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Lee Smith: Public health to lead the charge on COVID-19 vaccine

MORGANTOWN — “This is our moment to shine,” Monongalia County Health Officer Lee Smith said on Thursday when asked what role the county health department would  play in COVID-19 vaccine distribution.

Smith said he believes public health will do much of the heavy lifting once distribution of the Pfizer vaccine begins, likely in the next two to three  weeks.

“We stood up 12 or so years ago with anthrax. We have done H1N1. This is in our wheelhouse, and I talk to my colleagues in the other health departments, and while there is some moaning and groaning about how busy they are, if we don’t do a good job on this it won’t be particularly well reviewed when it comes legislative time,” Smith told the Monongalia County Board of Health.

As for who will be first in line for vaccination, Smith explained that the CDC and its advisory committee on immunization, the ACIP, have said health care personnel and residents of long-term care facilities will be the target of Phase 1a.

Health care personnel includes anyone, paid or unpaid, who works in health care settings with the potential for direct or indirect exposure to patients or infectious material.

Smith said first responders would potentially be Phase 1b, “but this is still very fluid.”

What is certain is that strict procedures for administration of the vaccine will need to be followed as it’s currently in limited supply — Smith said he believes West Virginia can initially apply for 14,575 doses per month — and extremely fragile.

“This is a very valuable commodity and if the person is a no show or whatever, you move on to the next one. No dose will be wasted,” Smith said, explaining that it will take two doses of the Pfizer vaccine and about 25 days for the vaccinated to reach maximum immunity

The vaccine must be stored at -70 Celsius, or -94 degrees Fahrenheit. Once thawed, it begins deteriorating rapidly.

In April, Gov. Jim Justice approved $100,000 in “hero pay” for each county to offset COVID-19 expenses.

Monongalia County Commissioner Sean Sikora said the commission will spend $37,000 out of that fund to purchase two -70 storage units and one -30 storage unit for the MCHD.

The vaccine, which utilizes messenger RNA, is a first of its kind, according to Smith.

“We take the viral RNA — the blueprint to manufacture this — bound it up into a lipid and then that gets inserted into your body. These get made, but it’s not making the whole virus. It’s just making a piece of the shell. Your body recognizes that as a foreign protein and makes the antibodies and you have immunity,” he said.

It was noted that information circulated by Pfizer indicates the 30 microgram dose has the potential to cause pain, redness and swelling at the injection site. Headache is the most common side effect, but fever, fatigue, nausea and muscle/joint pain have been reported.

In other news, Smith responded to questions about the in-home COVID-19 test recently touted by Gov. Jim Justice

The in-home saliva test, Justice said, is manufactured by Vault Health. The state is covering the cost through CARES money.

The test can be ordered at the Department of Health and Human Resources COVID dashboard, coronavirus.wv.gov. The top link box to the right of the dashboard says, “Free COVID-19 In-Home Testing.”

“It’s good that it’s quick and somebody can do it in the privacy of their own home. It’s bad in that I have no idea who’s getting tested and what the results are,” Smith said.