N.C. officials on Thursday released a list of 53 medical centers and health care systems that will soon receive shipments of Pfizer and BioNTech's COVID-19 vaccine, which federal regulators are expected to approve for emergency use this weekend.
That same level of disclosure is absent just to the south. South Carolina's public health agency has refused to name 15 vaccine sites with ultra-cold freezers that will get doses as early as next week, citing security concerns.
The S.C. Department of Health and Environmental Control on Thursday also denied a public records request made by The Island Packet and Beaufort Gazette seeking a list of providers enrolled in South Carolina's vaccine distribution network. DHEC said the records contained confidential proprietary information, among other things. "I don't know of any state thus far that has released the location names of where those vaccines are going to go to in their limited supply," Stephen White, DHEC's director of immunizations, told reporters in early December.
Several states around the South have yet to publish their providers' locations. And experts stress that vaccine security should not be taken lightly. A team at IBM has already discovered a large-scale phishing campaign against a global COVID-19 cold chain.
But some states like North Carolina, Kentucky and Texas have recently named hospitals that will get initial COVID-19 vaccines. Florida Gov. Ron DeSantis in a Nov. 28 tweet detailed which health care systems in his state would receive Pfizer's first shipments.
Washington, D.C. on Thursday also released a list of medical centers that will soon have the vaccine in hand, which will be the first available in the United States.
Those announcements have given residents a glimpse into how their states are helping choose which doctors and nurses can immediately get inoculated against the deadly pathogen.
"Not everybody could be in this very first grouping," Kentucky Gov. Andy Beshear said during a news conference on Dec. 3, explaining his state's decision. "The initial allocation sites were chosen because they were large enough to handle the minimum pallet or size of the Pfizer vaccine that's shipped, and that is 975 (doses)."
So when, exactly, will South Carolinians know who in their state's health care workforce is likely getting shots next week?
It's still unclear.
"At this time, South Carolina considers providing the specific locations of limited quantities of vaccine a security risk, with regard to the possibility of theft or disruption to the state's fair and equitable vaccine distribution plan," wrote DHEC spokeswoman Laura Renwick in a statement Friday. "Of course, information about vaccine locations and providers will widely be available as vaccine production ramps up and the vaccine becomes available for everyone."
Inside the State's Plan
Here's what we do know: Supply of Pfizer's vaccine, BNT162b2, will be extremely limited, at first. And South Carolina is planning to initially prioritize its distribution among critical health care workers and long-term care residents and staff.The general public is out of luck, for now. Vaccines won't be widely available until 2021.
The state expects to receive 200,000 to 300,000 doses of COVID-19 vaccines by the end of 2020, including from both Pfizer and biotech company Moderna, which is also seeking federal approval for its vaccine candidate.
Pfizer, for its part, is using FedEx to directly ship doses to states.
DHEC, meanwhile, is enrolling hospitals and other health care facilities into a vaccine distribution network. More than 300 providers were enrolled as of Friday, according to Renwick. Those organizations will handle inoculations, which could begin in some spots on Monday after the U.S. Food and Drug Administration's expected approval of an emergency use authorization for BNT162b2.
S.C. nursing homes will also get vaccines quickly as part of a Centers for Disease Control and Prevention program through which CVS and Walgreens are handling distribution.
Dr. Brannon Traxler, DHEC's interim director of public health, while in Greenville for a vaccine event Thursday told Vice President Mike Pence that roughly half of the state's vaccine allocation this month is going toward the CDC's long-term care initiative.
And while DHEC won't release vaccine providers' names, The Island Packet and Beaufort Gazette recently confirmed that dozens of hospitals are enrolled in the state network, from Abbeville Area Medical Center to St. Francis Downtown.
A Prisma Health spokeswoman in a statement Thursday added that Prisma Health Greenville Memorial Hospital and Prisma Health Richland Hospital will receive the Pfizer vaccine "as soon as it is available."
A Medical University of South Carolina spokeswoman also confirmed Friday that MUSC is expecting initial doses and will distribute those to five of the system's hospitals in Charleston, Chester, Florence, Lancaster and Marion counties.
Angela Shen, a visiting research scientist at the Vaccine Education Center at Children's Hospital of Philadelphia and a retired captain of the U.S. Public Health Service, in an interview Thursday said it makes sense that doses will go to hospitals first, and big hospitals at that.
"Large spots that can handle cold storage," she said, will be crucial during Phase 1a allocations.
The S.C. Law Enforcement Division, meanwhile, may also play a role in the state's vaccine network, according to DHEC's distribution plan.
SLED will provide security at sites and during vaccine delivery "as needed."
"There's not a whole lot I could get into on specifics," said Tommy Crosby, a SLED spokesman, adding in a phone call Thursday that disclosing information could impact the plan's "affectability."
'The Final Destinations'
So what don't we know?Renwick previously said five locations would receive Pfizer's vaccines first. She did not name them.
She later confirmed on Friday that 15 locations are now expecting to get initial doses.
During a briefing with reporters last week, White said the five sites at the time were scattered across the state. At least one was in each DHEC region: the Upstate, the Midlands, the Pee Dee and the Lowcountry.
DHEC also selected a "centralized distributing site," he said, where the agency could help get doses to smaller providers.
The first five locations, White added, could store doses at ultra-cold temperatures needed to maintain Pfizer's vaccine for an extended period of time.
"We were equitable, as far as selecting sites around the state," he said, adding that a "vaccine finder" showing sites will likely be available to people "in time."
Renwick confirmed that all 15 locations as of Friday had ultra-cold freezers. The 15 sites can "redistribute" vaccines to affiliated locations, she wrote, meaning up to 56 sites could be running by the end of next week.
Where exactly the Pfizer doses are headed immediately, though, remains unconfirmed by DHEC.
Other states are taking an approach similar to South Carolina's. Georgia, Mississippi and Virginia had not released vaccine providers' names as of Thursday, according to health department spokespeople.
Georgia said "security" was a factor in its planning. Mississippi said Phase 1a won't affect the public at large, so there's "no reason" to announce sites publicly. Virginia said it's leaving it up to hospitals to disclose their allocations.
West Virginia, meanwhile, has detailed which counties will have a vaccine hub, but has not named individual locations.
"The state of West Virginia wants to take all necessary precautions to prevent any disturbance in the vaccine distribution process to ensure that we can effectively, equitably and efficiently get the vaccine to our population," spokeswoman Allison Adler wrote in a statement.
Those types of concerns are well-founded, some experts stress.
The IBM Security X-Force group on Dec. 3 reported that it had discovered a global phishing campaign targeting organizations that will support the COVID-19 cold chain.
The team could not determine if the campaign was successful. It's unknown who launched the effort, which likely began in September, but experts assume it was a "nation-state."
IBM's report prompted the U.S. Cybersecurity and Infrastructure Security Agency to issue an alert encouraging those in the federal government's Operation Warp Speed to review the matter.
INTERPOL also sent a message to law enforcement on Dec. 2 warning officials to prepare for organized crime to target COVID-19 vaccine networks either physically or online.
But experts told The Island Packet and Beaufort Gazette that DHEC will have to name vaccine locations eventually.
"At some point you have to make the final destinations known, because people have to know where to go to get the vaccines," said Professor Mark Ferguson, a supply chain management expert at the University of South Carolina.
Shen, of the Children's Hospital of Philadelphia, echoed Ferguson. Both health care workers and the general public will have to know that information sometime, she said.
DHEC, Ferguson said, is likely keeping quiet until doses are actually in hand.
"From a security standpoint, once it reaches let's say a hospital, I think the biggest danger or risk is kind of over in terms of someone hijacking a shipment," Ferguson said in an interview. "As you can imagine, there's probably a really lucrative black market."
(c)2020 The Island Packet (Hilton Head, S.C.) Distributed by Tribune Content Agency, LLC.
