Marin County health officials expect to begin the first coronavirus vaccinations as soon as late December with a priority on immunizing frontline health care workers first.
The vaccine developed by the Manhattan-based Pfizer company is anticipated to be the first to gain U.S. approval sometime in mid-December. Pfizer’s vaccine must be transported and stored at ultra-cold temperatures of at least -94 degrees Fahrenheit — more than four times colder than the South Pole in Antarctica was at noontime Monday.
This requires specialized freezers typically only found at college campuses and research institutes. Fortunately, Marin County has both.
Three local research institutions — BioMarin, the Buck Institute for Research on Aging and Dominican University — are offering the county their ultra-cold freezers for free once the vaccines arrive.
“Fortunately in Marin, we’re able to leverage these public-private partnerships and all three of those partners eagerly stepped forward to offer resources,” Marin County Public Health Officer Matt Willis said. “We’ve got freezers identified at those three locations, which are going to allow us to store the Pfizer vaccine within Marin.
“Those become local hubs of distribution for the doses that would go along with the very first phases,” Willis continued. “So we’re talking about the first tier, which is not the general public. We’re talking about essential health care workers, hospital workers, staff at long-term care facilities, first responders and other highest priority groups that are part of our critical infrastructure.”
The Pfizer vaccine requires two doses spaced out three weeks to be effective. At least 10,000 people in Marin County will need to receive vaccines in the first phase, Willis said, which means at least 20,000 Pfizer vaccine doses will be needed.
Exactly how many doses Marin will receive in the first round is unclear, Willis said. Gov. Gavin Newsom announced Monday that the state will be receiving 327,000 doses of the Pfizer vaccine in mid-December assuming the U.S. Food and Drug Administration grants emergency approval to distribute it.
Pfizer states its trials show the vaccine is 95% effective in preventing people from contracting COVID-19, the disease caused by the coronavirus SARS-CoV-2.
Access to ultra-cold freezers likely will only be important for the first rounds of vaccination, Willis said. Other vaccines being developed by companies such as Moderna and AstraZeneca can be stored in typical medical-grade refrigerators found at hospitals and pharmacies. This will be important later when mass vaccinations on the general population are taking place, which Willis estimates could start in spring 2021. Moderna submitted an application for emergency approval with the U.S. Food and Drug Administration on Monday and states its vaccine could be authorized for distribution in mid-December.
How many doses can be stored in the ultra-cold freezers being made available in Marin is still being determined, according to the research groups. Both the Buck Institute and Dominican University plan to offer three ultra-cold freezers each that can reach temperatures of at least -94 degrees Fahrenheit.
If needed, Marin could access other freezers at nearby institutions such as the University of California San Francisco, Willis said.
The Novato-based Buck Institute, which specializes in research of aging and age-related diseases, typically uses its freezers for storing biological samples — some of which are set to be cleared out to make room for vaccines.
“It behooves us to really help,” said Eric Verdin, the institute’s president and chief executive officer. “This is the issue of our time. I would not want to be missing on the opportunity for Marin County to know that the Buck is helping.”
The institute has shifted its focus on studying the coronavirus given its significant effects on the older population. In addition to the freezers, the institute had also scoured its labs for testing tubes in March when the county was scrambling to get enough materials for coronavirus testing.
Dominican University, a private university based in San Rafael, typically uses its ultra-cold freezers to store samples for research in its biological sciences and biochemistry programs, according to university communications director Sarah Gardner.
BioMarin will be donating “several” ultra-cold freezers, according to company spokeswoman Debra Charlesworth.
“BioMarin will assist with the transfer and installation of the units for the county,” she wrote in an emailed statement. “The company uses these types of freezers in its operations to store pharmaceutical products, reagents used in laboratory experiments, and clinical samples.”
Pfizer plans to deliver 50 million doses of its vaccine globally before the end of the year and another 1.3 billion doses by the end of 2021. The vaccine will be shipped in containers with dry ice, which is good for 10 days of storage. Once received the vaccine can be stored for another five days in typical medical-grade refrigerators of 35-46 degrees Fahrenheit. Ultra-cold freezers, however, extend the vaccines’ shelf life by six months, allowing for greater flexibility for when they are used.
If approved by the FDA this month, Moderna states it could ship about 20 million doses by the end of the year. Similar to the Pfizer vaccine, the Moderna vaccine requires two doses to be effective but spaced out over four weeks.
The rollout of who gets the vaccine first before others will be decided by the U.S. Centers for Disease Control and California Department of Public Health, Willis said.
“We’re also working with the health officers across the Bay Area to make sure there is a fair and equitable process regionally,” Willis said.
A CDC advisory group voted on Tuesday to recommend health care workers and nursing home residents receive priority. The two groups encompass around 24 million Americans out of a U.S. population of about 330 million. Residents of long-term care facilities have been the hardest hit in Marin, accounting for about 84% of total deaths.
Assuring the public’s trust in the vaccine also will be vital to the success of achieving immunization levels needed to prevent widespread infection, Willis said. Information about the vaccines and trials so far have come through company press releases and have been the subject of politicization, Willis said. The state has established a commission of scientists to independently review the vaccine trials to ensure safety and effectiveness.
Marin County has had issues with vaccinations in the past, Willis said. In 2013, the county had one the lowest childhood vaccination rates in the state at 78% but has since improved the rate to about 95% in 2020, he said. SB 277, which became law in 2016, eliminated all non-medical exemptions to vaccine requirements for enrolling children in public or private elementary and secondary school.
“People are going to need to be assured of its safety and effectiveness before we would expect widespread adoption of this,” Willis said of the coronavirus vaccine. “We’re also planning to lean heavily into the review process of the scientific review committees that have been established by the state.”