In many ways, Alaska was already prepared for massive vaccine implementation – they used similar methods to distribute the flu vaccine across the state. However, much of its success consists of learning on the spot, finding creative ways to put vaccines in the arms and prioritizing the state’s most at-risk residents.
What works in Alaska will not work everywhere – after all, it is more than 660,000 square miles, and not all states require health professionals to travel on dog sleds to administer vaccines. But the rest of the United States can take hints from the state’s unique approach to its specific problems.
Alaska’s public health structure was built for complications – its size and tendency to harsh weather conditions require it. So when it came time to start vaccinating residents, the state did not have to build a robust public health system from scratch like some others, said Dr. Anne Zink, Alaska’s chief physician.
Zink credits the state’s success to its “hub-and-spoke” model of health: The “hub” – Alaska Department of Health and Social Services – provides local health providers, or “spokes,” with the resources they need. need. But because Alaska is such a varied state, it is up to local suppliers how to use these resources to better serve residents.
A localized approach to vaccination didn’t work everywhere, but it did in Alaska, said Zink. The state distributes vaccines to different regions, but does not provide guidelines, she said – it is up to the communities to decide how to administer the vaccines according to their needs.
“If you provide communities with the tools they need to protect themselves, they are often really able to do that,” she said.
As so much energy was delivered to different regions of Alaska and trusted health providers in those areas, health professionals were able to “find people where they are,” said Zink: This means that they will deliver vaccines by boat, sleigh pulled by dogs, helicopters and small planes, or go door to door in small communities to vaccinate as many community members as possible.
“It’s really different across the state,” she said. “It depends a lot on the local communities that know your system … much better than we (the state health department).”
He expanded the eligibility criteria
Expanding who is eligible for a vaccine is another strategy that helps them vaccinate Alaskan natives and low-income residents who are disproportionately vulnerable to Covid-19.
In areas where the population is mostly Alaskan natives, there are large numbers of people living in multigenerational homes. This qualifies young people who can live with an elderly person at risk to be vaccinated as well, said Dr. Bob Onders, administrator of Alaska Native Medical Center in Anchorage.
And since 25% of rural Alaska has no running water or sewage, which can increase residents’ risk of respiratory disease, it made no sense to exclude rural residents from the first round of vaccination, Onders said.
“Having more vaccines and faster eligibility for Alaskan Natives at higher risk is starting to balance Covid’s risk, Covid’s cases, hospitalizations and mortality,” he said.
Sovereign tribes received separate vaccines from the state
Tribal health systems had the option of receiving doses of the vaccine through the state or the Indigenous Health Service – Alaska’s tribal health system chose the latter. This option gives tribes more independence in the distribution of vaccines, as well as a specialized distribution of vaccines that takes into account the remoteness of where the tribes are located, the infection rate among the tribe and delivers the reins to suppliers that already have native communities. Alaska Trust.
“Rather than a top-down mechanism, where someone from outside Alaska or rural Alaska is dictating how things are going, it is much more about providing supplies,” said Onders.
The state receives its doses monthly
Alaska asked the federal government to be treated “as a territory rather than a state” so that it would receive a monthly distribution of vaccines instead of a weekly or biweekly batch. This made it easier to plan ahead and deliver vaccines “creatively,” said Zink.
It can be expensive to transport vaccines to some remote places in Alaska – more than $ 15,000 for a trip, in some cases, Zink said. To make vaccination more economical, some less populated areas receive their full quota of vaccines, which makes it possible to vaccinate entire communities at once.
The Alaskan State Department of Health also does not have to deal with vaccines on its own. Alaska’s 229 sovereign tribes, the U.S. Department of Veterans Affairs and the U.S. Department of Defense, each have a separate federal allocation for vaccines, meaning that more vaccines are being distributed in Alaska at once.
The state has done this before
The massive movement of vaccines is quite normal for Alaska.
“We have been redistributing vaccines for years,” said Dr. Anne Zink, Alaska’s chief physician. “It was very easy for us to support our current [public health] structure.”
Some areas of the state are so remote that items are not shipped directly there – instead, they are shipped to redistribution centers centralized in population centers across the state, such as Anchorage and Juneau. There, large quantities of vaccines can be stored and divided into the appropriate quantity for the community they are going to, so that no area receives more or less than it needs, said Zink – something that would not be possible if the vaccines were sent directly across the state.
So 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 populous states or with more urban centers, and certainly each state cannot obtain a monthly dose allocation, but part of its success could be replicated in other states.
Invest in the protection of minority communities. Alaska has expanded its eligibility for the first round of vaccines to include Alaskan natives and low-income residents of the state who are most vulnerable to Covid-19. While there is still work to be done to alleviate this disproportionate risk, Onders said so far, it is working.
“If we want equitable results, we have to invest disproportionately in the communities at greatest risk,” said Onders.
Alaska did this, Zink and Onders said, by relying on health professionals who live and work in communities that serve to educate residents. Zink conducts daily Zoom calls with Alaskans and conducts question and answer sessions to address misinformation about the vaccine. In Alaskan indigenous communities, this may seem like asking young residents to inform their elders.
Customize the approach. States that were behind on vaccinations are recovering, said Karmarck, as they formalize a vaccination approach that best suits their state. In Massachusetts, for example, large vaccination sites have been opened at Fenway Park and Gillette Stadium to accommodate more people and store vaccines. It 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 United States when vaccines were first made available, relying on local pharmacies to vaccinate residents of the most rural parts of the country. state, Karmarck said.
FIX: A previous caption in this story incorrectly described what was shown in the photo that heads this story. It has been updated to say it shows a chartered plane in Birch Creek, Alaska, preparing to take residents to receive the Covid-19 vaccine.