COVID-19 immunization

Coronavirus immunization includes efforts to design, manufacture and distribute vaccines to immunize the population against the SARS-CoV-2 virus which caued the 2020 Coronavirus pandemic.

Alabama began administering vaccines to critical health-care workers in December 2020 and to the elderly and residents in group settings in January 2021.

Vaccine research

UAB and Southern Research participated in early clinical studies of several vaccine candidates.

Research teams headed by Troy Randall of the UAB Division of Clinical Immunology and Kevin Harrod of the UAB Department of Anesthesiology and Perioperative Medicine joined with several researchers from the UAB Department of Microbiology in performing certain preclinical studies of an "AdCOVID" trial vaccine developed by Altimmune of Gaithersburg, Maryland. The potential vaccine, which would be administered by nasal injection, showed promising therapeutic results and advanced to Phase 1 safety trials in late 2020. Additional preclinical trials were conducted under UAB Department of Microbiology chair Frances Lund. The FDA placed a hold on Altimmune's Phase 2 trials on December 22 as it gathered more data about manufacturing. Approval for a small-scale human trial was granted in February.

Southern Research carried out pre-clinical studies of another vaccine candidate, a single-shot live modified horsepox virus vaccine dubbed TNX-1800, in partnership with Tonix Pharmaceuticals of Chatham, New Jersey. Raj Kalkeri of Southern Research's Infectious Disease Research Group led the local study. The company's Phase 1 trials concluded in November with positive results. Phase 2 trials with non-human primates concluded in March and also brought positive results. With FDA approval, human trials could begin in the third quarter of 2021. Kalkeri's team also studied the immune responses of individuals who had been exposed to SARS-CoV-2 and no longer showed symptoms.

Beginning in late July, UAB began enrolling volunteers for a portion of a larger human trial study of a vaccine candidate developed by Oxford University and Cambridge-based AstraZeneca. The research was led locally by Paul Goepfert. In September UAB began a clinical study of the effectiveness of tranexamic acid (TXA) in suppressing the virus' infectivity in patients with elevated levels of the extracellular protease plasmin due to comordities. Sadis Matalon and Timothy Ness were involved in developing the study.

Vaccine distribution

Birmingham superintendent of schools Mark Sullivan received his first dose of the vaccination at Parker High School on February 11, 2021. Photo by Erica Wright for The Birmingham Times.

In anticipation of the FDA's first Emergency Use Authorizations for vaccines developed by Pfizer and Moderna in early December 2020, the Alabama Department of Public Health began preparing to implement its distribution plans, prioritizing first-line workers in healthcare settings.

In early December state health officer Scott Harris announced that the state was set to receive 40,950 doses of the Pfizer vaccine for distribution to frontline health-care workers later that month. The initial shipment was just enough to vaccinate 20,475 of the state's 300,000 healthcare workers. Pfizer's first shipment of vaccines reached Alabama on December 15. The Birmingham VA Medical Center was the first to administer the vaccine in Birmingham, and Lee Elm Creel of Snowtown was the first to receive it there. On December 17 ADPH learned that a second expected shipment of 20,000 doses would not arrive, greatly reducing the number of healthcare workers who could be vaccinated early.

Moderna's vaccine candidate earned FHA emergency use authorization on December 18, with an initial shipment of 84,000 doses expected in Alabama on Monday, December 21 for distribution to healthcare workers.

The second group of vaccine candidates, including people over 75 years of age and those with comorbidities making them especially vulnerable to COVID-19, began receiving vaccinations on January 18. The state had been allotted 271,925 doses as of January 11. By January 22, 224,000 vaccine doses had been administered statewide and Alabama was receiving 50,000-60,000 doses per week. The restricted supply continued to hamper the progress of vaccination beyond the initial group.

UAB initiated a drive-through vaccination site at the parking deck for UAB Hospital-Highlands in January. Expansion of those efforts was limited solely by available supply of the vaccine. UAB opened two more large-scale drive-through vaccination sites at the Hoover Met and at Parker High School in early February as the Biden administration ramped up allotments to states. UAB expected to be able to deliver 17,000 doses per week. Wal-Mart and Sam's Club began administering vaccines at selected locations in the Birmingham area on February 19.

Another single-dose vaccine from Johnson & Johnson was expected to become available during February, greatly expanding the rate of immunizations. Most Alabamians not prioritized due to age, medical condition or critical worker status, would begin to have access to vaccination in early summer 2021.

No timeline has been established for vaccinating children under 16. The cost of the vaccines is free to all Americans, though some service fees may be charged to insurers or reimbursed through the Health Resources and Services Administration's Provider Relief Fund.

References

• Patchen, Tyler (July 13, 2020) "Covid-19 vaccine trial involving UAB shows promising results." Birmingham Business Journal
• Thornton, William (July 22, 2020) "Southern Research collaborating on COVID-19 vaccine tests." The Birmingham News
• Pillion, Dennis (July 24, 2020) "Alabama hospital seeking volunteers for COVID vaccine trial." The Birmingham News
• Patchen, Tyler (October 13, 2020) "More promising news for UAB vaccine efforts with Altimmune." Birmingham Business Journal
• Yurkanin, Amy (November 16, 2020) "COVID-19 vaccine in Alabama will be free, first doses could be available by December." The Birmingham News
• Patchen, Tyler (November 19, 2020) "Southern Research and Tonix make headway in Covid-19 vaccine." Birmingham Business Journal
• Whites-Koditschek, Sarah (December 6, 2020) "Here comes the vaccine. But will Alabamians take it?" The Birmingham News
• Yurkanin, Amy (December 15, 2020) "World War II veteran receives first COVID-19 vaccine in Birmingham." The Birmingham News
• Stanley-Becker, Isaac; Yasmeen Abutaleb; Lena H. Sun; & Josh Dawsey (December 17, 2020) "States report confusion as government reduces vaccine shipments, while Pfizer says it has ‘millions’ of unclaimed doses." The Washington Post
• Whites-Koditschek, Sarah (December 18, 2020) "Alabama shorted 20,000 vaccines in next week’s shipment, say feds cut allotment." The Birmingham News
• "U.S. FDA puts early-stage trial of Altimmune's COVID-19 vaccine on hold." (December 23, 2020) Reuters
• "'The vaccine is coming': Alabama health officials call for patience amid slow rollout." (January 6, 2021) Associated Press / The Birmingham News
• Gore, Leada (January 11, 2021) "COVID vaccine update: 41,778 vaccines given in last week in Alabama, online scheduling portal opens." The Birmingham News
• Pillion, Dennis (January 17, 2021) "UAB launches drive-through COVID vaccine, shifts focus to 75+." The Birmingham News
• Sharp, John & Ivana Hrynkiw (January 27, 2021) "Alabama’s problematic COVID-19 vaccine program leads to a rise of vaccine tourism." The Birmingham News
• Yurkanin, Amy (January 30, 2021) "UAB opening two larger sites for more COVID-19 vaccinations in Birmingham area." The Birmingham News
• Yurkanin, Amy (February 2, 2021) "First large-scale COVID-19 vaccination sites open in Alabama." The Birmingham News
• Whites-Koditschek, Sarah (February 5, 2021) "UAB aims to expand vaccinations by the thousands in weeks ahead." The Birmingham News
• Wright, Erica (February 11, 2021) "COVID-19 vaccinations begin at A.H. Parker High School in Birmingham." The Birmingham Times
• Patchen, Tyler (February 17, 2021) "Altimmune and UAB vaccine candidate approved to begin clinical trail." Birmingham Business Journal
• Fulmore, Miranda (March 4, 2021) "UAB and JeffCo to Expand Vaccine Outreach in Underrepresented Communities." WBHM / BirminghamWatch
• Carter, Robert (March 9, 2021) "Gov. Ivey Calls Out Alabama National Guard to Help with Vaccination Push." BirminghamWatch
• Patchen, Tyler (March 22, 2021) "Southern Research, Tonix Pharmaceuticals make headway on Covid-19 vaccine." Birmingham Business Journal