Tyler Evans, MD, MS, MPH, AAHIVS, DTM&H, FIDSA, on COVID-19 Vaccine and Distribution
Over the last few months, COVID-19 vaccines have been rolling out and distributed in the United States as part of President Joe Biden’s 100-day plan.1 As part of Consultant360’s “COVID-19 Research Briefs” webinar series, Tyler B. Evans, MD, MS, MPH, discussed “COVID-19 Vaccine Development and Distribution.”2 We caught up with Dr Evans after the webinar to find out more.
Tyler B. Evans, MD, MS, MPH, AAHIVS, DTM&H, FIDSA, is the deputy public health officer and chief of the COVID-19 Immunization Branch at the Marin County Health and Human Services Agency; a clinical assistant professor in the Department of Medicine at the University of California, San Francisco; and a research associate professor in the Department of Preventive Medicine, Division of Disease Prevention, Policy, and Global Health, at the Institute on Inequalities in Global Health, which is part of the Keck School of Medicine at the University of Southern California. He is also the CEO/CMO for Curative Medical Associates, a national COVID-19 mass vaccine distribution program.
Consultant360: How do you plan on increasing vaccine confidence in your patients?
Tyler Evans: Approximately 27% of the public remains vaccine hesitant,3 and much of this is related to distrust in government funding of the vaccine and perceived “rapid science” applied to authorize these vaccines. By sticking closely to the scientific evidence and focusing on the vaccine efficacy and safety data, as well as the ultimate benefit to society, we hope to instill the confidence to the communities we serve. It is critical to understand the variability in confidence among different communities, and we need to better understand their underlying reasons for hesitancy and address them with community-based organizations that have the trust and respect of these respective communities.
C360: How is your state/local government/practice allocating the COVID-19 vaccine? How were these guidelines decided?
Tyler Evans: The California Department of Public Health (CDPH) has created guidelines4 that follow the Advisory Committee on Immunization Practices (ACIP) rubric with additional prescribed “tiers.” These tiers are intended to reflect the contextual demographic needs in California. The ACIP guidelines were decided by an expert panel using the principles of science, implementation feasibility, and ethics. Ultimately, the objectives are to prevent morbidity/mortality and mitigate society disruption. The CDPH guidelines were decided on by CDPH leadership, presumably using similar principles, with a focus on health equity. Many of these prescribed tiers have gone through a number of iterations, and most Californians are somewhere between tiers 1 and 2 (ie, aged 65+ years and essential workers, including education, food-service, and agricultural workers).
C360: What outreach strategies do you believe will be successful to reach patients eligible for the vaccine?
Tyler Evans: There are a number of strategies, many of which focus on web-based messaging, including local and state health jurisdictional public information officer teams. Messaging using government websites and social media are an effective strategy. Town halls are another effective communication modality. The issue is that there is a “digital divide” when it comes to access to such information. This divide widens with older adult communities. Focusing on ways to target such communities is critical to achieving health equity. Working with community-based organizations is an essential strategy, using platforms that they know their community is more likely to use (eg, “What’s App,” community print newspapers, promontoras).
C360: Where are you receiving your vaccines from? Have you had any issues with the supply chain?
Tyler Evans: As the deputy health officer and chief of the COVID-19 vaccine branch at Marin county (ie, the bay area), we receive our doses directly from the CDPH. The CDPH directly distributes vaccines to local health jurisdictions and multicounty clinical entities (eg, Kaiser Permanente). As the CEO/CMO for Curative Medical Associates, we receive our doses from a number of sources—namely city, county, or state health departments. There have been significant supply chains for all since the arrival of vaccines. This is experienced across the nation. We hope that this will be remedied by May 2021 when supply may start to outpace demand.
C360: When do you predict your city/practice will reach stability with vaccination? When do you feel there will be a sufficient supply for the demanded?
Tyler Evans: With 3 different vaccine types now authorized and Oxford/Astra Zeneca likely approved by the end of April, we suspect that we will have sufficient dose supplies to meet the demands of our communities by May 2021. However, maintaining a focus on health equity remains critical to a successful distribution program.
- Amos A. 100 million COVID-19 vaccines in President Biden’s first 100 days. Consultant360. Published online January 21, 2021. https://www.consultant360.com/exclusive/consultant360/100-million-covid-19-vaccines-president-bidens-first-100-days
- Evans T. COVID-19 vaccine development and distribution. COVID-19 Research Briefs webinar. February 17, 2021. Accessed March 12, 2021. https://webinars.hmp1.com/registration/40
- Hamel L, Kirzinger A, Muñana C, Brodie M. KFF COVID-19 vaccine monitor: December 2020. Kaiser Family Foundation. Published online December 15, 2020. https://www.kff.org/coronavirus-covid-19/report/kff-covid-19-vaccine-monitor-december-2020/
- Updated COVID-19 vaccine eligibility guidelines. California Department of Public Health. Published February 13, 2021. Updated March 11, 2021. Accessed March 12, 2021. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/VaccineAllocationGuidelines.aspx