New Coronavirus Vaccination Program Sparks Questions: Cuomo

LONG ISLAND, NY — On Day 232 of the coronavirus pandemic in New York, many are struggling with "COVID fatigue," tired of wearing masks and of putting their lives on hold, Gov. Andrew Cuomo said Sunday. But with numbers spiking nationwide, Cuomo urged vigilance as he also laid out questions that need to be answered before a vaccination administration program, or VAP, can be rolled out.

With the onset of fall, just as science predicted, the "virus has become more aggressive," with people heading indoors and colleges opening, Cuomo said. A nationwide uptick couple with "COVID fatigue" could lead to less compliance at a time when the numbers of cases of coronavirus are increasing, he said.

New York, he added, is holding steady with a 1.08 percent infection rate just as states across the nation report escalating numbers: Wisconsin has an infection rate of 24.6 percent, Florida, of 12.7 percent, and Pennsylvania, of 9.0 percent.

New York has done well by adhering to a strategy of attacking "micro clusters" head on, by neighborhood, rather than by region, and causing less disruption, Cuomo said.

Winter, Cuomo said, means a focus on vaccinations. "Hopefully the last chapter of COVID is this winter," he said.

To that end, Cuomo said the state has been working on a draft vaccination administration program, or VAP, that has been circulating and sent to the federal government.

A New York State task force, comprised of experts, has been convened to review any vaccine before Cuomo recommends it to the public, he said.

"But we are coming up with a plan based on presumptions," he said. "This is all preliminary."

The federal government has to answer many questions, including what vaccines will be available, and when they will be received in New York, Cuomo said. Other questions include whether some groups will be prioritized, such as those at highest risk, essential workers, nurses and other health professionals.

In addition, he said, a matrix of several phases to administer the actual doses will have to be created.

"This is going to be a massive undertaking," Cuomo said, involving hospitals, urgent care centers, pharmacies, departments of health, and mobile units, among others.

The federal government will be in charge of producing the actual vaccines and New York will create one statewide vaccination plan that local governments will all be required to follow, Cuomo said.

"But, and this is a big 'but,' states cannot do this on their own. Period," Cuomo said.

Creating and administering the vaccination plan is a larger operational task than anything that's been done to address the coronavirus pandemic to date, Cuomo said. There are 20 million people in New York that will each require two vaccinations, or two dosages, with 21 to 28 days in between, Cuomo said. That's 40 million doses, he said. Even with the major testing efforts that have been underway in New York over seven months, only 12.9 million coronavirus tests have been administered so far, he said.

"That gives you a scale of how daunting this task is," Cuomo said.

Several vaccines will be available, possibly as early as December, just weeks away — and other issues to be addressed also include storage; the vaccine must be stored at -80 degrees, Cuomo said, leading to questions of how many refrigeration units will be needed.

Cuomo also said there will be "trust issues about the vaccines, conspiracy theories and rumors. There's not a lot of trust, let's be honest, in the federal health organizations right now."

Taking a COVID-19 test with a nasal swab is a lot less intrusive than letting someone inject something in your arm, Cuomo said.

The National Governors Association, of which Cuomo is chair this year, released a letter to President Donald Trump Sunday asking how the vaccine administration program is supposed to work, and how the vaccine will be allocated to states — for example, will the formula be based on infection rate, the number of COVID-10 cases, or population? he said.

Cuomo said governors also want to know if there is a national strategy on prioritization — and if the government is going to "condition" the release of vaccines. "Will they say, 'We won't give you the vaccine in New York State or California, unless you do X,Y, and Z?'" he asked. "And can we know that now?"

Other questions center on whether there will be multi-state coordination — and who is going to pay.

"New York State is already $50 billon in debt," Cuomo said. "And the federal government has not passed legislation on state and local relief. If states and local governments have deficits, we can't fund essential workers. And this vaccination program will require more essential workers, not less."

Regarding the vaccination program, Cuomo added: "It's not a question of knowing what to do, it's a question of how to do. it. How do you do it? How do you administer 40 million vaccines in New York State?" The issue of the uninsured also needs to be resolved, the governor said. "That's the difference between life and death in situations like this," he said.