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COVID-19 Vaccine in Boulder, CO:
What You Need to Know at This Stage

By Sharon Udasin and stacy feldman, The Boulder Reporting Lab

December 11, 2020 (Updated Feb. 22, 10:00 am MST)

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About 24,300 Boulder County residents have been fully vaccinated for COVID-19 (as of Feb. 22),  roughly 8 percent of the population. Some 25,100 people have received a single dose, as vaccine supplies remain limited but are improving.

"Vaccine is not being wasted in the county, and all the doses coming to the county are going into people's arms," Boulder County Public Health said.

There are now six groups eligible for vaccination. They are:

  • High- and moderate-risk healthcare workers.
  • First responders.
  • People age 70 and older.
  • People age 65-69.
  • Pre-K through high school teachers and staff.
  • Childcare workers in licensed programs.

While all these group are eligible, "people who are 70+, along with healthcare workers, continue to be the focus for vaccinations," the county said on Feb. 19. About 70 percent of Boulder County residents age 70 and older have received at least one dose.

The county is encouraging eligible residents to sign up for an appointment through their healthcare providers. Instructions and links for doing so are here. Educators and school staff should contact their schools and/or district; childcare workers should contact their program directors.

If you're not yet eligible, you can sign up here to be notified when you will be.

Many questions remain. How many doses are arriving in Boulder County? Will there be vaccine mandates? What about the general public, and our kids? Can a vaccinated individual still spread the virus?

The Boulder Reporting Lab has compiled an explainer to help you sort through the information.

We will update this story as we learn more.

Critically, Boulder residents should plan on donning masks and postponing gatherings well into the foreseeable future. 

"It's a middle step," said Dr. Thomas Campbell. Campbell is a virologist and infectious-disease specialist at the University of Colorado School of Medicine and UCHealth. He is leading the Moderna Phase 3 clinical trial at UCHealth on the CU Anschutz campus.

"The end game will be when COVID-19 stops overwhelming our hospitals and stops killing people. The vaccine is not going to be the end of SARS-CoV-2," he said.

How many doses has Boulder received? How many are coming?

Colorado is getting about 90,000 vaccine doses per week from the federal government. State health officials, however, said they are preparing for a "significant increase" in vaccine shipments.

About 7,300 doses ended up in Boulder County last week (Feb. 15-Feb. 19), a decrease from the previous week.

"Overall, we have capability with all vaccine providers  to provide about 22,000 vaccinations each week, so we will be able to ramp up as soon as more vaccine is available," Boulder County Public Health said on Feb. 5.

Will anyone be mandated to take the vaccine?


Colorado "will not be issuing a vaccine mandate," the Colorado State Joint Information Center told The Boulder Reporting Lab. 

In Campbell’s opinion, a mandate would not be sensible at this point. 

The Pfizer and Moderna vaccines were designed to protect individual health — to prevent a person from getting ill, once exposed. They’ve been about 95 percent effective at that. The hope is that the vaccines would also protect societal health by preventing the spread of the virus. But these clinical trials weren’t designed to evaluate transmission.

That’s "going to be evaluated by good epidemiology studies," Campbell said. (Not knowing whether vaccinated individuals are spreaders is also why mask-wearing and other restrictions must continue.) 

Dr. Nancy Stolpman, director of pharmacy at UCHealth, agreed that a mandate is premature. 

"There are so many unknowns right now — how long does the vaccine last, do we have to be vaccinated again, does it give us the herd immunity people are looking for?" she told The Boulder Reporting Lab. "I think it will be a while before a mandate will come out."

How is BVSD planning? 

The Boulder Valley School District will not be requiring teachers to get vaccinated. 

"Our practice has been to follow the best advice of our partners in public health," Randy Barber, BVSD chief communications officer, said. "We will encourage participation, but do not expect to mandate the vaccine."

"Knowing that it will be an important development in returning our schools to more normal operations, we are advocating that educators be among the first to receive a vaccine," he said.

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Who's getting vaccinated when?

There are three phases in the state's vaccination program, and several sub-phases.

We’re currently in Phase 1A, 1B.1 and 1B.2.

Phase 1A covers the highest-risk healthcare workers and individuals, and includes residents and staff members of long-term care facilities. In Boulder County, this phase is nearly finished.

Under Phase 1B.1 are moderate-risk healthcare workers, such as home health, hospice and dental workers. Signup for this phase is complete, according to Boulder County Public Health. But there are still people in this group who are awaiting their vaccines.

This phase also includes emergency first responders. Their vaccinations are largely complete, according to the county.

People age 70 and older are also eligible to get vaccinated under Phase 1B.1, and their vaccinations have begun.

Phase 1B.2, as of Jan. 29, covers people age 65-69; pre-K-high school educators and staff; childcare workers in licensed programs; and members of executive and judicial branches of state government.

Under Phase 1B.3 are other frontline essential workers, including grocery store employees, restaurant workers, postal service workers and people who work in high-density environments like farms or meat-packing plants. Service providers for people experiencing homelessness and essential frontline journalists will also be vaccinated in this phase. So will individuals age 16-64 who have two or more high-risk conditions. (See chart below for detailed list.)

Phase 2 would begin in the spring, and would include individuals age 60-64, people age 16-59 with one high-risk condition, and state and local government officials.

Adults who received a placebo during a COVID-19 vaccine trial would also be part of Phase 2.

Source: Graphic courtesy of CDPHE

What about the general public?

Only in Phase 3, expected in summer 2021, would members of the general public — anyone age 16-59 without high-risk conditions — be eligible for vaccination. 

What about children under 16?

The Pfizer vaccine was authorized for anyone 16 and older. Moderna's was authorized for anyone 18 and older. There remain unknowns about young children and the vaccines (see below), which is typical at this stage of vaccination trials. 

It’s likely to be a long while before there is enough data to begin vaccinating children.   

How will vaccines be distributed in later phases?

Boulder County Public Health has said that in Phases 2 and 3, vaccines will be made available through a federal contract with 12 national pharmacy chains as well as regular health care provider offices.

How much will it cost residents to be vaccinated?

The cost of the vaccine is free.

Boulder County Public Health explains here how the administration fee will work:

"Many providers will be charging for the administration of the vaccine. Agencies may charge insurance for a set priced administration fee of approximately $23, and agencies providing vaccination for uninsured individuals will be compensated by the US Department of Health and Human Services."

Importantly, "a vaccine provider may not turn you away for the vaccine because of an inability to pay or your medical coverage status," according to the state.

This is not unprecedented. The State of Colorado allows individuals without private insurance, Medicare, Medicaid or Child Health Plan Plus (CHP+) to receive other recommended vaccines for free at select healthcare providers. 

How far apart are the doses adminstered?

Both the Pfizer and Moderna vaccines require two doses. Pfizer’s booster must be administered three weeks after the first shot, and Moderna’s has to be given four weeks later. While Pfizer’s vaccine needs a deep freeze of -70 degrees Celsius, Moderna’s requires a milder freeze of -20 degrees Celsius. 

On Jan. 18, the state directed hospitals to use their reserved second doses as first doses. Boulder County Public Health said it does not have a vaccine reserve; it's using them all up.

Still, it said: "We want to assure all Boulder County residents that second doses will be provided to those who receive a first dose."

Are there any concerns about the deep-freeze requirement? 

Administering vaccines at local hospitals that lack ultra-low freezers will be "challenging, although doable," Stolpman, the UCHealth director of pharmacy, said.

The Pfizer vaccine, she explained, arrives in storage containers that can extend the drug’s shelf-life by 20 days, without an ultra-low freezer. Upon  arrival, pharmacists have to replace the dry ice, extending the vaccine’s life by five days. They can do this up to three times, before placing the drug in the refrigerator, where it can survive an additional five days.

"You can get 20 days just using the ultra-low containers to get you going," Stolpman said. "That's going to be really really helpful when we have to start vaccinating the mass population."

Many hospitals already had ultra-low freezers, she explained. At two rural UCHealth hospitals, the state provided the freezers. (Click, and scroll down, to see where these freezers are in Boulder County.) 

Dr. Amie Meditz, an infectious diseases specialist for the Beacon Center for Infectious Diseases, operated by Boulder Community Health, said she was able to secure four portable ultra-cold freezers that will be capable of transporting the Pfizer vaccine to communities that can’t easily access vaccine hubs, once enough doses arrive.

How will the county ensure the vaccine is distributed equitably?

Chana Goussetis, Boulder County Public Health spokesperson, said the state’s distribution model inherently accounts for equity, as many of the individuals in priority categories are members of populations who have been disproportionately affected by the virus.

"For example, many workers in high-risk settings, such as long-term care facilities, often are new immigrants or non-English speaking residents, and many essential workers who directly interact with the public are part of our Latinx/Hispanic communities," she said. 

"What will be most important is ensuring that populations who have been most impacted have accurate and timely information about where and how to get vaccinated should they choose to do so," she said.

The city and county are relying on "a cross-sector collaboration of Cultural Brokers beyond city and county government" to deliver that information to vulnerable communities, according to Guillermo Estrada-Rivera, the program coordinator for Boulder County’s Cultural Brokers Resilience Program. 

Cultural brokers act as bridges between groups of different cultural backgrounds, to advance racial equity and social justice.  

"Cultural Brokers have already been working on this capacity by sharing resources and updates from original sources," he said.

What is the City of Boulder’s plan to encourage vaccination more broadly?

In short, the same: information. 

"The city will use its communication platforms to help amplify need-to-know information from our valuable health partners," said Sarah Huntley, the director of communication and engagement for the City of Boulder. 

What should we know about severe side effects?

No vaccine is free from side effects, but severe reactions to the Pfizer and Moderna vaccines have been rare.

A small number of healthcare workers have had serious allergic reactions to their doses, severe enough to be considered anaphylaxis. 

“People have allergies to vaccines,” Meditz, who was the first person to be vaccinated in the City of Boulder, said. “We do not know whether this is some sort of specific signal with this vaccine. We don’t have a denominator now of everyone who has gotten the vaccine.” 

Vaccine administrators, she explained, have safety precautions in place to reverse the rare case of anaphylactic shock. After receiving a COVID-19 vaccine, recipients are required to wait for observation, in order to rule out an allergic reaction. 

The CDC has said that people who have had serious allergic reactions to other vaccines should talk with their doctors about risks before geting the vaccine. If the reaction was to any ingredient in the COVID-19 vaccine, they should not receive it.

The agency wrote:

If you have ever had a severe allergic reaction to any ingredient in a COVID-19 vaccine, CDC recommends that you should not get that specific vaccine. If you have had a severe allergic reaction to other vaccines or injectable therapies, you should ask your doctor if you should get a COVID-19 vaccine. Your doctor will help you decide if it is safe for you to get vaccinated.

CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications — such as allergies to food, pet, venom, environmental, or latex — may still get vaccinated. People with a history of allergies to oral medications or a family history of severe allergic reactions, or who might have an milder allergy to vaccines (no anaphylaxis)—may also still get vaccinated.

Following her own inoculation, Meditz said that her only symptom was a mildly sore arm the next day. “That’s my immune system responding to the proteins my cells are making — the spike protein,” she added. “Even if people get a little more symptomatic, that’s OK. It’s your immune system responding to these proteins.”

What are some important unknowns about the vaccines at this point?  

1. How long protection will last. 

Both the Moderna and Pfizer Phase 3 clinical studies will last two years to determine the durability of the vaccine’s protection. (That’s standard for a Phase 3 trial.)

"We need to know what happens over the long-term and whether protection diminishes," Campbell said. "And of course, if it does, there might be a need for another booster dose at a later time."

Both Pfizer-BioNTech and Moderna are working to develop boosters to protect against highly contagious virus variants that are emerging.

2. The vaccines' effectiveness in children.

There are question marks about whether the current vaccines could be effective in individuals under age 16. Pfizer enrolled adolescents who are 12-17 in its Phase 3 studies, and Moderna is now doing so. 

"The answer to that question lies in what are these vaccines intended to do?" he said. 

The initial intention of vaccine development, Campbell stressed, has been to prevent the occurrence of COVID-19 illness, rather than stop the transmission of SARS-CoV-2 virus.

In a school environment, this means that the goal of vaccination would be to protect the teachers from becoming sick if they were exposed to SARS-CoV-2, rather than eliminate the virus’s existence entirely.  

"If we protect the vulnerable part of the population that is at risk for getting very sick, then it’s possible that schools could open even without getting children vaccinated," Campbell said. 

"It’s really a question of how much the infection of children contributes to the current spread of COVID-19. We won’t know that until we see what the effect is of vaccinating adults. The important things to monitor will be hospitalizations and illness of COVID-19."

3. Pregnancy and breastfeeding.

None of the vaccines in development have been tested on pregnant women or women who are breastfeeding. The CDC has said pregnant and lactating women should have the opportunity to be vaccinated, if they choose, but they should discuss their situations with their healthcare providers. 

“We really have no data to speak to risks specific to the pregnant women or the fetus, but also no data that would warrant a contraindication to use in pregnancy at this time,” said Dr. Doran Fink, deputy director for vaccine development at the FDA, according to The New York Times. 

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