An example of the Pfizer COVID-19 vaccine vial is visible on a desk before FedEx Regional President of the Americas and Executive Vice President Richard Smith, left, and UPS President of Global Healthcare Wesley Wheeler, right, testify at a Senate Transportation subcommittee hearing on transporting a coronavirus vaccine on Capitol Hill, Thursday, Dec. 10, 2020, in Washington. Credit: Andrew Harnik / AP

After months of planning, Maine’s multi-step plan to distribute a coronavirus vaccine will go into motion after a federal panel recommended the first immunization for use in the U.S. on Thursday in a step that could lead to states seeing first doses within days.

Advisors to the Food and Drug Administration endorsed a Pfizer vaccine, a key step to the vaccine getting emergency use authorization, allowing use without formal approval. The designation is only used when there is a serious public health emergency and no alternatives are available. The FDA is likely to follow the panel’s recommendation, though its final decision could take up to a week.

There are many moving parts to vaccine distribution. Health care providers will focus first on vaccinating first responders before the general population is vaccinated and the entire process will take months. Misinformation can muddy the water. Life will not return to normal immediately after vaccination. Here is what Mainers need to know. 

When can Mainers get vaccinated and who is first in line?

Maine Center for Disease Control and Prevention Director Nirav Shah said in a Wednesday briefing that the state’s first shipment — believed to be enough to vaccinate 12,675 people — could arrive “days” after its approval.

But it may be some time before the average person is able to get it. High-risk health care workers are first in line to get the vaccine, as are first responders, under the Maine CDC’s four-phase vaccination plan. Those with comorbidities and older individuals in congregate settings are next, followed by other essential care workers; other older adults who are not immediately at risk, school staff, and prisoners and corrections staff. 

Children, young adults and essential workers come next, and then general population vaccination. The New York Times can help you calculate when it might be your turn in line.

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That first phase could take some time. MaineHealth, one of the state’s biggest health systems, is based in Portland, the largest city in the state. Between scheduling vaccinations around work shifts, anticipating possible side effects and onboarding extra staff to help with the vaccinations, it could be weeks before their employees are all covered, said Dora Mills, chief health improvement officer for MaineHealth and Gov. Janet Mills’ sister. 

As cases and hospitalizations rise in Maine and across the country, the system cannot begin to think of vaccinating the rest of the population. University students, former employees and staff from administrative areas of MaineHealth are being recruited to help with the vaccination process, she said.

“Our staff is already overstretched by the surge,” Mills said.

Who will be responsible for administering the vaccine?

There are 468 possible vaccine providers in the state, according to the plan, with the biggest share consisting of doctors offices, clinics and pharmacy chain locations. If all agreed to administer the vaccine, the state could provide 129,000 weekly doses and reach 80 percent of residents within three months. As of Thursday, 212 providers had signed up, according to Maine CDC spokesperson Robert Long.

There are limitations on who is able to store the vaccine. Only five hospitals have ultra-cold freezers needed to keep it from expiring. The state has freezers and ordered two more with the hopes that they will arrive before the vaccine is distributed. Some colleges and universities also have freezers. It could be a barrier for rural areas with less access to big hospital systems and whose hospitals may be too cash-strapped to have or purchase a freezer.

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If an ultra-cold freezer is not available, dry ice can keep the Pfizer vaccine sufficiently cold for 30 days if replenished every five days. Shah told Slate last week that piece of the vaccination puzzle does not worry him — dry ice is prolific in Maine thanks to its use in the lobster industry. Mills said MaineHealth has three ultra-cold freezers, but she does not see them as part of the equation. 

“We don’t plan on storing it,” she said. “We want to get as many shots in the arm as possible.”

Shah said last week that the state plans to distribute the first doses “equitably” from Presque Isle to Portland. But many in rural areas may have to wait until the third phase to easily access the vaccine, as the state predicts that is when pharmacies will be routinely providing vaccinations.

How will the vaccine work?

The Pfizer vaccine is administered in two doses, 21 days apart. According to an analysis from the FDA released on Tuesday of a clinical trial involving 36,621 people, the vaccine is believed to be effective 95 percent of the time when a person is exposed to the virus a week after receiving the second dose. That is a similar effectiveness rate to Moderna’s vaccine, which has its own hearing next Thursday.

Is the vaccine safe?

Yes, according to the federal government. The FDA found no specific safety concerns with the Pfizer vaccine that would prevent it from being distributed on an emergency basis.

Common reactions among the trial population included injection site reactions — which 84 percent of individuals experienced — fatigue (63 percent), headache (55 percent) and muscle pain (38 percent). Up to 4.6 percent of the participants experienced severe adverse reactions, that generally occurred after the second dose and in younger participants.

That analysis did have some limitations. It noted there is “insufficient data” to determine how safe the vaccine is for children under the age of 16, pregnant and lactating people and those who are immunocompromised.

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There are misconceptions about the vaccine circulating that could dissuade people from getting it. A September report from Northeastern University, Harvard University, Rutgers University and Northwestern University found that roughly 12 percent of Mainers in a national survey believed common false claims about the vaccine, in the middle of the pack nationwide.

Community leaders are urging residents to get vaccinated. Notable among them was Bishop Robert Deeley of the Roman Catholic Diocese of Portland, who in a Thursday statement said members of his faith should not be dissuaded by claims that vaccines derived from cell lines of an aborted fetus are immoral. No coronavirus vaccine contains fetal cells, though some are developed with cell lines replicated from aborted fetuses or use those lines in tests of efficacy.

The Pfizer and Moderna vaccines have only a “remote” connection to abortion, Deeley said, and he followed other Catholic leaders who said the common good from getting the vaccine when there is a serious public health risk outweighs moral concerns.

“I have already been asked several times: should I receive the vaccine when it is available to me?” Deeley said. “My answer is a resounding ‘yes.’”

What should you do after you get the vaccine?

Even if you get vaccinated, there is a chance you might still be able to carry the virus and pass it on to others, Shah said Wednesday. With the general population relegated to the third and fourth phases of Maine’s vaccine distribution plan, social distancing and mask-wearing must continue to curb new cases, he said.

“The better we get control of the virus today, the more success we will have with a vaccine tomorrow, the next week and the next month,” he said.

Clarification: Bishop Robert Deeley of the Roman Catholic Diocese of Portland only referenced the Pfizer and Moderna vaccines in a statement on Thursday encouraging Catholics to get vaccinated. An earlier version of this article was unclear.

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