COVID-19 vaccines are coming to Miami. Hospitals want to figure out who will get them

At age 87 and with some underlying medical conditions, Dr. Stephen Fredd of Fort Lauderdale has the same question as the top vaccine chiefs in South Florida’s hospitals: When will he — and others like him — be inoculated for COVID-19, and how?

Scientists at pharmaceutical companies and federal officials are those closest to knowing the answer, but it’s up to the state of Florida to develop a plan on how those vaccine doses will be distributed to the masses. So far, the Florida Department of Health has made only a vague draft plan available and has declined to answer questions about the specifics of distribution.

Even federal lawmakers are unclear on the details. On Wednesday, Florida U.S. Sen. Rick Scott sent a letter to U.S. Department of Health and Human Services Secretary Alex Azar pressing for more information on funding requests and distribution plans for the vaccines.

“More information is needed to reassure Americans that their states will do everything possible to efficiently and equitably distribute a vaccine,” said Scott, who is currently isolating after recently testing positive for the COVID virus.

What’s clear is that healthcare workers — who are in Phase 1 of the state plan — will be first. But with enough doses expected in South Florida to vaccinate virtually all healthcare workers by the end of the year, it’s unclear who comes next.

Two of the region’s largest public hospital networks — Jackson Health System in Miami-Dade County and Memorial Healthcare System in southern Broward County — are among the five Florida hospitals first in line to receive the Pfizer vaccine, which is nearing federal approval. Baptist Health of South Florida, the region’s largest nonprofit hospital, isn’t one of the hospitals tapped to participate in the state’s vaccine pilot program, but it still expects to get the vaccine during Phase 1. It’s unclear if that’s guaranteed to happen.

Fredd, who worked at the U.S. Food and Drug Administration for 22 years as the head of products development and director of gastrointestinal and coagulation drugs, said he is no stranger to “the bureaucratic needs of setting up something that works under the laws and regulations,” and that’s part of the reason he’s concerned.

The former regulator, who now lives in Fort Lauderdale and won’t be seeing his children this Thanksgiving because of the pandemic, has called his local representatives and local hospitals, and he isn’t finding any answers.

“Unless we are proactive in setting this up, it’s going to be a mess,” he said.

Part of the reason Fredd isn’t hearing a more detailed plan is that one hasn’t been made available in Florida — for the general public or the hospitals that will be vaccinating front-line staff and other healthcare workers.

Along with the state’s draft plan and federal guidelines issued by the U.S. Centers for Disease Control and Prevention, hospital officials are trying to figure out what the distribution plan will look like.

What’s in Phase 1?

Though it isn’t one of the five hospitals chosen by the Department of Health to receive the vaccines first, Baptist Health’s chief pharmacy officer is working under the assumption it will receive doses of the vaccine during the initial phase, when healthcare workers will volunteer to receive it.

Madeline Camejo, who is leading the hospital system’s vaccine plans, said she’s still not sure how it will work, partly because the hospital system doesn’t yet know how many doses of the Pfizer vaccine will end up in Jackson’s and Memorial’s hospitals.

Though she said Baptist has worked closely with state officials, Camejo said she has no details of how those other hospitals might share vaccine doses with Baptist.

“We’re all trying to figure it out,” she said.

All hospital networks interviewed by the Miami Herald shared the same understanding of how healthcare workers would be vaccinated.

The process is expected to be voluntary. Front-line workers, including physicians, nurses and other staff in COVID wards, are first in line. Other providers who don’t work directly with COVID patients are up next, until eventually anyone who works in the hospital networks can volunteer to get vaccinated.

Venessa Goodnow, chief pharmacy officer at Jackson Health System, said there’s still no date set for when the hospital network, which is part of the initial group to receive the vaccine, is expected to get the vaccine.

“Everything is in place,” Goodnow said. “It’s just the final date and final quantity that we’re waiting for.”

Who comes next?

Phase 2 calls for nursing home and long-term care residents to be vaccinated next, followed by high-risk portions of the general public in Phase 3.

Goodnow, of Jackson Health, said she is still working to come up with a plan to identify those patients who could fall under Phase 3 who are already in the hospital system.

Older patients with underlying conditions like chronic obstructive pulmonary disease, diabetes and heart disease are likely to be vaccinated in the early groups, she said, but it’s unclear how other aspects of someone’s medical history might come into play, such as a past COVID-19 infection.

Goodnow said she is working with the hospital network’s infectious disease chief, Dr. Lilian Abbo, to answer those questions.

“At the moment, it would really depend on how recent their COVID infection was and to see if they still have antibodies to that COVID infection,” she said.

Fredd, the former FDA official, said he’s heard through media coverage that essential workers might be in line after nursing home residents as part of Phase 3, as opposed to high-risk patients like him.

He said he’s asked his doctor for more information, but it’s still unclear.

Any plan would be fine, Fredd added.

“I just wish it were clear and settled,” he said, “given the massive nature of that vaccination about to take place.”