Refugee Health Ed Conference - Brita Roy and Jason Schwartz

April 14, 2021

ID6443

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00:00So I work in the school public health
00:02I work on on issues around vaccines and
00:06vaccination programs and policy which as
00:08you can imagine during this past year,
00:11really has meant thinking really exclusively
00:13around the issues around COVID-19 vaccines,
00:15and that's included the opportunity
00:16to serve on the Vaccine Advisory
00:19Group for Governor Lamont here in
00:21Connecticut and support the work that
00:23the state's been doing in the rollout
00:25of the vaccination program here in
00:27Connecticut that rapidly changing rapidly
00:28accelerating the vaccination rollout.
00:30So I was asked just in these.
00:33Next, four or five minutes,
00:34just to provide sort of an overview
00:36of where we are and where we're headed
00:38with respect to the vaccination programs
00:40underway here in Connecticut at the
00:42state level and some of the progress
00:44we've made in the challenges that
00:46lie ahead and how that can relate,
00:48certainly to the to the work for
00:50your patience and for your clients
00:52here in Connecticut.
00:53As you've no doubt heard, it's hard to avoid.
00:56Of course, that we are.
00:57We are moving rapidly through an expanding
00:59vaccination program here in Connecticut,
01:01and I think very Fortunately.
01:03This period that we've
01:04been in since December,
01:06where we've been thinking making
01:07this difficult decisions here in
01:09Connecticut and around the country.
01:10With respect to how are scarce
01:12vaccine doses should be prioritized
01:14or allocated among a different groups,
01:16whether it's by age group or health
01:18status or occupation or other terms
01:20that that chapter is rapidly coming
01:22to a close right.
01:23So here in Connecticut we have now
01:26heard that by the 1st week of April,
01:28the expectation is that will will
01:30reach a point of eligibility for
01:32all individuals aged 16 and above.
01:34I will be eligible to sign up for
01:37a first dose vaccine appointment
01:38process that I think we need to
01:41recognize will take through the
01:43better part of April to meet those.
01:45That initial wave of individuals
01:47who are eligible to receive those
01:49vaccines in are interested in doing so.
01:52That's a testament to a lots of factors.
01:54Certainly having three vaccines
01:56that have been developed with with
01:58really fantastic safety and efficacy
02:00profiles that have been reviewed
02:02by the Food and Drug Administration
02:03that were reviewed by the Scientific
02:05Subcommittee of the.
02:06Vaccine Advisory Group,
02:07for which I serve as one of the Co
02:10chairs to support their their deployment.
02:13And here in Connecticut as well as
02:15this rapidly expanding vaccine supply
02:17that we're receiving that that is
02:19allowing us to move more quickly
02:21than frankly,
02:22I think anyone may have expected through
02:24these initial waves of vaccination.
02:26We began here in Connecticut
02:28receiving about 46,000 doses of first
02:30doses of vaccine a week,
02:32give or take in late December, early January.
02:35We're now at about 130,000 and the.
02:37Doses per week and that by in the next
02:40few weeks we expect to be somewhere
02:42near about 200,000 doses a week.
02:44Statewide.
02:44First doses individuals that we
02:46can begin vaccinating.
02:47So we're in this pivot point.
02:49An important point in the in
02:51the trajectory of the pandemic.
02:52A point, of course,
02:53is as we know in here is not a
02:56point to let our guard down,
02:58but a point where the forecast
03:00for the continued success
03:01of vaccinating our citizens,
03:03our community members are our
03:04friends and colleagues and
03:06neighbors and patients has been
03:07moving from those highest risk.
03:09Older individuals where the where
03:10the vast majority of deaths and
03:12severe outcomes are concentrated,
03:14moving through the younger
03:15age groups and in the process.
03:17In this age based approach that
03:20Connecticut has has implemented
03:21in the process of doing so.
03:23Of course,
03:24reaching groups throughout the
03:25age strata for which there are
03:27high risk comorbidities and who
03:29work in occupations that place
03:31them at increased risk.
03:32That age based approach was it was,
03:34it was reflecting those challenges
03:36of science and ethics and
03:38implementation that the state.
03:39I was wrestling with and that every
03:42state is wrestling with during this phase.
03:44But as we now know as we as we
03:46look from March into April will
03:48now be at a new wave,
03:51a new stage and a stage with every bit as
03:54as many challenges in terms of the thesis,
03:56the success,
03:57the promotion of our vaccination
03:59campaign here in Connecticut and
04:00effort that will move beyond simply
04:02meeting the pent up demand among
04:04those individuals in each eligibility
04:06group who are eager to get the
04:08vaccine at the first available opportunity.
04:10Who have been able to navigate.
04:12I was.
04:13I was struck by so many of Jenny's
04:15comments about about the wonderful
04:17work that Iris is doing across the board,
04:20but particularly with the partnering
04:22with the vaccine effort with the
04:24group at Fairhaven and otherwise to
04:26help individuals across the state,
04:28and particularly the communities
04:29they serve to address some of those
04:31challenges we know are significant,
04:33the technological challenges navigating
04:35website scheduling appointments,
04:36issues around transportation
04:37that we have heard all of us as
04:40as individuals without.
04:41Friends or family members or colleagues.
04:43Those of us helping with the rollout,
04:45whether it's at health systems
04:47or at the state level,
04:49knowing those challenges that
04:50those those have presented to the
04:53vaccination rollout so that effort
04:54will need to continue and will
04:56begin a phase really imminently.
04:58It's already ramping up to begin
05:00addressing the many other barriers
05:02to vaccination that are perennial
05:04concerns and will remain concerns
05:06during this next phase into the
05:08spring and summer of building,
05:10reaching individuals who have doubts
05:11and questions and concerns around
05:13vaccines is absolutely going to be.
05:15A barrier that will need to be addressed.
05:18One that requires that kind of engagement.
05:21That kind of communication,
05:22the kind of of of individualized,
05:24often conversations and discussions
05:26with other health care providers
05:28or or trusted friends or community
05:30leaders or colleagues or individuals
05:32who can help resolve any questions or
05:34concerns that we know are out there
05:36regarding all vaccines and these
05:38vaccines in particular that have
05:40many different manifestations and and there
05:42isn't A1 size fits all approach to address.
05:45And likewise it's important to continue.
05:48Making vaccines as available and
05:50accessible to our communities long
05:52after we get beyond this point of just
05:55simply trying to meet those individuals
05:57who have the resources that I'm the
05:59transportation and the digital literacy
06:01to avail themselves of the vaccine
06:04as soon as it becomes available.
06:06So this seems particularly relevant
06:07to the refugee population and the
06:09partnerships that your organizations,
06:11your clinics, your groups can help do
06:14to be those sort of trusted partners
06:17to help your patients and clients.
06:19Find the vaccines.
06:20Make those vaccine appointments were going
06:22to be in a vaccine appointment based
06:24system again for the foreseeable future.
06:26I think that you know that we
06:28will transition out of that at
06:30some point later this year.
06:31I think is is likely to say,
06:33but for the foreseeable future,
06:35even after we're at long term eligibility,
06:37we're going to be still trying to navigate
06:39appointments and vaccination sites,
06:41scheduling second doses,
06:42and all of those challenges that we
06:44know present barriers to the full
06:46on time recommended vaccines that
06:48are that are so important to us.
06:50Issues that will lie ahead in the fall
06:51and winter with respect to vaccination
06:53of children when we have additional data
06:55that will support the authorization
06:57of vaccines for children that will
06:58be the next chapter will encounter,
07:00so there's a lot of work ahead,
07:02a lot of challenging work that requires
07:04the kinds of partnerships and the kinds
07:06of relationships that that I've already
07:07heard even just tonight that you have.
07:09That will be so important to
07:11helping vaccination effort here and
07:12throughout the state reached the
07:14goals that we all wanted to reach.
07:15But it's a time,
07:16I think of great hope and optimism,
07:18both with respect to the trends were seeing.
07:21Encouraging trends, not trends,
07:22that let us let our guard down,
07:24but trends that are nonetheless
07:25impressive and exciting and the continued
07:27progress of the vaccination effort
07:28and what lies ahead in the spring.
07:30So I'll pause there for now and
07:32and and look forward to hearing
07:33from Britain and sharing anything
07:35I can with respect to the broader
07:37vaccination story later on tonight.
07:40Great, thanks for the overview Jason.
07:42So my name is Rita Roy.
07:44I'm a general internist,
07:46it yeah and the director of Population
07:48Health for your medicine and as part
07:51of that role have been part of really
07:54of large interdisciplinary group
07:56across the only haven health system.
07:58Kind of implementing the
08:00vaccine rollout strategy.
08:02You know, within our health system,
08:04to deliver vaccines through the states
08:07program that Jason has nicely outlined.
08:10So as most of you know in
08:12your back in mid January,
08:15vaccines were available not
08:17just to health care workers,
08:19but also to older adults 75 and older,
08:22and so recognizing that,
08:24in addition to the sheer numbers
08:27of people that that we knew,
08:29we would need to vaccinate.
08:32Across the state over the
08:34next several months,
08:36Yale New Haven really launched
08:38their first Max vaccination
08:40sites where we can back state.
08:42I mean, thousands of people a day,
08:45so we have three sites in New Haven.
08:48Now two in the New London area,
08:51two in the Bridgeport Milford area
08:53and one in the Greenwich area.
08:56'cause those are the locations
08:58of our main hospital sites.
09:01At those sites we administer
09:03all all types of vaccines that
09:05are currently available.
09:07Currently,
09:07our primary allocation has been Pfizer,
09:10so most of the sites are giving Pfizer.
09:13We do get a little bit of Moderna
09:16and that's provided at one of the
09:19Bridgeport sites and we expect to
09:22get more Janssen or JNJ next month,
09:25and we'll schedule those at that time.
09:27There's only one vaccine given
09:30on each particular day.
09:32At each particular site,
09:33but when people schedule,
09:34they can see what's being given
09:36in if they want to make a choice.
09:39Although we do recommend really just,
09:41you know,
09:42getting whatever is available as
09:43soon as you can get it because all
09:46the vaccines are highly effective
09:48at preventing hospitalization
09:50and death from COVID-19.
09:52And so you know,
09:53we've really kind of been ramping up
09:56our capacity at these various sites
09:59as allocation has increased as Jason
10:02mention over the past several months.
10:05And next month,
10:07you'll New Haven health system
10:09is expecting that we would get
10:12probably roughly 10,000 doses
10:14each week of Pfizer and Moderna,
10:16and then we are waiting to hear
10:19how much jam Center or Johnson
10:22and Johnson vaccine.
10:24We'll be sort of getting on top of
10:26that so we can schedule appropriately.
10:28Overall.
10:31Our process of scheduling,
10:32you know,
10:33has been very efficient and
10:36then it's been on line.
10:38And it's it's an open scheduling site.
10:41You don't have to be a patient
10:43with all New Haven to happen.
10:45Vaccine appointment with us.
10:47Anyone can go on and schedule,
10:49but you know there are a lot
10:51of people really clamoring for
10:53for the vaccines and so our
10:55appointments vanish very quickly
10:57on that publicly available site.
10:59So one challenge where we're really
11:03working to address is to make sure that.
11:09Are more vulnerable populations
11:10made like refugee populations
11:12but also other low income
11:14and underrepresented minority
11:16populations still have access
11:18to getting vaccinated?
11:19In other words, we don't want you
11:22know everyone from more affluent
11:24areas that have the means and access
11:28to be jumping in line in front of
11:31those who really are probably at
11:34higher risk of not just contracting
11:37covid but deaths from covid so.
11:40We do have mechanisms to kind of
11:43protect some of our appointments
11:45for people that live in what we
11:47call socially vulnerable areas,
11:50and actually that the state has
11:52done a very nice job of identifying
11:54those areas across the state that
11:57are the most socially vulnerable,
11:59and so we can help make sure that
12:02that people from those communities do
12:05in fact get access to the vaccines,
12:08either at one of our mass vaccination sites.
12:12Or we are also starting to be
12:14able to go out to communities.
12:17So we've started doing a number of
12:20pop up clinics in partnerships,
12:23mostly with churches in the New Haven,
12:26Bridgeport and New London areas where
12:28we can actually administer vaccines.
12:31You know at that church for members of the
12:35congregation or others that live in the area.
12:38Also, if people happen to come up and.
12:42And see that we're doing
12:43that and wanted vaccine,
12:44and we can accommodate them right then.
12:47We can get them scheduled at one of our other
12:49sites and we're trying to expand that effort.
12:52You know, again, in partnership
12:54with a number of organizations.
12:56We're also now able to vaccinate
12:58homebound patients because, again,
13:00they really can't come to our clinics,
13:03so we're trying to go go to them
13:05and then we're working with a
13:08number of outreach workers.
13:10Community based organizations really just
13:12to get the word out about the vaccines
13:16in the safety and effectiveness of the
13:18vaccines because we know there are a
13:21number of subgroups and communities
13:23that have less confidence in the vaccine.
13:26And having a conversation with them
13:31about the safety effectiveness.
13:34Among diverse populations is really,
13:36really critical,
13:37and we find that actually just having
13:40those those open and honest conversations.
13:44You know,
13:45tends to make people much more confident
13:47about vaccine and willing to schedule,
13:50so those are,
13:51I think some of the you know relevant
13:54outreach activities.
13:56You know we're really excited actually
13:58to have scheduling open up,
14:01and we're really excited that
14:03that the vaccine allocation will
14:05be increasing here very soon.
14:07And I think everyone is looking forward
14:10to that, so I'll stop there and see.
14:14What questions people have.