proteins  and  this messenger  RNA  (mRNA)  cannot get  into  the                                                               
nucleus or mitochondria where DNA lives.                                                                                        
CHAIR WILSON asked if the vaccines are made of fetal material.                                                                  
11:24:36 AM                                                                                                                   
DR.  ZINK  replied  neither  Pfizer nor  the  Moderna  use  fetal                                                               
material to develop these vaccines.                                                                                             
11:24:48 AM                                                                                                                   
CHAIR WILSON  asked if there  is any type of  micro-chip tracking                                                               
device contained in the vaccine.                                                                                                
DR.  ZINK replied  there  is no  tracking  associated with  these                                                               
vaccines. She said the CDC will  be offering an app for people to                                                               
monitor  their symptoms,  but  that  is a  close  as  it gets  to                                                               
11:25:17 AM                                                                                                                   
CHAIR WILSON asked  if she had any reason to  believe the vaccine                                                               
poses a risk to fertility.                                                                                                      
DR.  ZINK answered  no;  there are  no  concerns about  fertility                                                               
related  to  these  vaccines. However,  COVID-19  is  a  vascular                                                               
disease  and increasing  data indicates  the  disease itself  may                                                               
cause vascular problems, which can cause fertility challenges.                                                                  
11:26:04 AM                                                                                                                   
CHAIR  WILSON asked  how likely  it is  that a  person will  have                                                               
severe side effects from the vaccine.                                                                                           
DR. ZINK  said that in the  first two months, neither  test group                                                               
had  any  significant side  effects  or  allergic reactions.  One                                                               
vaccine trial had  over 30,000 participants and  another had over                                                               
40,000 participants.  She added that  the basis for  RNA vaccines                                                               
have been  studied for a  long time and  are thought to  be among                                                               
the safest platforms available.                                                                                                 
11:27:08 AM                                                                                                                   
CHAIR WILSON asked  if mRNA vaccines are new and  how people know                                                               
they are safe.                                                                                                                  
DR. ZINK  answered that mRNA  vaccines have been around  for some                                                               
time but there has not been  a widely spread mRNA vaccine used in                                                               
the past  because of efficacy  concerns - making the  mRNA stable                                                               
enough that it works well once it is in the body.                                                                               
11:28:44 AM                                                                                                                   
CHAIR  WILSON asked  if http://covidvax.alaska.gov  was the  best                                                               
website  for people  to visit  if they  want more  information or                                                               
have questions.                                                                                                                 
MS. WALKER LINDERMAN answered yes; it  is the best website to get                                                               
up to date information.                                                                                                         
CHAIR WILSON  thanked the presenters  and asked Ms.  Wing-Heir if                                                               
she had any comments.                                                                                                           
11:30:13 AM                                                                                                                   
LORI WING-HEIER,  Director, Alaska Division of  Insurance, stated                                                               
that  the taskforce  has worked  very  hard to  make the  vaccine                                                               
available to  Alaskans as  soon as  possible. She  expressed hope                                                               
that  it  would help  turn  the  corner  for  Alaska once  it  is                                                               
11:30:49 AM                                                                                                                   
There being no further business to come before the committee,                                                                   
Chair Wilson adjourned the Senate Health and Social Services                                                                    
Standing Committee meeting at 11:30 a.m.                                                                                        

Document Name Date/Time Subjects
12.07.2020 COVID Vaccine SHSS presentation Final.pdf SHSS 12/7/2020 10:00:00 AM