Roundtable: What will a COVID-19 vaccine mean for EMS?
Public health messaging, EMS administration needed to reap the benefits on safety, staffing and stress
COVID-19 vaccine distribution in the U.S. appears imminent, as manufacturers Moderna, as well as Pfizer Inc. and its German partner BioNTech, have sought emergency FDA approval to begin disseminating their vaccines. Moderna reports its vaccine is 94.5% effective, while Pfizer claims its vaccine, already approved in the U.K., is 95% effective at preventing mild to severe COVID-19 disease.
The looming approval begs many questions as to supply, deployment and storage logistics, EMS' role in administering the vaccine, population prioritization, and, perhaps, the biggest of them all – who will be vaccinated?
We asked the EMS1 Editorial Advisory Board and contributors, “what will a COVID-19 mean for EMS?” Here are their predictions.
Meet doubts with data
“EMS leaders will need to prepare for both receiving the vaccine as front-line healthcare providers, as well as likely playing a public health role in administering the vaccine to the public. This will require knowledge of vaccine basics in order to combat vaccine skepticism within your EMS service along with the general population. A thorough review of the peer-reviewed vaccine publications is a must, which will allow us to meet doubts with data. From a public health standpoint, EMS agencies will need to keep open lines of state, regional and local communication in order to assist with vaccine administration to the public. This process will likely vary by locale and have multiple caveats depending on how the multiple vaccines are allocated, stored and administered.”
— Casey Patrick, MD, FAEMS, assistant medical director, Montgomery County Hospital District EMS, Houston; community emergency physician
The potential to begin recovery
“For EMS, a COVID-19 vaccine means cause for optimism and the potential to begin recovering from the staggering toll the novel coronavirus has had on every aspect of EMS life, on- and off-duty. A COVID-19 vaccine is also an opportunity for EMS to continue serving its community by amplifying public health messages about vaccination. Finally, EMS also has an opportunity to join the ranks of those able to administer the vaccine, especially in high-risk shared living situations like skilled nursing facilities, jails and college campuses – all areas where EMS already operates.”
— Greg Friese, MS, NRP, editorial director, Lexipol/EMS1
A biological level of protection
“A COVID-19 vaccine would provide another means to protect EMS providers physically and provide some psychological relief from this harmful virus. Vaccination should create a reduction in the frequency of providers being on sick leave or in quarantine. At the organization level, this would translate to improved staffing levels, decreased worker overload or burnout caused from having to work additional overtime to cover those out sick or quarantined, and a decreased need to develop alternate staffing contingency plans. Since the chances of becoming infected increase with more frequent or longer contact times with infected patients, frontline workers would likely experience less stress and greater confidence in being protected from the virus. Though wearing PPE and following appropriate safety practices do work, vaccination provides a biological level of protection that is not compromised by possible human error each time a COVID-19 patient is encountered.”
— Maria Beermann-Foat, PhD, MBA, NRP, battalion chief of operations for MED-ACT Emergency Medical Services
Don’t forget the first line of protection
"The arrival of a COVID-19 vaccine for EMS could provide some reassurance for EMS providers. However, whether a vaccine relieves any of the anxiety about SARS-CoV-2 among EMS providers depends on how well the vaccine works, ease of access to the vaccine, and its immediate and long-term side effects. Another challenge related to the vaccine is the storage requirements for some of the formulations. Providing deep freeze storage can prove to be expensive if not subsidized. The introduction of a vaccine should be an addition to infection control processes. Use of gloves, gowns, masks and eye protection provide a first-line defense against many diseases. The vaccine could provide an invisible second layer that could make all the difference."
— Ernesto M. Rodriguez, MA, LP, EMS chief, Austin-Travis County EMS
A need for public health messaging
“I'm really hopeful about the results of the current vaccine trials. However, I think that we will not see changes as fast as we might hope due to slow adoption and logistical issues with distributing the vaccines. I think it is important for EMS to be prepared to answer questions about the vaccine, especially in areas that are minimizing transport of certain COVID-19 patients. If not already in place, agency leaders should work with their local public health department to ensure consistent and accurate messaging regarding vaccination.”
— Ann Marie Farina, BS, mental health advocate and educator
Seize the opportunity to take part
“Release of the COVID-19 vaccine will be an important opportunity for EMS providers to, once again, demonstrate their critical role in the public health system. Vaccination of millions of citizens simply cannot be done in an efficient and timely manner if left only to public health officials, medical clinics and hospitals. EMS must step up and take the opportunity to help put needles in arms of fellow providers, populations-at-risk and eventually everyone that wants the vaccination. Intramuscular injections are well within the scope of practice for advanced EMTs and paramedics, and many states have included immunizations as an allowed medication. Seize this opportunity to take part in this important job. Contact your local public health officials to see how you can partner with them to help protect your community.”
— Michael Fraley, BS, BA, NRP, paramedic; coordinator, regional trauma advisory council
Able to continue the mission
"COVID-19 is taking its toll on people all around the world. Of course, nothing is getting more taxed than the healthcare agencies, and EMS is no different. EMS agencies are stretched to the max with responses, more expenditures and loss of resources contracting the virus. With the development and distribution of the vaccine, at least we can develop the confidence that as providers we are safe from a deadly virus, we can treat people with more confidence, and know in our hearts we will not be bringing a deadly virus home to our families. We have been waiting patiently for help to arrive, as far as a vaccine goes, hopefully, this is one of the many things that EMS needs to continue their mission of delivering care to those in need."
— Chris Cebollero, president/CEO for Cebollero & Associates
A reduced strain on EMS staffing
“The early vaccination of first responders will reduce the negative impact on staffing related to quarantine and isolation. Recruitment during COVID-19 has been difficult and advent of the vaccine may improve the potential to recruit personnel to the profession.”
— Jay Fitch, PhD, founding partner, Fitch & Associates; co-chair, Pinnacle EMS leadership conference; founding commissioner, American College of Paramedic Executives
Continued infection control practices
“I predict that when the dust finally settles on COVID-19, among other things, EMS providers will forever change they way they look at transmissibility of communicable diseases. Finally, providers will have been forced to recognize that everything they touch touches everything else they touch. From door handles to ambulance keys to radios and even seatbelt latches – all of them and everything else can be vectors for transmission against which they must be constantly aware. Most of all, I am confident that providers will be more diligent about not only self-protection, but protection of others, on the job and at home. Providers, I predict (and hope) will forever be more aware of what they are bringing home to their families and conscious, deliberate steps in mitigation will become habit.”
— David Givot, Esq., criminal and EMS attorney, The Legal Guardian
Trepidation and uncertainty for some
“In a time of great uncertainty, we find we are on the horizon of yet another unknown. As EMS providers, we strive to lean on science and evidence-based medicine in our daily practice but with the limited and short testing of a vaccine, many EMS providers are filled with fear and trepidation. I believe a COVID-19 vaccine will bring increased fears – fears of employers mandating a vaccine, to long-term side effects. If you factor in a public that has mixed emotions about science, data, the CDC and the governmental response to a global pandemic, I expect that EMS will have more feelings of uneasiness as opposed to comfort.”
— Xavier De La Rosa, BS, LP, NRP, FP-C, lieutenant, Fort Bend County EMS, Texas
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