“Time to move faster and bigger”: Dr. Rai on what’s needed to get us vaccinated

GREEN BAY, Wis. (WBAY) - “We need scale. Not more locations, but bigger locations, and more people to do it,” says Prevea Health President and CEO Dr. Ashok Rai. He’s talking about the infrastructure we need to get our community vaccinated.

“The infrastructure is not small. Instead of looking at say, 50 sites in a city, we should get maybe two sites in a city or three sites in a city that are built on scale. This is not about doing 100-shots-a-day. This is about getting 200-shots-an-hour done,” says Dr. Rai.

Dr. Rai joined us Thursday on Action 2 News This Morning to talk about the state’s rollout, why we shouldn’t compare it to other states, and the need to get shots in arms.

Dr. Rai joins us Tuesdays and Thursdays. Have a question? Email news@wbay.com

Previous Dr. Rai segments: https://www.wbay.com/health/drrai/

WISCONSIN RANKS LOW IN VACCINATIONS

“Every state, number one, got a different allocation. And like we’ve talked before, every state has a different list of people to vaccinate. So if, the state of Wisconsin said let’s vaccinate everybody over the age of of 75, our numbers would be way different. It would be closer to Florida. You can’t compare state to state with every state having a different list of people to vaccinate. And definitely on a per capita basis it’s very different. Because even if you said, ‘they’re both doing health care’, well one state may have 400,000 health care workers, one may have a half-a-million or two million, so it’s not an apples-to-apples comparison. I’m not making an excuse for Wisconsin, but that comparison doesn’t work.”

UW MASS VACCINATIONS

UW System Interim President Tommy Thompson has suggested using UW campuses as mass vaccination sites.

“I think it’s a great idea. I think people need to take a step back. This is not the kind of vaccine you’re going to likely be able to give-- especially the Pfizer one which we have the most of, which we have the most of, and I think it’s important to note that--that it’s not the kind of vaccine that’s easy to give at the doctor’s office between every fifth patient. It’s best done with an entire team, very large areas, great parking, handicapped parking, as we’re going to start to do people who are older or have medical issues. You need pharmacy on site. There’s a lot of different things. The UW campus is set up really well for that. Large areas, large parking. They’ve been a great partner in testing, why wouldn’t they be a great partner in vaccines? And let’s just say that Tommy and I might have more to say about that later in the day.”

SHAWANO SCHOOLS TESTING STUDENTS

The Shawano School District has announced on-site COVID-19 testing for students who are not experiencing symptoms. The testing days are Jan. 12 and Jan. 19.

“I’ve said it since March, I’ll say it until we’re doing with this: testing, testing testing. That’s where our weapons are. That’s how you find people who are positive and prevent them from infecting other people. Now, are the tests being used perfect? No, but none of the tests we’ve used so far have been perfect. We’ve done this pilot with schools and athletic teams. We want to do it more with schools. The funding is the big issue. Now that health care workers are being immunized, maybe there will be more testing resources that can be diverted to schools. That would be our passion. I’m glad they’re doing it. It’s what other countries have done to keep schools going, and we should really look at that.”

VACCINATION STAFFING AND INFRASTRUCTURE

“We need scale. Not more locations, but bigger locations, and more people to do it. It’s much more than a person putting a needle in your arm--and that’s a very important person, I don’t want to undermine that--but let’s not forget the pharmacists that help draw up those syringes. Let’s not forget the IT people that put together this infrastructure to schedule a test, to make sure you have your second dose, to make sure all the paperwork is electronic so we can fast pass you to get through line. Let’s not forget all the construction people who have to put up these booths right away. The infrastructure is not small. Instead of looking at say, 50 sites in a city, we should get maybe two sites in a city or three sites in a city that are built on scale. This is not about doing 100-shots-a-day. This is about getting 200-shots-an-hour done. I think that’s the mentality Green Bay needs, Sheboygan needs, Oconto needs, Door County needs. That’s the kind of mentality we’ve got to work with. Not just go down to that physician’s office or to X pharmacy and get a shot in the arm. This has to be done at scale if we’re going to get the amount of people vaccinated we need to get vaccinated.

“Think about it. If you’re doing 100-people-an-hour but, say, one vaccinator is doing somebody every eight minutes, there’s an overlap in that watching area, too, of significant time. So it’s not 100 seats, it’s 400 seats that are necessary to watch people. So all of that’s needed.”

DR. RAI’S SECOND SHOT

“Physical--I’m tired, but that’s your fault (laughs). My arm hurts, but that’s OK. That means the shot’s working. Otherwise, I’m doing good. Emotionally, the first one, it was a sign of the end of the pandemic and it was great. Emotionally, now with the second shot, we’re done. It’s time to get everybody else done. And it’s time to move faster and bigger to get this area immunized and be done with COVID-19.”

REACTIONS TO VACCINE

A viewer who had a reaction to the first dose of the Pfizer COVID-19 vaccine wants to know if she should get the second dose.

“It really depends on what kind of reaction it was. But the typical reactions you get, that sore arm, fever, not feeling well, headache, those types of things, that’s good. That’s your immune system reacting. In some people, it lasts 24 hours. In some people, it can last a few days. And yes, you should get the second shot. There’s really a very, very tiny window, much less than half a percent, that shouldn’t get the second shot. And those are people who have a severe allergic reaction to the shot requiring medical intervention, such as an epi-pen. Those people we need to watch for the second shot. Everybody else should schedule their second shot.”

ALLERGY MEDICATION AND VACCINE

Should people who have reactions to the shot use allergy medication such as Benadryl?

“It depends on when she used it. You don’t want to pre-dose. You don’t want to effect that reaction you’re getting, that reaction I’m getting today. That’s what we expect and those things are good. After the shot, if you’re still sore or not feeling well, Tylenol would be a great solution there. Maybe some ibuprofen after a day. But really, just want to let that happen in your body. You want that immune reaction to happen. You want to let your immune system do its thing. Essentially what you’re doing is you’re training it to do its thing when it interacts with COVID.”

WHEN WILL THE ELDERLY GET THE SHOT?

“It’s a great question, and I wish I had an answer. The CDC’s committee, called ACIP, they meet, and they’ve already met and made recommendations what to do after health care. They’ve given those recommendations to the state. But this is a state-driven process. So if you go to Florida right now, you could get vaccinated, but not get vaccinated in Wisconsin, because they have different rules. So the next set of Wisconsin rules are getting decided by a committee, SDMAC. You can Google that and DHS at the same time. And you can actually look up their minutes, you can tune into their meeting. And I suggest people do that. And, so they met on Tuesday. They had done, basically, an online poll amongst their members to say, we have these 13 categories we should rank. Where does a 75-year old rank? Maybe where does a 65-year-old cut off rank? Where does a law enforcement or a teacher rank? And they ranked them. Now they have to decide a cut-off line of where the next 1B will be. I think one of the most important things to remember is there’s no hard stop here. There’s no ‘we’re done with 1A, it’s time for 1B.’ There’s a significant amount of overlap. Those of us who are immunizers. That’s all we are in health care. Our job is to make sure it’s safe. Draw the vaccine up safely, and it’s a technical process. Put it in your arm. Watch you. And make sure you get a second shot. And that’s really our responsibility. We don’t get to decide who gets the shot next. We’ve done our practice laps for 21 days. We’re in our starting blocks right now. Our number one goal is to put as many shots in arms as possible in a given day. And even if we have to expand our hours or move to larger sites, we’ll do that. But we are not the ones who are going to tell you that. It will be the state. It will be publicized. And then we will make sure you have an ability to schedule an appointment.”

WILL PUBLIC VACCINES HAPPEN IN JANUARY?

“I’m begging and pleading for it. A good amount of 1A is done. We’re on our second round of shots. The people that we were supposed to protect to keep health care going, to take care of you in case you got COVID, to take care of you if you had a heart attack, to take care of you in case you had a car accident, to make sure the business of health care can keep running to take care of the community, they’ve gotten their first shot. Their second shot should have been scheduled. It’s time to finish up everybody else involved in health care, which we are doing every single day now, and it is time for us to start moving on and doing those at risk, those that are teachers, law enforcement, whatever decision the state makes, let us go.”

WISCONSIN’S VACCINE ROLLOUT

Wisconsin knew a vaccine was coming. Why are we moving slowly to vaccinate people? Were they not prepared?

“It’s easy to Monday morning quarterback everything. I know I could go back and watch my episodes from March and regret things I’ve said and want to change my mind, science involves. We needed the science to be decided before we could figure out how to distribute and get this vaccine out. Because you need to understand what populations would need what. And we needed to understand what populations would be in that 1A category and then distribute it. The distribution--you have to remember it’s been 21 days--three weeks with two national holidays in between, and we still have millions of people immunized. Somebody went out there and put an arbitrary goal out there for immunizations before the end of the year. And that person, that group of people, has never done this before. It is not like giving a simple immunization. There’s a lot of complications involved in it.”

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