Stanford Medicine is ready to inoculate health care workers against COVID-19 with the first vaccine authorized for emergency use in the United States.

By Patricia Hannon

Stanford Medicine expects to receive the first shipment of a coronavirus vaccine on Dec. 18 and start inoculating health care workers the next day.

The plan to vaccinate health care workers first aligns with federal recommendations shaped by two national committees whose members include Stanford Medicine faculty.

“Having a workforce that’s vaccinated and well will protect the community,” said Lisa Schilling, RN, MPH, vice president of quality, patient safety and clinical effectiveness at Stanford Health Care. “If the workforce gets sick, anybody who is ill or injured in the community will not have care because there won’t be enough workers.”

Schilling, who is co-chair with Stanley Deresinski, MD, clinical professor of medicine, of Stanford Medicine’s vaccine planning committee, said Stanford is expected to receive an initial vaccine delivery of 3,900 doses, and possibly as many or more weekly after that. She said she anticipates that all Stanford Medicine health care workers will be vaccinated within two or three months. 

The vaccine can cause side effects, including flu-like symptoms, so vaccinations will be staggered to avoid staffing shortages that can result from health care workers feeling ill the day after they’re inoculated, Schilling said. It’s crucial that Stanford Medicine maintain adequate staffing levels for patient care, said David Magnus, PhD, director of the Stanford Center for Biomedical Ethics, who is on the committee. 

“If you have all of these people from a single unit vaccinated together, you may wipe out all your critical personnel for the next few days,” he said.

In accordance with federal recommendations, the first Stanford health care workers to be vaccinated will be those who provide direct care and service to patients, those who are at the highest risk of being exposed to COVID-19 and those who have an elevated risk of complications from the disease.

Vaccinating Stanford Medicine patients is expected to begin in March.

Engendering trust in coronavirus vaccines

Besides ensuring that health care workers are inoculated against COVID-19, the Stanford vaccine committee is also focused on building trust in the vaccines.

Committee member Grace Lee, MD, associate chief medical officer for practice innovation at Stanford Children’s Health and a professor of pediatrics, said people worried about vaccine safety can rest assured that, despite how quickly coronavirus vaccines have been developed, federal regulators are rigorously reviewing them.

Lee is also a member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, which advises the CDC on vaccine use and safety. She and Stanford epidemiologist Yvonne Maldonado, MD, who represents the American Academy of Pediatrics as a liaison to the committee, have expressed confidence in the Pfizer vaccine that the Food and Drug Administration authorized for emergency use on Dec. 11. The clinical trial, which enrolled about 44,000 people, has found that the vaccine is 95% effective and that there are no significant safety concerns. The final phase of the trial is ongoing.

Lee said it’s incumbent on health care providers to share what is known about the vaccines and why it’s important to be vaccinated against a disease that is infecting and killing people in record numbers. 

“I think it would be normal for any patient to ask me, ‘Are you going to get that vaccine? Will you get your family members vaccinated?’” Lee said. “If I can answer yes to both questions, hopefully the people who are asking will also feel a sense of trust in the vaccine.” 

Maldonado, who is senior associate dean of faculty development and diversity at the School of Medicine, said that sharing that kind of message and reinforcing COVID-19 prevention efforts in local communities are priorities for Stanford Medicine. 

In communities with high concentrations of Black and Latino residents, for example, Stanford Medicine clinicians are helping local health care workers conduct COVID-19 testing and providing them with personal protective equipment. They’re also offering people in these communities opportunities to enroll in vaccine trials. 

“A lot of what we’re trying to do is really to support those communities who may not have access to the resources,” said Maldonado, professor of pediatrics and of epidemiology and population health and also a member of Stanford Medicine’s vaccine committee.

A focus on reducing health inequities

Lee said that such efforts reflect the Stanford Medicine vaccine committee’s goal of addressing health inequities.That goal is also a recommendation of the CDC’s immunization practices committee, which gathered input from a wide range of experts, including those on the vaccine allocation committee for the National Academy of Medicine. Margaret Brandeau, PhD, who is the Coleman F. Fung Professor in the Stanford School of Engineering and whose research focus is health policy, was on the academy’s committee, which created the Framework for the Equitable Allocation of Coronavirus Vaccines. 

The framework was developed to help local entities create vaccine distribution plans that are equitable and that will reduce COVID-19 deaths, the spread of the disease and the negative impacts of the disease on society, Brandeau said. 

Magnus said there are many similarities between the CDC-approved recommendations and Stanford Medicine’s vaccine allocation plan, which is based on principles of equity and ethics and theories of justice.

“I think people should be assured by the fact that everybody is really committed to considering these tough decisions through a justice and equity lens,” he said.

Lee said the value of equity is especially important considering the high percentage of Black and Latino Americans who are infected with and die from COVID-19. 

“With COVID-19, the inequities are so extreme, and they continue to be such a huge challenge for us,” Lee said. “Vaccines are one way to start to address the consequences of compounding inequity that has taken place over generations, and in what we’re now seeing during the COVID-19 pandemic.”