The South Carolina Department of Health and Environmental Control (DHEC) today (Dec. 31) provided the following update on the state’s distribution of COVID-19 vaccines, including the state’s progress in vaccinating those in Phase 1a and ongoing efforts to protect the health and safety of all South Carolinians:

Since receiving the first doses of the vaccine on Dec. 14, we remain encouraged by the commitment of South Carolinians in continuing to do their part in the fight against COVID-19 by getting vaccinated. As of this morning, 39,100 doses of COVID-19 vaccines have been administered in South Carolina, with vaccines continuing to be administered each day.

Distributing mass doses of COVID-19 vaccine rapidly, effectively and equitably represents a public health logistics effort on a scale not seen before in the U.S. and is a massive undertaking. DHEC is leading this effort in South Carolina, but it could not be accomplished without our many state and federal partners.

Our ultimate goal is to save lives. DHEC remains dedicated to working with our partners to ensure that everyone who wishes to be immunized against COVID-19 in South Carolina will be vaccinated, but it is going to take time. It’s important to recognize that this is a rapidly evolving event. This vaccine is unlike any vaccine that we have ever dealt with before.

South Carolina, like other states, has faced several challenges due to the unique requirements of the mass distribution of the COVID-19 vaccine. Challenges to date include limited supplies of vaccine during the phased rollout, complex logistics and adapting to changes in federal guidance. DHEC anticipates additional challenges to evolve but is confident that with collaborative problem solving and support of our partners we will meet each new challenge head on.

Preparing for Historic Ultra-Cold Storage Requirements

The Pfizer-BioNTech vaccine is the first authorized vaccine in history that must be stored at ultra-cold frozen temperatures, requiring locations who receive it to have specialized ultra-cold freezers with temperature monitoring capabilities in place. The Pfizer-BioNTech vaccine also is only shipped in packages of 975 doses, meaning the location that receives a direct shipment of it must have the ability to give in a timely fashion or store in an ultra-cold freezer. While these logistical challenges make distribution of the vaccine complicated, DHEC and our partners identified storage opportunities and expanded capacity months ago.

Adjusting to Rapidly Changing Federal Guidance

In addition, federal guidance regarding populations to be vaccinated changed just as the initial vaccine distributions were sent to the states. This resulted in a significant increase in the population included in Phase 1a. In South Carolina and other states, agencies such as DHEC then had to review and edit some of the plans and protocols that were in place for in-state distribution. The same assessment and changes then had to be made at the local level as hospitals and distribution sites began to receive shipments and vaccinate their employees. The sites are now actively vaccinating per state and federal guidelines as aggressively as possible.

Similar to the rest of the nation, the initial process has required states to remain flexible as we adjust and adapt to the evolving situation. Work continues at large vaccination sites across the state with plans to begin distribution to smaller facilities in the next week.

Progressing from the Initial Phase into Widespread Availability in Summer

The CDC’s Advisory Committee on Immunization Practices (ACIP) has provided guidance for categories of individuals to include in Phases 1a, 1b, and 1c. South Carolina is currently in Phase 1a and is vaccinating individuals in that phase per the SC COVID-19 Vaccine Advisory Committee’s recommendations based off of the ACIP guidance. The committee is currently working to translate the national Phase 1b and Phase 1c recommendations to action in South Carolina. The following outline provides an overview of the anticipated categories for each phase. This is subject to change at any time for many reasons, such as a change in federal guidance or in the SC COVID-19 Vaccine Advisory Committee’s recommendations for South Carolina.

Phase 1a

Residents and staff of long-term care facilities
Healthcare personnel (with initial focus on healthcare workers critical to the mission of preventing death), including:
Persons performing direct medical care to suspected and/or confirmed COVID-19 patients: medical house staff (i.e., interns, residents, fellows), nurses, nurse’s aides, physical therapists (PT), physicians, physician assistants, respiratory therapists (RT), speech pathologists providing swallowing assessments during a patient’s infectious period, occupational therapists, translators with direct patient contact, students (medical, nursing, PT, RT)
Ancillary staff directly interacting with suspected and/or confirmed COVID-19 patients: laboratory personnel handing potentially infectious specimens, phlebotomists, and radiology technicians
Emergency room staff in the above categories who provide direct patient care who are at high risk of exposure to undiagnosed, suspected and/or confirmed COVID-19 patients
Paid and volunteer medical first responders (EMS, fire department, and law enforcement personnel who provide emergency medical services as certified EMTs or paramedics) and hospital transport personnel in direct contact with suspected and/or confirmed COVID-19 patients
Persons providing direct medical care in correctional facilities
Persons providing direct medical care in dialysis and infusion centers
Workers in outpatient medical settings treating persons with suspected or confirmed COVID-19 infection
Workers in settings where monoclonal antibodies for COVID-19 infusions are given
Home health and Hospice workers
Public health nurses/personnel at risk for COVID-19 exposure
Autopsy room staff, coroners, embalmers, and funeral home staff at risk of exposure to bodily fluids
Dentists and dental hygienists and assistants

Phase 1b

Persons aged 75 years and older (with or without underlying health conditions)
Frontline essential workers (sectors included by ACIP include fire fighters, law enforcement officers, corrections officers, food and agricultural workers, United States Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the educational sector—teachers, support staff, and daycare workers)

Phase 1c

Essential workers not included in Phase 1b (examples included by ACIP include people who work in transportation and logistics, food service, housing construction and finance, information technology, communications, energy, law, media, public safety, and public health staff who are non-frontline healthcare workers)
Persons aged 65-74 years (with or without underlying health conditions)
Persons aged 16-64 years with underlying health conditions that increase the risk for severe COVID-19 (more information to follow from the SC COVID-19 Vaccine Advisory Committee)

As vaccine supply increases, ACIP vaccination recommendations will expand to include more groups, in Phases 2 and possibly 3. The following outline provides an overview of estimated timeframes for each phase:

Early Winter – Vaccinations for Phase 1a is anticipated to continue through February 2021.
Late Winter to early Spring – Based on current CDC guidance, the state will move into Phase 1b once 70 percent of South Carolinians identified in Phase 1a have been vaccinated.
Spring to Summer – Phase 2 is anticipated to begin in Spring 2021, with the vaccines expected to become available for the general public during the summer and fall of 2021.

Understanding the Next Steps in the Phased Vaccine Roll Out

Everyone in our state who wants to be vaccinated will get their turn. In the meantime, we commit to keeping you informed of the progress being made in the phased approach for administering vaccines and will let you know when and where you can receive it. We call on all South Carolinians to step up by stepping back until it is their turn in the plan.

For individuals in Phase 1a who have not been contacted regarding an opportunity for vaccination yet, DHEC is working with our partners at SCHA and SCMA as well as numerous independent providers and vaccination locations to onboard them and allocate and distribute vaccines in the coming weeks. As more locations for vaccination become available, we will be contacting healthcare workers via their employers, associations, or licensing entities to provide a way for them to sign up if they wish to be contacted when it is their turn to make an appointment for vaccination. It is going to take several weeks to a couple of months to vaccinate all members of Phase 1a, so please be patient as we go through this process.

As more information becomes available, we will update our website at scdhec.gov/vaxfacts.