DSHS’s Imelda Garcia discusses Texas’ unique Phase 1B population in vaccine update

In a meeting of the Texas Task Force on Emergency Disease Preparedness and Response Friday Imelda Garcia, associate commissioner of Laboratory and Infectious Disease Services, presented updates on vaccine distribution in the state. She also highlighted how the state’s 1B population differs from what was recommended by the CDC.



“Texas definitely took a different approach than what the CDC and the Advisory Committee on Immunization Practices had laid out for the next eligible population,” she said. “We looked at the data, we looked at where the burden of the disease was, we looked at the outcome, and really debated wholeheartedly what populations should really go first. At the end of the day, where Texas ended up is that we prioritized those that are the most vulnerable for severe outcomes, that being hospitalizations and deaths, with this vaccine priority.”

Texas’s Phase 1B population includes people 65 and older as well as people of 16 years and older with at least one chronic medical condition such as cancer, chronic kidney disease, heart conditions and other diseases that increase an individual’s risk of vulnerability to COVID-19.

“I think that our pivot away from the CDC and the Advisory Committee on Immunization Practices is a significant one, but it is one that is rooted in the data,” she said. “It is rooted in trying to have equity in distribution, and really trying to prioritize those that are truly most vulnerable for those severe outcomes.”

According to Garcia, while vaccines are still in limited supply, the state expects them to soon become more widely available as manufacturers ramp up production.

Texas is still in Phase 1 of its distribution program, in which vaccines are directly shipped to registered providers to give vaccines to frontline health care workers, she explained. She said approximately 1.6 million health care workers in Texas are eligible to be vaccinated. In late December, large chains also received vaccine shipments to provide its targeted populations in long-term care facilities through the CDC’s long-term care program, she said.

Phase 2 is set to begin in March, when the state predicts vaccine supply will increase, according to Garcia. During this period, the state will ensure all Phase 1 populations who have not received the vaccine have access to it, and the network of providers offering the vaccines will increase. Phase 2 also includes the use of specialized vaccine teams who will vaccinate groups who lack access to the vaccine, like rural communities.

Phase 3 is slated to begin in July, when there will be a “sufficient supply of vaccine doses” for the entire Texas population, according to Garcia. This phase will focus on ensuring equitable access to the vaccine across Texas. Phase 4 is predicted to begin in October, when the state will no longer be involved in administration and providers can order the vaccine on their own.

“We have people in every county across the state that have received a COVID-19 vaccine, so I do think that it’s a huge success to our local partners on the ground and the efforts, outreach and recruitment that they’re doing day in and day out,” she said.

She spoke about the 17-member Expert Vaccination Allocation Panel (EVAP), which makes recommendations to the state about the best vaccine distribution practices. Some of EVAP’s guiding principles are protecting health care and frontline workers, mitigating health inequities and using data-driven allocations for distribution.

Garcia cleared up potential confusion about second dose allocation, denying the claim that providers withheld their initial vaccine allotments because they thought they needed to save them for second doses. She said the state will administer second doses separately when they are needed, which, for Texas, was the week of Jan. 4th for Pfizer, and is the week of Jan. 11th for Moderna.