SUNDAY SEPTEMBER 6 2020 NEIGHBORS 19NEMIAMIHERALD.COM

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4A SUNDAY SEPTEMBER 6 2020From the front page MIAMIHERALD.COM

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Even once a vaccine isadministered, it will taketwo doses three to fourweeks apart, so even arushed process wouldn’t becompleted for many to getvaccinated by ElectionDay, Nov. 3.

The Centers for DiseaseControl and Preventionindicated last week itwants states to be ready togo in October. Last week, itsent out a letter askinggovernors to fast-trackpermits and licenses fornew distribution sites, andrequested states submitproposals by Oct. 1.

Florida is one of fivejurisdictions — California,North Dakota, Minnesotaand the city of Philadelphiaare the others — selectedby a CDC working group tocreate pilot distributionprograms intended to serveas models across the coun-try.

The group, which beganmeeting weekly in August,discussed allocation strate-gies, weighed how to pri-oritize who gets a vaccinefirst and reviewed datafrom the initial clinical trialphases of the leading vac-cine candidates.

But while the state maybe preparing for a vaccine,the White House’s chiefvaccine adviser on Thurs-day cast doubt about theprospect that the vaccinecould be ready by the endof October.

“There is a very, verylow chance that the trialsthat are running as wespeak could read beforethe end of October, ex-tremely unlikely but notimpossible,” MoncefSlaoui, the chief scientificadviser of the Trump ad-ministration’s coronavirusvaccine and treatmentinitiative, said in aninterview with NationalPublic Radio.

He said that if a vaccineemerges, “the right thingto do” is to be prepared.

If and when a vaccine isready for distribution inFlorida, hurdles remain,not the least of which iswhether the public willtrust a vaccine whose fastdevelopment, named Op-eration Warp Speed by thepresident, is strategicallybeing timed to coincidewith the election and tar-geting Florida.

NOVEMBER SURPRISE?

“I want to hope that ourstate is not putting people’slives in danger as it pre-pares to be that modelstate and that this is hap-pening because they be-lieve people will be helpedand lives will be saved,”said state Rep. ShevrinJones, a Broward CountyDemocrat and one of fourlegislators who has beendiagnosed with COVID-19.

Florida is a logical choiceto be on the front end ofvaccine distribution “be-cause it’s [the president’s]home state and the gover-nor is working with thepresident trying to dowhat’s best for Florida,”said state Sen. Joe Gruters,a Sarasota Republican whois chairman of the Repub-lican Party of Florida.

Gruters denied Floridawas selected because it is apivotal swing state deemedessential for PresidentDonald Trump to win re-election and said the vac-cine plan “is not a Nov. 1surprise.”

“This pandemic tran-scends politics,” he said. “Idon’t know if it will havemassive political implica-tions because people al-ready know it’s coming.”

He hopes Trump “willget the credit he deservesfor pushing OperationWarp Speed as fast as hu-manly possible” and pre-dicted that the vaccine willultimately “have a biggerimpact on the economythan it does on politics.”

But uncertainty over thetiming of a potential CO-VID-19 vaccine on Thurs-day had investors squeam-ish, as the Dow dropped807 points as stocks postedtheir worst day since June.

At a news conference in

Daytona Beach onWednesday, Gov. RonDeSantis tamped downexpectations about a vac-cine, and laid the responsi-bility for its distribution onthe federal government.

“I wouldn’t want peopleto think that in two moremonths, you know, every-thing is going to be gone,”the governor said, suggest-ing that the flu vaccine isonly 50% effective amongthe senior population com-pared to other populations,“so just people should havetempered expectations.”

(The governor did notcite research related to theflu vaccine, but recent datafrom the NationalInstitutes of Health refutesthat claim.)

DeSantis added that hedoesn’t know how manyvaccines “will end up beingproduced,” but he signaledthat the burden of produc-ing a successful vaccinenow falls on the drug com-panies.

“I know they basicallypaid all these companiesalready so that they couldjust go ahead and roll withit as the trials are going,”he said.

MANAGING

EXPECTATIONS

How the federal govern-ment handles the messa-ging about a vaccine isgoing to be crucial to man-aging public expectations,public health experts said.

Peter Pitts, president ofthe Center for Medicine inthe Public Interest and aformer FDA associate com-missioner for externalrelations, said one of thebiggest challenges stateswill face when distributinga new vaccine is publicskepticism.

“Having a vaccine thatnobody uses is a publichealth failure,” he said,adding that time is runningout for public health offi-cials to get out a persuasivemessage.

Americans already areskeptical. A poll releasedMonday by Harris andSTAT found that 78% ofAmericans believe that theCOVID-19 vaccine processis being driven more bypolitics than science.

But when it comes totrust in the president, thepublic breaks down alongpartisan lines. Althoughonly 46% of the publictrust the president or theWhite House to provideaccurate information aboutthe development of a CO-VID-19 vaccine, 71% ofRepublicans believe Trumpcompared to only 28% ofDemocrats.

There is more trust inthe FDA than the presi-dent: 68% say they areconfident that the FDA willonly endorse a vaccine thatis safe.

Gruters, who is one ofthe president’s most vocalcheerleaders in Florida,said he expects most of thepublic will trust a vaccine.

“There is a lot of distrustin government overall, butthe FDA and its policiesand science transcendspolitics,” he said. “If theysay it’s ready and if theyare getting results in thesetrials, then I’m confident.”

In a presidential electionyear, Pitts said, the pan-demic and the govern-ment’s response have be-come “hyper-politicized.”

“If you don’t believe themessenger, you’re notgoing to believe the mes-sage,” he said.

The president and theFDA didn’t help engendertrust when the head of theFood and Drug Adminis-tration grossly misstatedclaims about the lifesavingpower of a plasma therapyfor COVID-19 authorizedby his agency on the eve ofthe Republican NationalConvention, then quietlytried to correct it anddemoted the official incharge of the botchedrollout.

Barry Bloom, an immu-nologist and research pro-fessor with Harvard T.H.Chan School of PublicHealth, said the FDA’strack record of question-able emergency use ap-provals during the pan-demic is worrisome.

He noted that in addition

to the the FDA’s emergen-cy approval of convales-cent plasma, it also gaveemergency approval forhydroxychloroquine as aCOVID-19 therapy in April,only to revoke the autho-rization in June. The agen-cy also allowed dozens ofcoronavirus antibody testson the market withoutreview, only to later findthat many of the tests werenot accurate.

“That is worrisome be-cause in the case of vac-cines, the pressure will befar greater,” Bloom saidduring a conference callwith reporters on Aug. 25.

“I would hope the lead-ership of the FDA wouldstand firm on the scientificbasis. Otherwise, the trustin the whole scientificenterprise becomes com-promised. And there are alot of people in the anti-vaccine world that arelooking forward to precise-ly that.”

LOGISTICAL HURDLES

The government also hasto manage the logistics ofdistributing a vaccine on amass scale.

Only two of six vaccinecandidates that have thebacking of the federalgovernment — those beingproduced by Moderna andPfizer — are in active PhaseIII clinical trials, and theyrequire extremely coldshipment and storage con-ditions.

Sen. Gayle Harrell, chairof the state Senate HealthPolicy Committee, invitedrepresentatives from phar-maceutical companies amonth ago to conduct abriefing session for fellowRepublican lawmakersabout the status of vac-cines. She said that be-cause of the need for sup-er-cold conditions thereare a limited number offacilities in Florida that canstore it.

She said that once avaccine is thawed, it mustbe used within a day ortwo. That leaves researchhospitals and research labsas the most likely locationsto handle the product.

“You have to really thinkthis thing through to set upa mass distribution,” Har-rell said.

“The healthcare logisticsaren’t being discussed,which is a huge issue, notthe least of which is coldstorage,” Pitts said. “It’snot as though a big box ofpills arrives and you putthem on a shelf. Vaccinesrequire special care. Theyhave to be shipped in dif-ferent ways and have to bestored in different ways.The question is: Is ourhealthcare infrastructure

prepared for that?”

WHO GETS

VACCINATED FIRST?

After logistics, the statemust decide who will beeligible for the first roundof limited supplies of avaccine.

The governor said thisweek that “if there is a safeand effective vaccine, Ithink that the most vul-nerable population shouldhave priority.” He de-scribed that as people whoare 65 and older and thosewith underlying healthconditions that increasetheir risk.

Operation Warp Speedofficials have suggestedthat the state should expectthe elderly — includingthose homebound, in nurs-ing homes and in seniorliving facilities — as well ashealthcare workers, front-line essential workers,national security workersand communities of colorto be among the prioritygroups for the first vaccinedoses.

Bloom, the Harvardimmunologist, said thelimited availability of vac-cines in the beginningstages will create pressure“for every group, everypressure group, every orga-nized group and lots ofinfluential individuals totry to get access to thatvaccine.”

But Harrell, the statesenator, said “not everyonewill want to get vaccinat-ed,” especially in the earlymonths of the vaccine.

Critical to the publicmessaging is that everyoneshould be allowed to eval-uate their own risk, shesaid. Unlike using experi-mental therapy for treat-ment of COVID-19, a vac-cine involves giving a doseof the virus to healthypeople, she said. “It has tobe a voluntary thing, and ifyou don’t want to do it, youcan’t be forced to do it.”

Jones, the Broward legis-lator, said that many in theBlack community are goingto be reluctant to get vacci-nated given the state’s

historical failure to providehealthcare access to it.

“Is the state coming tous because they wanteveryone to be safe or arethey coming to the Blackcommunity because theywant them to be your labrats?” he said. “That’s themessage that is out thereon social media. They needto educate the communityfirst.”

He said he doesn’t seeany effort to educate thepublic now, however, andthat could lead to in-creased distrust.

“If the governor’s officeknows this is coming inOctober, the smart thingwould be to launch a cam-paign to show this is aboutto happen,” Jones said. “InFlorida, we get a lot ofthings wrong and we arethe laughingstock on a lotof things. We need to getthis right.”

Mary Ellen Klas can bereached atmeklas@miamiherald.comand @MaryEllenKlas

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VIRUS

JOE RAEDLE TNS

Barbara Corral, a nurse practitioner, and Jose Fernando Henriquez, a research assistant, are seen in an exam room as theyconduct a COVID-19 vaccination study on a patient at Research Centers of America on Aug. 7 in Hollywood.

AFTER LOGISTICS,THE STATE MUSTDECIDE WHO WILLBE ELIGIBLE FORTHE FIRST ROUNDOF LIMITEDSUPPLIES OF AVACCINE.