In many ways, Alaska was already prepared for a massive vaccine effect – they used similar methods to deliver the flu vaccine across the country. But much of its success is through quick learning, devising creative ways to get vaccines into the weapon, and prioritizing the residents of the state at the greatest risk.
What works in Alaska will not work everywhere – after all, it’s more than 660,000 square miles and not every state requires health workers to drive dog sleds to administer vaccinations. But the rest of the US can take advantage of the state’s unique approach to its unique problems.
Alaska’s public health structure is built for complications – the extent and trend of inclement weather requires it. When it came time to vaccinate residents, the state, like some others, did not need to build a robust public health system, Dr. Anne Zink, chief medical officer of Alaska, said.
Zinc attributes the state’s success to its ‘hub-and-spoke’ model of health care: The ‘hub’ – the Department of Health and Social Services in Alaska – gives local health care providers, or the ‘spokes’, the resources they need. But because Alaska is such a diverse state, local providers need to determine how they can use the resources to best serve residents.
A localized approach to vaccination is not yet working everywhere, but it is working in Alaska, Zink said. The state distributes vaccines to different regions but does not give instructions, she said. It is up to the communities to decide how to administer vaccines based on their needs.
“If your communities provide the necessary tools to protect themselves, they can often do so,” she said.
Because so much power has been transferred to different regions of Alaska and the health care providers trusted in those areas, health care workers were able to ‘meet people where they are,’ Zink said: that means they will deliver vaccines. by boat, dog sled, helicopters and small planes, or go door-to-door in small communities to vaccinate as many members of the community as possible.
“It’s really different in the whole country,” she said. “It depends a lot on local communities that know their system … better than us (the health department).”
This has expanded the admission requirements
Expanding who is eligible for a vaccine is another strategy that helps them vaccinate Alaska natives and low-income residents who are disproportionately vulnerable to Covid-19.
In areas where the population is mostly Alaska residents, more people live in multigenerational housing. It also enables young people who may be living with an elderly person at risk to be vaccinated, said dr. Bob Onders, administrator of the Alaska Native Medical Center in Anchorage, said.
And since 25% of Alaska in rural areas does not have running water or sewage, which could increase the risk for residents of respiratory diseases, it did not make sense to exclude rural residents from the first round of vaccinations, Onders said.
“Having more vaccinations and being more eligible for Alaska residents at higher risk is starting to compare Covid’s risk, Covid cases, hospitalizations and deaths,” he said.
Sovereign tribes received vaccinations separately from the state
Tribal health systems had the option of receiving vaccine doses through the state or through the Indian Health Service – Alaska’s tribal health system chose the latter. This option gives the strains more independence in the distribution of the vaccines, as well as a specialized allocation of vaccines that takes into account the distance from the place where the strains are located, the rate of infection under the strain and the reins handed over to suppliers Alaska Indigenous communities already exist. confidence.
“Instead of a mechanism from top to bottom, where someone from outside Alaska or Alaska in the countryside determines how things are going, it’s much more about giving them supplies,” Onders said.
The state receives its doses monthly
Alaska has asked that the federal government be treated ‘like an area instead of a state’ so that it will receive vaccines monthly against a weekly or fortnightly amount. This has made it easier to plan ahead and give ‘creative’ vaccination, ‘Zink said.
It can be expensive to transport vaccines to some remote part of Alaska – in some cases more than $ 15,000 for one trip, Zink said. To make vaccinations more cost-effective, some areas with less dense populations receive their entire vaccine grant, making it possible to vaccinate entire communities at once.
The Alaska Department of Health also does not have to deal with vaccinations alone. Alaska’s 229 sovereign tribes, the U.S. Veterans Affairs and the U.S. Department of Defense each have a separate federal grant for vaccines, meaning more vaccines are distributed simultaneously in Alaska.
The state has done this before
The massive movement of vaccines is pretty standard for Alaska.
“We have been doing vaccine redistribution for years,” said Dr. Anne Zink, chief medical officer of Alaska, said. ‘It was pretty easy for us to stand up for our existing [public health] structure. ”
Some parts of the state are so remote that articles are not sent directly there, but rather to centralized redistribution centers in population centers such as Anchorage and Juneau. Large lots of vaccines can be stored and distributed in the right amount for the community they go to, so that no area gets more or less than they need, Zink said – something that would not be possible if vaccines were sent directly not. throughout the state.
When it came time to distribute Covid-19 vaccines, the state benefited from years of preparation.
What the rest of the US can learn
What works for Alaska will not work in more populated states or states with more urban hubs, and each state may certainly not receive a monthly allocation of its doses, but some of its success may be repeated in other states.
Invest in the protection of minority communities. Alaska has expanded to qualify for the first round of vaccines, with Alaska Indigenous and low-income residents more vulnerable to Covid-19. Although there is still work to be done to alleviate the excessive risk, Onders has so far said it works.
“If we want fair outcomes, we need to invest excessively in the highest risk communities,” Onders said.
Alaska has done that, Zinc and Onders said, by trusting health workers living in the communities that work to educate residents. Zinc conducts daily Zoom calls with Alaskans, and she keeps asking questions about disinformation about the vaccine. In the indigenous communities of Alaska, they may seem to be appealing to young residents to inform their elders.
Adjust the approach. States left behind with vaccinations are catching up, Karmarck said as they formulate an approach to vaccination that best suits their condition. In Massachusetts, for example, large vaccination sites have been opened in Fenway Park and Gillette Stadium to accommodate more people and take up the storage space needed for the vaccines. That has improved the state’s vaccination rates, she said.
This approach may work in a relatively small state like Massachusetts, but the opposite is true in a state like West Virginia, which led the U.S. when vaccines first became available by entrusting local pharmacies to residents of rural vaccinate parts of the state, Karmarck. said.
CORRECTION: An earlier caption about this story accurately describes what was shown in the photo at the top of this story. It has been updated to say it shows a charter plane in Birch Creek, Alaska, preparing to take residents to receive the Covid-19 vaccine.