The Montgomery County Public Health District is working through preliminary planning for distribution of COVID-19 vaccines to county residents, which could begin before the end of the year.

While no vaccine for the coronavirus has yet been approved or authorized by U.S. Food & Drug Administration regulators, dozens of candidates across several clinical trial stages remain under development worldwide, and a vaccine could reach some Texans this year.

Most recently, Pfizer Inc. and BioNTech SE announced Nov. 9 that their mRNA-based vaccine had proven effective in preventing COVID-19 infections for 90% of participants in a Phase 3 clinical study of its candidate. The companies said they plan to seek Emergency Use Authorization from the FDA later this month following the collection of additional required safety information, and up to 50 million vaccine doses could be produced worldwide in 2020, with up to 1.3 billion doses following in 2021.

Once a vaccine is widely available, information from state and county sources indicates the Texas Department of State Health Services and county health organizations will begin the process of distributing the vaccine to Texas residents.

In Montgomery County, Public Health Director Alicia Williams said county health officials have been advised to expect leading vaccine candidates, such as Pfizer's, as soon as late November or early December.

Williams said nearly 40 county pharmacies, hospitals, urgent care centers and doctors' offices, including the Montgomery County Public Health Clinic itself, have already registered with the state as COVID-19 vaccine providers, and more are expected to sign up through the end of November. Once a vaccine is available, Williams said, providers countywide will receive vaccines from the state based on individual need and capacity.

“We don’t know exactly how many we will be getting as a county or even as an individual provider," she said. "It’ll be that they allocate 'X' number. There’s a formula that they’re using for our ability to store the vaccine correctly and also how many vaccines ... we can actually provide at our locations.”

Based on initial state guidance, only some Texans would be eligible to receive vaccines in 2020 through Phases 1A and 1B of the immunization rollout due to expected limited supply this year. The first in line would be health care personnel, including hospital and pharmacy workers; first responders; and some education staff in Phase 1A. They would be followed by those age 65 and older and those with comorbidities for the virus in Phase 1B. The CDC defines comorbidities as underlying medical conditions which put someone at higher risk of severe COVID-10 illness.

Additional "critical populations" not served during Phase 1 would become eligible for vaccines in Phase 2, which would begin in early 2021. That would be followed by widespread vaccine availability for the general public in Phase 3 beginning next summer, according to DSHS.

Through all phases, Williams said Montgomery County residents can expect minimal- or no-cost vaccinations. Health care providers may not charge for the vaccine itself, although administrative costs at private locations may vary.

Williams said the county public health clinic—which typically only serves patients who are under-insured, uninsured, or Medicaid-eligible—could provide its vaccinations to all county residents either for free or with an administrative fee of up to $10.

Williams said Pfizer and Moderna Inc.—which shared updates this week on the first analysis and review of its candidate—may be the closest to completing their trials and passing through federal regulations. Both companies' vaccines would be provided in two separate doses, she said.

Leading up to the availability of a COVID-19 vaccine in Montgomery County, Williams said, the county health district also plans to engage in educational campaigns about safety and recommended use for residents on social media and through local providers.

“It is exciting. It's also stressful, and so we’re trying to make sure that no matter what cards we’re dealt, ... we can provide protection for our community and our residents. We are excited to do it," she said. "We are patiently waiting to see what comes first, as far as vaccines go."

The public health district recommends all county residents receive vaccinations for the flu and, eventually, for the coronavirus, Williams said, and anyone with questions about vaccines or the coronavirus itself may contact the public health district.