Frontline Advocate Aurora Health workers could be vaccinated as soon as next week if the Pfizer COVID-19 vaccine receives U.S. Food and Drug Administration approval today as is expected.
The Milwaukee- and Downers Grove, Illinois-based health system is prepared to distribute the vaccine to all of its patient-facing employees in four to six weeks, depending on supply, said Robert Citronberg, director of the division of infectious disease at Advocate Lutheran General Hospital in Park Ridge, Illinois.
The system will prioritize employees who are most at risk for contracting COVID, including those who work in emergency departments, ICUs and COVID units. Vaccine supplies through the end of this month likely won’t be enough to immunize all those team members, however, Citronberg said.
Wisconsin is expected to receive nearly 50,000 doses in its first allocation of Pfizer’s COVID-19 vaccine in the coming weeks, pending its FDA emergency use authorization. The state is then expected to receive weekly supplies of vaccine moving forward, including Moderna’s prospective vaccine, which is up for FDA review next week. The timeline of how long it will take to vaccinate the state’s roughly 450,000 health care workers will depend on FDA approval and vaccine supply, state health officials say.
“Immunization is an urgency; it’s not an emergency,” Citronberg said. "It’s very important to maintain an orderly process around immunization of our team members to make sure we identify the right people who need the vaccine and then to go from there.”
Advocate Aurora does not plan to require its employees to be vaccinated, Citronberg said.
"We think as a system a more prudent approach is to encourage the vaccine among our team members, and we are, by the way, very optimistic that the vast majority of our team members will take the vaccine over the next few months," he said.
Health care workers and long-term care residents will be the first in Wisconsin to receive the vaccine, likely followed by non-health care essential workers, people over the age of 65, and those with comorbidities. Current projections anticipate the wider public who don’t fall into one of those categories will receive the vaccine in the summer of 2021.
As the vaccine begins to be distributed, Advocate Aurora chief medical officer Gary Stuck stressed that the general public and the health system’s employees will need to continue to adhere to masking and physical distancing.
“We know that we’re in the long haul here with our public health measures and it’s going to be a long time before we have everyone vaccinated who wants a vaccine,” Stuck said.
While the vaccine can prevent sickness and severe illness for those who receive it, it doesn’t prevent acquisition of the virus, Citronberg said.
“You can easily become colonized with the virus in your nose,” he said. "If you’ve got the vaccine you may not get sick from the virus but you can still pass it to other people.”
Nkem Iroegbu, chief medical officer at Aurora St. Luke's, said masking can also prevent the spread of influenza, which would reduce the burden on hospital systems.
Advocate Aurora had 960 COVID-19 inpatients across its Illinois and Wisconsin network as of Wednesday. That includes 385 patients admitted to its 16 Wisconsin hospitals and 575 patients across 10 Illinois hospitals.
Across the health system’s Wisconsin facilities, Aurora St. Luke’s Medical Center in Milwaukee has the highest COVID patient admissions, at 118, as of Wednesday. Aurora West Allis Medical Center has 42 COVID patients, followed by South Shore (28), Grafton (22), Sinai (22) and Kenosha (21).
The system recently surpassed 15,000 COVID patient discharges to date since the beginning of the pandemic.
Stuck said overall inpatient numbers are down a little over the past two weeks but the system expects an increase as people stay inside more during the winter months and as a result of Thanksgiving gatherings.
Stuck urged people to avoid in-person gatherings for Christmas, Hanukkah and other upcoming holidays to prevent the further spread of COVID.
“We know this is a hard thing to hear,” he said. “I know it’s been a difficult year for everyone. But it’s going to be especially difficult for our team members and their families if people gather for the holidays. Our doctors and nurses are making big sacrifices too, and we’re strongly encouraging you to think of them and your own loved ones as you make your holiday gatherings virtual this year.”
Iroegbu said Advocate Aurora workers who have been caring for COVID patients are dealing with exhaustion, grief, anger, anxiety and depression and other effects of chronic stress.
"Many have had to make very tough decisions around life or death for patients, who contract COVID-19, multiple times a day," he said. "...You look at our bedside nurses and nursing assistants, they have often been called to be conduits for patients whose families are unable to come in, to assist with video calls. Those are very traumatizing situations and the frequency of it adds to the stress and the trauma that our frontline staff feel."
Advocate Aurora has engaged agency nurses and volunteers to shore up its staffing during the pandemic. It has also redeployed employees across state lines and from ambulatory settings into hospitals. The health system said last month it would scale back its elective procedures by 50% in response to the surge of COVID cases.
"I think that's one of the advantages of being a large integrated delivery system across two states, that we are able to move staff, ventilators, PPE, etc. around," Stuck said. "We feel that we are well positioned but this is hard, there's no question about it."
Advocate Aurora president and CEO Jim Skogsbergh announced this week that workers that provide direct patient care will receive a $1,300 year-end bonus.