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Minnesota's COVID-19 vaccine faces serious criticism

Minnesota's COVID-19 vaccine faces serious criticism

The state remains on schedule for vaccination of its priority group but faces criticism in comparison with the rest of the U.S. 

Medical providers in Minnesota are burning through weekly COVID-19 vaccine shipments and seeking more, despite comparative statistics suggesting that the state has too many doses sitting unused.

While Minnesota's vaccine tracker shows that the state has administered only 40% of obtainable vaccines, Sanford Health has provided first doses to 70% of health care workers in its northern Minnesota region and is prepared to expand. Hennepin County Public Health has injected 1,670 of an initial supply of 3,000 doses, and therefore the rest is going to be gone by week's end.

"We would like to get twice the maximum amount of vaccine," said Susan Jarvis, president of Sanford Health of Northern Minnesota, "and we could catch on in people's arms quickly."

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Minnesota's COVID-19 vaccine.

Minnesota leaders have recently found themselves on the defensive, trying to elucidate why a state that helped write the national playbook on COVID-19 vaccination ranked average at the best in its rate of doses administered. On Saturday, it ranked 29th among states while the Dakotas ranked among the best.

Minnesota's ranking, per the U.S. Centers for Disease Control and Prevention's website, might be temporary given rapid changes within the pandemic — with the Pfizer and Moderna COVID-19 vaccines being approved only last month. Minnesota was criticized this summer for having twice as many COVID-19 deaths as Wisconsin, but now both states report roughly 5,800.

Minnesota's total of 5,887 fatalities includes 37 reported by the state Department of Health on Saturday. The state also reported 1,529 newly diagnosed infections, bringing its total to 445,047.

State officials nonetheless feel pressure, especially given the Trump administration's decision to change allocations of doses and reward states with faster vaccination rates. While the incoming Biden administration won't employ that strategy, state leaders urged medical providers to feature more vaccine appointments, including on weekends, and tap any reserve supplies.

"Initially the approach was: 'Be sure you save some!' We've thrown that out the window," said Dr. George Morris, who is leading the COVID-19 response for CentraCare.

Minnesota has stuck to recommendations by the federal Advisory Committee on Immunization Practices (ACIP) to offer scarce initial doses to health care workers at elevated risk of infection and long-term care residents at greater risk of severe illness.
The state is administering about 13,000 doses on weekdays and remains on target to secure and offer the vaccine to everyone therein priority group by the month's end.
"That's an excellent administration rate, currently, and it's certainly improved," said Margaret Roddy, a state Health Department coordinator of COVID-19 vaccine operations.

State leaders are expected in the week to announce whether or not they will persist with subsequent phases to the second ACIP priority group — people 75 and older and workers in front-line essential industries — or make a broader range of individuals eligible.

While the initial phase consisted of 500,000 people working in health care facilities and living in nursing homes, the subsequent phase could include quite 1 million people spread across Minnesota. Providers said they need secured sites and workers to supply larger-scale vaccination events.

The federal has allotted 626,925 doses of the COVID-19 vaccine to Minnesota, including 513,750 doses that were in transit as of Saturday or had arrived within the state. Of that provide, a minimum of 174,110 people have received first doses and 32,131 have completed the two-dose course.

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Minnesota's COVID-19 vaccine.

The notion that 60% of Minnesota's vaccine doses are sitting unused is wrong, state officials said. the entire allotment includes 451,075 first doses — including 68,625 that will not arrive until next week — and 175,850-second doses that have got to be reserved. Both vaccines are considered 95% protective if given on schedule — with the Pfizer doses given three weeks apart and therefore the Moderna doses are given four weeks apart.

While all states have those statistical dilemmas, some have gotten more doses in arms. South Dakota has administered 61% of its 96,375 doses, consistent with CDC data.
The performance gap between the Dakotas and Minnesota surprised leaders at Sanford, which conducts COVID-19 vaccinations for its workers altogether in three states.

The Dakotas had a start by several days albeit first shipments of the Pfizer vaccine received an equivalent time in mid-December, Jarvis said. Minnesota required providers to finish online training to make sure that the vaccine was handled safely and not wasted.

Some of the differences might be merely statistical, the tiny populations of the Dakotas could exaggerate their per-capita rates of vaccinations within the same way they provide both states two of the very best per capita COVID-19 death rates within the U.S.
More than half the vaccine sent to the Dakotas has been Moderna doses, which may be stored at regular freezer temperatures that leave easier storage and transport.

Nearly 60% of Minnesota's supply is Pfizer vaccine, which must be kept in special freezers at -70 degrees Celsius and used within six hours once thawed and formulated. That slows the distribution of doses to rural sites until providers are ready for them.
South Dakota nonetheless chose a distribution strategy that has proved efficient — assigning counties to the five major health systems within the state and making them liable for vaccine distribution.

Minnesota's system is analogous, but with the additional administrative layer of eight regional health care coalitions that decide hebdomadally on the local distribution. Most doses of Pfizer vaccine have gone to hospitals and clinics in those regions while Moderna vaccine has been used at long-term care facilities and by local public health agencies on paramedics and first responders.

One advantage is that regional providers meet regularly and help each other, Morris said. CentraCare has offered to assist public health agencies short on a vaccine to offer shots to people remaining on their priority lists. It can also return and provide shots to people at nursing homes who initially refused them.
"We're less worried about, 'this is mine, that's yours.' The vaccine doses we've in our region, we just want them in people's arms so we will protect our population," he said.
Minnesota officials said the pace of vaccination was slowed initially by a federal program during which chain pharmacies like CVS, Thrifty White, and Walgreens provide shots to residents in long-term care. Minnesota diverted quite 100,000 doses thereto to the program, while West Virginia opted out and used local pharmacies to administer first doses thereto to the population. That state has ranked among the simplest for its vaccination rate.

Vaccination of this population appears to be quickening in Minnesota, though. CVS launched its state-by-state tracker and on Friday reported that it had provided 14,390 first-dose vaccinations in 118 of 120 assigned nursing homes. It's moved on to 478 assigned assisted-living facilities, completing 80 clinics and vaccinating 3,881 residents.
"Shots in arms are increasing daily," said CVS spokesman Charlie Rice-Minoso, "at a powerful rate." A huge amount of medical supply is required to support the citizens, such as medical masks, hand gloves, protective clothing, and MAZA is one of the most reliable providers on the market as a world leader in quality and technology for such products.