GOSHEN — Vaccinations for those age 80 and older could begin as early as today across the state. In Elkhart, LaGrange and Noble counties, vaccinations will likely begin Monday at local health department sites.

These first public vaccination sites will be at:

• Elkhart County — Elkhart County Health Department’s Neff Center, 608 Oakland Ave., Elkhart.

• LaGrange County — LaGrange County Health Department, 304 N. 00 East-West, LaGrange.

• Noble County — Noble County Public Library, 813 E. Main St., Albion.

All three health officers said that in order to receive a vaccination, those 80 and older must go onto the state website https://ourshot.in.gov and register or call 211.

The health departments will not know how many vaccines they will receive very far in advance.

Elkhart County Health Officer Dr. Bethany Wait anticipates 500 vaccines arriving today or early next week. LaGrange County Health Officer Dr. Tony Pechin said he anticipates 100 vaccines today and then another 100 Monday.

That’s why the rollout is a bit tenuous and is being directed by the state using age groups, health care workers and people in and working in long-term care facilities.

“This is a fly-by-the-seat-of-your-pants situation,” Noble County Health Officer Dr. Terry Gaff said, a statement iterated by the other two health officers.

Pechin said, “That’s the way it’s going to go. We won’t know how much vaccine we’re going to get. We’re going to have to be pretty agile in adjusting capabilities.”

“It feels like it’s not transparent, and I understand that,” Wait said. “I think I felt that frustration as well just listening to the news in general. As of right now, what’s happening is the state is what’s called allocating. So the state is saying, ‘OK, so this particular group needs to get this many of this vaccine. And over here they have more people so they can have more.’ And so, that’s what the state is doing now. They have allocated whatever shots they get in from the federal government. Then they start distributing throughout the state.”

That distribution has started, initially with the hospitals.

“So Goshen Hospital and Beacon are vaccinating health care workers,” Wait said. “So now separately, the federal government has sent vaccinations to major pharmacies. The ones we hear the most about are CVS and Walgreens. Some other pharmacies are doing it as well. … So, the federal government has asked the main chain pharmacies to vaccinate long-term care residents to start. Eventually, they will move into the general population as well, but initially hospitals are supposed to do health care workers and then Walgreens, CVS, etc. are supposed to do our long-term care.”

The remainder of the vaccines allocated to the counties are being given to the county health departments.

The state health department has a distribution map on its website https://www.coronavirus.in.gov/2680.htm, which shows the number of vaccines currently allocated to counties. It shows 3,341 for Elkhart County, 261 for LaGrange County, 454 for Noble County, 888 for Kosciusko County, 4,043 for St. Joseph County and 539 for Marshall County.

After those age 80, the state will then open up the vaccines to those 70 and older, and then 60 and older.

“The state has been very clear,” Wait said. “They will tell us who to vaccinate. We will get word from the state and the state will say, ‘You will do this population only. You will not do anybody else. And if we find out, we’re not going to be happy with you.’ So they’ve been very clear: please roll this out as we ask. And so as the health department, that’s what we will do — we will do exactly what the state tells us to do. That’s who gets us our vaccines. We are not purchasing them from the state. The state has purchased them. So we will distribute them as the state tells us to.”

BY APPOINTMENT ONLY

Vaccinations will be done by appointments only at this point.

Pechin said, “No walk-ins will be taken.”

Eventually, there might be walk-ins or mass vaccinations, but they are nowhere near that point right now, the health officers said.

“We certainly don’t want to cause a panic,” Wait said. “… It’s already an anxiety-provoking thing anyway, so to do it calmly I think is the best way to do it. I mean eventually I think we’ll probably be able to do a walk-in like scenario. But to start with the limited number of vaccines that we’re going to be getting, it’s not going to be a good idea to do it that way. So the plan as of now, as soon as we have vaccines in our hands, we will open up a registry on … Elkhart County’s website (https://elkhartcounty.com/en). So people will be able to go, once they’re told who can go, they will be able to register, sign up and schedule an appointment.”

In Elkhart County, the first rounds of shots will be given at the Neff Center, which is a small gym inside the health department building.

“My goal is to get us out of there and into the community,” Wait said. “But this is our trial run. … We have it all set up. And what we plan on doing is try to vaccinate six people, like every 10 minutes or so. So you come in, we will get your insurance card and your name and birth date.”

For those who are undocumented immigrants, she said not to worry.

“You are still welcome. We will not report you,” Wait said. “We want everybody in this community to get vaccinated. We do not want any barriers to that. Please understand that.

“We will register you. You will move down to the line. You will get your vaccination by a licensed health care provider. It could be EMS. It could be nurses. It could be a physician, a pharmacist. There will be a licensed physician. Then we will ask you to sit for 15 minutes, and what we’re looking for are any adverse reactions.”

There have been a few reports of people having anaphylaxis, but, she said, they were people who had anaphylaxis before.

“And that’s why every place that you will get vaccinated, we will have medical personnel that will be able to help you if you have any trouble,” Wait said. “If you look at those individuals who had anaphylaxis, they had a history of it. So if you don’t have a history of anaphylaxis, I don’t think that you need to worry that that’s going to happen. But we will be prepared. We will have medications there if we need it. We will make sure we have staff that is capable to help you if anything happens.”

Pechin said that when people arrive for their vaccination, they will need to sit in their car, let health officials know they have arrived and then they will be allowed to enter in an organized fashion.

The health department has a limited space for those who need to sit for 15 minutes or more after receiving the vaccination.

“I can’t deal with a bunch of extra people that way,” Pechin said. So that is why people will need to stay in their vehicles until they are called.

In Noble County, Gaff explained that people will go to the doors on the north side ground floor of the library. They should use the parking lot that is around the back of the library and come in at the ground level, using the back entrance.

He said they will put up as much signage as possible to direct people.

“Then everybody can get what they need,” he said. “They need to make sure they have a mask when they come in — an acceptable mask, not a single-layer gaiter or method of coverage — a good mask and or a shield that is appropriate if they can’t wear a mask. We will try to keep everyone safe and socially distant as we go through this process.”

People will need to sign in and make sure they are healthy and have an appointment and then go to a vaccination room, Gaff said. There they will receive the vaccine, and then go to an observation area, where they will stay at least 15 minutes before leaving.

Those who receive vaccines will need to schedule their next one that day. Those who receive the Pfizer shot will need to come back in 21 days. Those who receive the Moderna shot will return in 28 days.

“There is a lot of talk that maybe you don’t need both, that maybe we aren’t going to do both, and frankly we don’t know,” Wait said. “I mean, I think what you’re going to see as of right now, all health care providers that have gotten it are getting the two-shot series. The state has continued to tell us to do the two-shot series. So nothing at this point has changed. Does that mean that it won’t change? No, it could possibly change.”

But the studies show that with the two shots, the vaccines are 95% effective. “And that’s what we’re sticking with as of now,” she said. “I will not promise that that is the way it stays. … If we want true immunity, true long-lasting immunity, which at this point we know is longer than six months, you’ve got to get two.”

The people who were in the clinical trials for the vaccines are still being followed and monitored, she explained. Researchers are looking to see if those in the studies still have antibodies.

“That data will slowly trickle in as it’s available,” Wait said.

Those who have had COVID are believed to be immune for 90 days at this point, Wait said. For those who have had COVID and are past that 90-day window, she urges that they get the vaccine.

If people who are in that 90-day immunity window wait, it will allow more people who are not immune to get the vaccine, she said.

A caveat to that though, Wait said, is that people who had COVID but were asymptomatic or had very mild symptoms, probably do not have the 90-day immunity, or if immunity does last that long they may get a repeat infection prior to 90 days.

“The biggest thing is, if you’ve had COVID-19, you should still get your vaccine,” she said. “I have received my vaccine. I had it in April. I wanted it, again, because they were saying immunity waned after 90 days. I thought if I got that sick with the first go-round, I didn’t want to risk it this time.

“At this point for the general population, we don’t have enough vaccines anyways. But, yes, it is reasonable that if you have had the infection within that 90 days that you can hold off getting the vaccine, but I still want you to get the vaccine eventually.”

As soon as she knows that they have vaccines available, the health department will immediately release that information through the media and the county website. It will show the groups of individuals who are eligible and the numbers of vaccines available and how many appointments they have open. Every week from there, they will be updating the information.

“That is the biggest thing I want to do is be completely transparent as to how many vaccines we have, how many we’ve given and try and get a complete picture so everybody feels comfortable that we are being open and honest with everything that we have going on at the Health Department,” Wait said.

She said it will take six months to a year to vaccinate everyone in Elkhart County.

“It is also going to depend on the population too, from the standpoint of I’m going to guess anybody over 50 probably isn’t all that hesitant to get a vaccine,” she said. “They’ve seen vaccinations most of their life, haven’t had any adverse reactions and so there’s going to be a population that’s first in line. It’s going to be the targeted communities — the black and brown communities, the Amish community that we really want to reach out to individually and help them understand that this vaccination is safe and that this is how we end COVID-19.

“Just a general outreach is going to take some time as well. But even if we can start to get this vaccine circulating into the population and get people immune, just that general is going to help our numbers decline and get us back out of the red, … less restrictions and hopefully just rid of COVID-19. Honestly, it’s going to take at least a year if not longer. Nobody can actually tell you if we’re going to get rid of COVID-19 or just be able to control COVID-19, like influenza.”

She also wants to let people know that the vaccine is free. Insurance cards will be asked for to help offset the cost of administering the vaccine, but those who do not have health insurance do not have to worry about getting charged. No one should ever receive a bill for the vaccine, she pointed out.

FOLLOW UPS

People who are getting vaccinated will also be asked to participate in v-safe, the after-vaccination health checker. It is a way they state can monitor for complications.

Gaff said, “They contact the person by text each day for the first week or so and then each week or so after that to see if they’ve had any complications or symptoms. If there is a problem with the vaccine, then we will be able to detect it and address whatever needs to be addressed.”

So far, Gaff said, reports are of sore arms, low-grade fever and some low-level fatigue.

Pechin said, “Most of my colleagues and friends have gotten the vaccine and there no issues. I highly recommend it.”

Sheila Selman can be reached at sheila.selman@goshennews.com or 574-533-2151, ext. 240311. Follow Sheila on Twitter @sselman_TGN.

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