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The word of the week is vaccine

EMS finds its place in COVID-19 vaccine priority and administration


Building public (and public safety) confidence in the vaccination will grow over time, but leaders must face the command decision of how they are going to ensure immunization occurs as soon as it is rolled out.

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The COVID-19 vaccine has presented EMS leaders with a few challenges. We can see the vaccines coming over the horizon with their reports of unprecedented efficacy levels and even the return of Dr. Fauci to the White House podium extolling the virtues and safety of the Pfizer and Moderna vaccines.

But at this time, a general level of skepticism continues to pervade as the information produced and touted is effectively the press release of each company. All are awaiting the safety data sheets to be publicly presented as part of the EUA – Emergency Use Authorization to appraise the vaccine and anticipate the risks. That said, Britain’s regulator has approved the Pfizer/BioNTech product, and this may provide the true answers we seek as it heads for immediate roll-out.

The predicament is the same one we face when a new marque of ambulance or monitor comes out – no one wants to be first and all want others to experience the initial teething problems. Perhaps the UK may now do that for us.

Vaccine priority

Currently, polls and surveys indicate there are large elements of the population, including our workforce, that do not wish to take up the vaccine. This presents a problem as the Advisory Committee on Immunization Practices (ACIP) met this week to confirm that healthcare workers, including EMS, are placed in immunization Category 1a – the first of the first. Healthcare workers included in Phase 1a encompasses 21 million workers from hospitals, long-term care facilities, outpatient clinics, home health care, pharmacies, public health and EMS.

Word on the street has it that some states are not following federal direction and are moving EMS down their lists, and this is a shame. While many healthcare providers deal with COVID-19 positive patients daily, EMS crews are face-to-mask with a patient in a 15’x8’ box for the majority of their shift. Social distancing is all but impossible and for those trying to convey an image to help climb the priority ladder, this may be it.

Another ACIP conundrum has come as firefighters and police officers are placed in category 1b and – as we know – many fire departments operate in a dual capacity, whether it is first response or transport, so I’m sure the question – “when is a firefighter not a firefighter” is being posed in many locales right now. The difference between 1a and 1b may only be a few weeks, so, hopefully, this will not be a major issue.

Confidence in a COVID-19 vaccine

Building public (and public safety) confidence in the vaccination will grow over time, but leaders must face the command decision of how they are going to ensure immunization occurs as soon as it is rolled out.

For those who are fully prepared to be inoculated, there will be no problem, for the others, OSHA helps by supporting the creation of the requirement, if necessary, to be COVID-19 vaccinated as a condition of employment. This brings tension as labor groups are already defending their members’ rights to choose not to be vaccinated. My hope is that science, a sense of planetary preservation, and now the early actions of the British Isles will inform and placate.

Vaccine administration

The vaccine distribution and administration plans contained within Operation Warp Speed and its associated state plans may include EMS as one giver of the vaccine. There are several planning and logistical issues to overcome here.

The current presidential hand over/take over period is creating the issue of span of control. Warp Speed sees states taking the lead, whereas the incoming administration is leaning towards a federal lead. Time (Jan 20, 2021, to be exact) will tell. Logistic issues of distribution and (cold) storage, as well as the electronic documentation and onward transmission of patient data also need to be understood.

All agencies and organizations should inquire with their local public health departments or indeed state offices of EMS what their part in the plan actually is – some know, others don’t.

We have had a lot of information to process this week and there have been lots of answers, unfortunately, some may not have been to the questions we asked. Nevertheless, there seems to be a feeling of upward and onward. In the words of the World Health Organization’s Dr. Michael Ryan at press brief this week, “we have arrived at Everest base camp – all we have to do now is climb the mountain.”

Scott Moore on COVID-19 vaccination: EMS One-Stop With Rob Lawrence

The word of the week is vaccine, but is it giving EMS leaders a headache already? Host Rob Lawrence discusses the issues with American Ambulance Association HR Consultant, Scott Moore. Rob and Scott discuss the options open to managers to ensure all are vaccinated, while acknowledging the hope that science and understanding will prevail. They also discuss the other major news item of the week, EMS funding and the lack of it as reduced incomes put the very viability of service delivery at risk.

Scott Moore is a Massachusetts licensed attorney and possesses certifications as both a Professional in Human Resources (PHR) and the Society for Human Resources Management Certified Professional (SHRM-CP). He is a member of the American Bar Association (ABA), the Massachusetts Bar Association (MBA), the Northeast Human Resource Association (NEHRA), and the Society for Human Resource Management (SHRM).

In addition, Scott is an active member of the American Ambulance Association and has been a site reviewer for the Commission for the Accreditation of Ambulance Services (CAAS) for many years.

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.