After Fast Start, Connecticut Broadens Vaccinations with Uncertain Distribution

As phase 1B of the vaccine rollout is set to begin today, regional health officials have been voicing frustrations over the last week at the uncertainty surrounding the number of vaccines that they will receive on a weekly basis, a problem which they hope will stabilize as the state administers the vaccine to a much broader population.

This phase includes 1.367 million people, according to a presentation given by Benjamin Bechtolsheim, the current director of the COVID-19 vaccination program, to the Governor’s Vaccine Advisory Group on Thursday.

Included in Phase 1B are frontline essential workers, all individuals 64 and over, individuals ages 16-64 who have a prior health condition, those living in congregate settings and frontline essential workers — teachers, food service workers, agricultural workers, sewage and wastewater workers and first responders.

Bechtolsheim said that of the 210,000 doses the state has received so far, 155,000, or approximately 73 percent, have already been administered. 

Connecticut is currently receiving between 40,000 and 80,000 first doses of the vaccine every week. Additional doses could push the number to 200,000 first and second doses that the state will receive next week. On Tuesday, Gov. Ned Lamont announced that the federal government had promised to send Connecticut a one-time shipment of 50,000 additional doses because of the state’s early success in distributing the vaccine. Connecticut is fourth in the nation in terms of the percentage of vaccines delivered from the federal government that have been administered throughout the state, according to data from the CDC

Other states that have had notable success in the vaccine rollouts include West Virginia, North Dakota and South Dakota. Like Connecticut, these states went beyond the federal recommendations for phase 1A and 1B. South Dakota added corrections officers and law enforcement to Phase 1A, and West Virginia added individuals over the age of 80 to its 1A category, according to information from the Kaiser Family Foundation.

North Dakota and West Virginia also relied heavily on local pharmacies to administer vaccines to long-term care facilities rather than large chains, which may have cut through some of the red tape that has tied up other states, an article in Becker’s Hospital Review suggests. The same article attributes Connecticut’s success to the state’s strong coordination with hospitals and the large pharmacy chains, CVS and Walgreens. 

Oklahoma and Utah, the states with the closest population sizes to Connecticut, rank 13th and 14th for vaccine distribution, respectively, according to the CDC. 

A challenging regional distribution

Bechtolsheim said that upward of 90 percent of vaccines delivered to hospitals and local health districts have been administered. However, demand has far exceeded supply, and many of the health districts are receiving a fraction of what they order — if they receive anything at all. 

Scott Martinson from the Connecticut River Area Health District said they ordered 500 vaccines last week and received 200. Mansfield and Steve Civitelli, director of the Wallingford Health District, said that there was one week in which their districts received no doses at all. Kevin Elak, acting director of health for the City of Middletown, said that prior to this week, they also had not received any doses of the vaccine. When he made the request, Elak said, he was told that the number of the requests from the health departments were double the number of doses available. 

A number of  regional health district directors told CT Examiner that this uncertainty has made it extremely difficult to plan correctly for their clinics. Stephen Civitelli, director of the Wallingford Health District and a member of the Governor’s Vaccine Advisory Council, said this was the biggest complaint he heard from other health districts.

Health districts place orders for vaccinations on Wednesdays, and they find out on Friday what number of vaccinations have been approved. When they receive the vaccines on Monday, they start scheduling appointments for the clinics for that week. 

“It’s a moving target for sure,” said Mansfield. 

Health districts in addition reported that a new mandate from the Department of Public Health has caused some districts to halt or delay the start of vaccination clinics. According to Patrick McCormack, director of UNCAS Health District, the local districts now need to have a standalone freezer to store the vaccine doses. 

Steve Mansfield, the director of Ledge Light Health District, said that originally the district had been instructed not to spend money on a freezer, since there was little likelihood that the towns would be receiving the Pfizer vaccine, and the Moderna vaccine could remain stored at refrigerator temperatures – between 36 and 46 degrees Fahrenheit. 

However, in recent weeks the Department of Health changed its recommendations. McCormack said that the state’s concern was that in the event there was a power outage, having the vaccines frozen would buy the health districts more time to find people who could be vaccinated once the doses thawed. McCormack said that UNCAS did not have a standalone freezer — all it had was a freezer/refrigerator combo the district purchased during the H1N1 epidemic. 

McCormack and Mansfield partnered with local hospitals who agreed to store the vaccines for them while they waited for the freezers to arrive. McCormack said that UNCAS wasn’t able to hold a vaccine clinic that week. Charles Brown, head of the Central Connecticut Health District, also said that he had to delay ordering vaccines because he didn’t have the proper freezer.

Mansfield said that, in addition to having enough vaccines, health districts still needed clear guidance on who is eligible under phase 1B. He said he also hopes the mandatory use of the VAMS system for scheduling vaccine appointments would be relaxed so that the districts could focus less energy on administrative tasks and more on administering doses of vaccines.   

“I’m telling everyone, just, patience”

Regional health officials say they are hopeful for more vaccines arriving next week with the rollout of phase 1B.  

Elak said that he expects that Middletown will receive 400 of the 500 doses they requested this week. Martinson predicted that the allocation of doses “should get better over time.” Mansfield said that for the last two weeks, Ledge Light has received all of the 200 doses it ordered, and said that he hopes this means the supply chain is opening up. 

Brown said that the lack of communications was “challenging,” but that he assumed the state wasn’t receiving  the best information from the federal government. He compared the lack of vaccines to what happened during H1N1. 

Maura Fitzgerald, a spokesperson for the state Department of Health, said in an email that regional availability would be decided on the basis of several favors, including the number of doses a health district can distribute within a certain timeframe, how many doses the district has left over, and the population being served.

“In times of lean allocation it sometimes is just a matter of not having enough doses and trying to make as much go around as possible,” said Fitzgerald. 

State Sen. Heather Somers, R-Groton, a member of the Governor’s Vaccine Advisory Group, said that with Connecticut receiving about 44,000 doses per week, and over 1.2 million people eligible as part of phase 1B, it would necessarily take time to vaccinate everyone. 

“I’m telling everyone, just, patience,”said McCormack. 

Bechtolsheim said on Thursday that he expects the number of weekly first doses to remain steady after a temporary surge of expected additional doses.He predicted that if 75 percent of people eligible in phase 1B opted to take the vaccine, the state would remain in this phase through May. 

The state is working on several other initiatives to improve the vaccine rollout, including allowing doctor’s offices that serve elderly patients to administer the vaccine, creating a COVID-19 access line with the help of nonprofits, and using the CDC Social Vulnerability Index to determine where to make vaccines available to high-risk individuals.

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