Sean Avedissian, an assistant professor with UNMC lecturing in infectious disease and pharmacokinetics, receives a shot from Rachel Gregory-Sachs, a registered nurse with the Douglas County Health Department.
OMAHA — Nebraska will start vaccinating anyone 65 years and older as part of its next phase in administering the COVID-19 vaccine.
But a top official in Nebraska’s vaccine effort cautioned that the shifting priority will add some 300,000 to 400,000 people to the next vaccine group.
And one UNMC expert warns that the expanded rollout might not speed the effort and even could create more confusion.
Nebraska’s move comes after federal officials shifted guidance on the vaccine Tuesday.
The Trump administration urged states to open up vaccines beyond the previously stated priority of people 75 years and older.
The new recommendation calls for vaccinating people 65 and older, along with younger people with documented medical conditions.
Asked about the changing guidance early Tuesday, Gov. Pete Ricketts declined to sign off on the change locally. He said the state would examine the guidance, but wanted to be sure Nebraska had its necessary supply to get people their recommended second doses.
Then later Tuesday, Angie Ling, incident commander with the Nebraska Department of Health and Human Services, said Nebraska will move the 65 and older group up on its priority list.
Gary Anthone, the state’s chief medical officer, said: “Things are changing by the hour here.”
Ling and Anthone spoke during a tele-town hall organized by U.S. Rep. Don Bacon to address the vaccine rollout.
Ricketts, speaking on CNBC on Wednesday morning, noted the shift on the 65-and-older group: "Obviously, with the CDC change in the guidelines yesterday, we are going to be looking at accelerating the 65-year-olds as part of our vaccine program."
The second part of the shifting advice involves people with medical conditions. Ling said the state will work with health care officials to determine which high-risk medical conditions would qualify younger residents to move up on the priority list.
With a significant increase in the numbers, Ling said it could take four months to vaccinate the group that now includes those 65 and over, those with medical conditions and essential workers.
Dr. Mark Rupp, chief of the University of Nebraska Medical Center’s infectious diseases division, said he understands the reasons for opening up the categories. But he added: "I don’t know that it’s going to solve much."
Rupp said health officials are coming under increasing pressure because more vaccine is being sent out than is getting into people’s arms. In all, the new guidance added another 53 million people across the country to the vaccine priority, he said.
Behind the scenes, officials are still shaping Nebraska's upcoming vaccination campaign. It's unclear exactly how the next phase of vaccinations will go.
In parts of western Nebraska, public health districts and health care professionals already are vaccinating the very first of the 75-plus group — as the vaccination of health care workers wraps up and a separate effort to reach long-term care facilities makes steady progress.
Part of the challenge ahead is that the current vaccines are not simple to administer and the logistics of putting together a mass vaccination program are complex and difficult.
Both the Pfizer and Moderna vaccines must be stored at colder temperatures than most shots, with the Pfizer vaccine requiring ultra-cold storage. Because of rare incidences of severe allergic reactions, vaccinators are observing those who get the shots for 15 minutes. Those with a history of allergies are observed for 30 minutes. Those receiving the shots are being kept socially distant, which adds to space requirements in vaccination locations. Drugs that can reverse an allergic reaction also must be on hand.
For all of those reasons, public health officials are trying to roll out the vaccine very carefully.
“I would just plead with folks to continue to have patience,” Rupp said. “We’re working through this as quickly as possible. And overall, the public health services are doing a really good job with this.”
PHOTOS: BRYAN STAFF WHO CARE FOR COVID-19 PATIENTS
Staff use personal protective equipment in the COVID-19 unit at Bryan Health.
Patients in the COVID-19 ICU unit at Bryan East Campus are monitored and treated for a variety of issues, including blood clots and pneumonia.
Bryan has made counseling services available to its employees who work in the units hit hardest by the pandemic and has offered to rotate staff who need a week respite on another floor. "That gives them just enough of a break to come back and say 'I can do this for another four weeks,'" said Candy Locke, the nurse manager.
The people who work in the COVID-19 ICU that currently takes up a large part of the sixth floor at Bryan East Campus say they are worn out. "When the nurses are having nightmares at night and they're telling you about it, it's rough," said Leah Harrington, an assistant nurse manager.
A staff member in personal protective equipment tends to a patient in the COVID-19 unit at Bryan Health. COURTESY PHOTO
For months, doctors, nurses and respiratory therapists have worked to help COVID-19 patients on 6N, the ICU unit at Bryan East Campus. In many cases, patients who are breathing on their own see their conditions quickly worsen. "It's hard to go home and not think about that, to just kind of de-plug from work, because these patients are so scared, and we're trying everything," nurse Kelsey Hoppe said.
Staff talk outside a patient's room on 6N, the ICU unit for COVID-19 patients at Bryan East Campus.
