J&J-based mobile vax program forced to adapt just before rollout

Local Coronavirus Coverage

JOHNSON CITY, Tenn. (WJHL) – Things were looking up Monday morning for a half-million dollar grant-funded program aimed at vaccinating harder to reach people where they live across Northeast Tennessee.

“We can do this this week,” East Tennessee State University College of Pharmacy’s Adam Welch said. “We have everything lined up we just need essentially to have space to do it.”

First Tennessee Development District’s (FTDD) Lottie Ryans, who’s spearheading the effort, said Johnson & Johnson’s one-dose vaccine was the preferred weapon in this particular front on the fight against COVID.

FTDD wrote the grant, funded by BlueCross BlueShield of Tennessee, with the aim of targeting rural areas and communities of color with a three-van fleet that would meet people where they lived.

“If you think about the fact of trying to mobilize three vans over eight counties and to get as many people vaccinated as possible, not making a second trip was important,” Ryans said.

Lottie Ryans of First Tennessee Development District

FTDD, ETSU, Ballad Health and regional health departments were poised to announce initial sites in Washington and Hancock counties within days.

Then came Tuesday and a scramble to adapt as the federal government put a hard pause — of unknown duration — on administering the Johnson & Johnson vaccine.

Ryans spent time via phone with Ballad officials Tuesday morning. They’ll have to rewrite a comprehensive plan that Tennessee Department of Health (TDH) had approved based on the J&J strategy.

But Ryans was relatively sanguine about the whole thing.

“While it may not give us the same impact that being able to do the one and done with the Johnson and Johnson could have done, there are two other vaccines that are approved and are moving along fine so we can shift – and that’s what we’ll do.”

Ryans said vaccine availability has increased significantly since area leaders wrote the grant. Still, she said, the people it targets may have difficulty accessing even what’s available now.

“We still have people that whether it be because it’s not close to their home or it doesn’t fit into their work schedule we know there are still challenges,” Ryans said.

Logistics of the Pfizer and Moderna vaccines also aren’t as convenient as the J&J, ETSU’s Welch said. J&J doesn’t require the same level of refrigeration, for one thing.

“We can take it into the community a little bit easier than some of the other brands,” he said.

“Typically you have a few months to store the vaccine before it would expire so we have flexibility so that we can get it out into the community.”

Welch said ETSU Health was also excited about the prospect of reaching underserved groups.

“I think taking the vaccine into the community where we remove that barrier of access will help more people get vaccinated,” he said.

Ryans said the show will go on and the target groups will remain the same.

“Access to people in rural areas, intentionality around getting into communities of color and things like that,” she said.

Both those demographics, in addition to having access issues, have some level of vaccine hesitancy. Black Americans sometimes point to a history of less-than-admirable actions by the federal government surrounding medicine, untested drugs and medical experimentation.

“We are going to be hearing from some very trusted voices across our community in terms of why they have had a vaccine, why they are encouraging others to have a vaccine,” Ryans said.

It’s not yet known whether most people who benefit from the vaccination program will see these vans once or twice, depending on which vaccine they get.

That includes Ryans, who actually took the J&J vaccine. She said the positive changes with respect to race, science and medicine hit her when she watched media coverage of the vaccine research teams.

“When you saw people of color who were part of the teams, had been working on this type of technology for 10, 15 years – they’re not gonna harm us, they’re not gonna harm our own community, so that gave me a lot of confidence just knowing some of the people who were part of that whole development team.”

But unless something changes, maximizing participation will be made a bit more cumbersome — and the labor and other costs per full vaccination will rise — by dint of the need to use two-dose medicines.

“You’re having to go circle back, right, and go back to the same place, so it’ll just make scheduling a little bit different,” Ryans said. “I’m still confident that we’re gonna be able to get vaccines through many means out to people in our communities.”

That process is looking like it could include some regional employers in addition to churches, community centers and other locations in more vulnerable communities.

“Working with businesses we’ll hit some of the demographics we were hoping to hit,” Ryans said.

She added that despite the current fly in the ointment, the project should be up and running soon.

“The vans are in the process of being wrapped with the logo and everything on it and just as soon as we have some pre planning things underway then we will provide some information on when people can expect to see a van,” she said.

Whether they’ll see those vans twice throughout the project’s duration or at some point just once remains to be seen. Ryans said if the FDA recommends resumption of J&J use, she’ll defer to FTDD’s partners in the project.

“We certainly want to be able to offer things that people are very comfortable with, and certainly our friends at Ballad and the health department and ETSU are going to do what’s best.”

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