Obstacles jam distribution of vaccines

In some cases, doses in the Dayton area have sat on shelves forweeks.

Weeks after delivery, thousands of coronavirus vaccine doses locally and millions of doses nationwide are sitting on shelves instead of getting into arms.

Between 5 million and 6 million Americans have received the fifirst dose of a two-shot regimen, according to the Centers for Disease Control and Prevention, far fromthe federal government’s goal to give the fifirst shot to 20 million people before the end of 2020.

Asof Friday, 576,000doses had been sent to Ohio in the nearly four weeks since the fifirst shipment arrived on Dec. 14, according to the CDC. But less than half of those doses have been administered, according to Ohio Department of Health numbers. And Ohiois doing better than about 30 other states.

Ohio Gov. Mike DeWine has said he is not satisfified with the rate at which the vaccine is being distributed in the state and has urged providers to move faster, even setting a goal for hospitals to administer doses within 24 hours of receipt.

“( The vaccine) does no good sitting on a shelf,” he said. “Waiting two or three days, five days, whatever, someone could have been vaccinated and been protected that period of time. So there’s a moral imperative that we push this as hard as we can.”

About 2% of Ohio’s population — less than 25% of the 1 million Ohioans in the fifirst priority group (frontline health-careworkers and group living residents)— had received their fifirst dose, as of Friday afternoon. Against this backdrop, Ohio is preparing to begin vaccinating Phase 1B in two weeks while it fifinishes Phase 1A.

At the rate of 100,000 doses administered per week, itwould take months to completephase 1Aand1B, let alone inoculate all of the willing 11.7million Ohioans.

Experts and leaders say this vaccinerollout isunprecedented in American history and providers are doing the best they can within an underfunded public health systemwhile receiving scant information and battling skepticism. Federal guidance has been lacking, and health leaders say a coordinated plan from the topdown that utilizes every resource possible is needed.

How is Ohio distributing the shots?

Each state is distributing the vaccine difffffffffffferently. For this fifirst round of vaccinations, Ohio is using a patchwork of providers: hospital networks for most healthcare workers, local health departments for emergency medical service personnel and some others, and retail pharmacy chains for residents and staffff at long-term care facilities.

While someproviders (like theClarkandGreeneCounty healthdistricts) aredistributinganentireshipmentwithin days of its arrival and begging for more supply, others (like PremierHealth) are sitting on thousands of doses and only distributing the last of their shipment over two weeks later.

Some providers and the Ohio National Guard were not tapped for Phase 1A but mayhelpwith futurephases.

Doses in the Dayton region

Premier Health received 5,900 vaccine doses to its locations betweenDec. 21-23. A spokesman said Friday morning the network will administer about 90% of that first shipment by the end of Saturday. Meanwhile, the hospital network has received shipments of 3,500 additional doses.

Dr. Roberto Colon, the associate chief medical offifficer ofMiami ValleyHospital, saidPremierHealth is “meeting the spirit” of the governor’s goal. Colon pointed out that small subpopulations in Phase 1A were initially prioritized and there were two major holidays recently.

“Looking back, there are things that we can learn from our vaccination process every single week,” he said. “And we get faster and faster and faster for a process that is brand new.”

AspokeswomanforMercy Health said on Wednesday that Springfield Regional Medical Center had administered more than 975 of the 2,500 doses it received, and Fairfifield Hospital had given out nearly 825 of the 1,100 doses it received. Thespokeswoman declined to answer questions about the challenges of distributing the vaccine.

A spokesman for KetteringHealth Network said the hospital systemhas received 9,300 doses, but he declined to say how many shots the hospital systemhas administered. Dayton Children’s did not respond to requests for comment.

The obstacles

Besides a lack of supply coming intoOhio, a problem that can only be addressed on a national level, a many issues have contributed to a slow rollout. Health-care leaders pointed out that this undertaking kicked offff just before two major holidays.

AnalystLorenAntheswith the Cleveland- based Center for Community Solutions said Ohio and other states’ decisions to underfund public health infrastructure is “coming home to roost.”

Ohio spent $ 14 per person on state public health funding in 2019, according to State Health Access Data Assistance Center, a health policy research center. Only three states spent less than Ohio. Because the state’s public health infrastructure is underdeveloped, Anthes said, it must rely on private entities like hospitals and pharmacies.

When this began, health departmentoffifficials andhospital administrators didn’t know exactly when their fifirst shipments would arrive or how many doses would be in the box. They’re still not given much warning. County health departments find out each Friday how many doses they’ll likely

Public Health-Dayton& Montgomery County distributes doses of the coronavirus vaccine produced byModerna toemergencymedical service personnel and members ofOhio’s Phase 1A priority group.

receive the following week any time between Monday and Wednesday. This lack of specififics canmake it diffifficult to schedule individuals in advance for their shots, said public health offifficials.

Local providers also were not supplied with any systemfor scheduling or tracking patients, anecessary and tricky task as both coronavirus vaccines approved for emergency use by the federal government require two doses. Since neither the federal or state governments developed a central system for scheduling, each clinic is left to purchase software.

Meanwhile, many Ohioans who are eligible to get the shot early are passing on the opportunity. According to DeWine, 60% of longtermcarestaffffmembershave opted not to get the shot.

Clark CountyHealth Commissioner Charles Patterson said about 46% of the county’sEMSpersonnel that were offffffffffffered the shot took it. A spokesman for Public Health-Dayton & Montgomery County said 31% of the county’s EMS workers have gotten the vaccine so far, but he’snot sure if the remaining individuals don’t want it or haven’t had time to schedule the shot yet.

Colon, ofMiamiValleyHospital, said interest in receiving the vaccine remains high among health-care workers, particularly those involved in the direct care of COVID patients. However, less than 50% ofMercy Health Springfifield employee who are eligible for the vaccine want it, saidMercyHealth-Springfifield President Adam Groshans.

Possible solutions

Some offifficials areworried about reports of low vaccination uptake. Ohio House Minority Leader Emilia Sykes, D-Akron, said more needs to bedone to acknowledge the public’s fears and educate Ohioans on the vaccine, especiallyamongmembers of the Black community, many of whom distrust the health-care system. DeWine has previously said the state is partnering with faith leaders to reach the Black community on this topic. Sykes said that’s not enough.

Patterson said he is not concerned about youngEMS andhospitalworkersnot getting the vaccine. They’re hesitant to go fifirst butwill hopefully get the vaccinewhen it’s available to the general public later, he said. Over 75% of nursing home residents in Ohio are opting for the vaccine, DeWine said. The large part of the next priority group, adults age 65 and older, will likely followsuit, Patterson said.

“Thedemandfar outstrips the supply,” he said.

Other states have put increased pressure on hospitals to distribute their vaccine. New York state is fifining hospitals and cutting offff their supply if they don’t distribute all their doses in a week. Florida is allocating doses to hospitals that distribute them the fastest.

Some lobbyists sayproviders should be sharing excess supply with other providers. Antonio Ciaccia, a Columbus- based adviser for the AmericanPharmacistsAssociation, said it’s “absurd” to

send doses to entities that haven’t depleted their previous shipment.

“We should not be shippingvaccines toplaceswhere they’re going to collect dust,” hesaid. “Idon’tknowif that’s an indictment of (these hospitals) or an indictment of those who are making the decisions to ship to them.”

Approximately 1,700 providers, including retail pharmacies and primary care offiffices, have registered with the Ohio Department of Health, been trained and are waiting for marching orders. DeWine announced plans on Thursday to utilize an unspecifified number of these institutions inPhase 1B.

Dr. Gary LeRoy, associate dean at theWright StateUniversity Boonshoft School of Medicine and former president of the American Academy of Family Physicians, also suggested that providers could be given latitude from the state tomove onto vaccinating the next priority group if not enough members of the fifirst group want the shot.

Ultimately, beyond a steady supply of vaccines, health leaders said more information from the topdownwouldhelpthemplan.

“It will get faster,” LeRoy said. “I think that nowsince there’s more discussion about, OK, what has gone right, what hasn’t gone so well, now, I think we will see a bit more traction.”