Florida doesn’t know where Publix will send vaccines
Florida’s public health officials don’t know where Publix will distribute COVID-19 vaccines it sends to the grocery chain. The Department of Health sends them with no plan.
State officials have shipped 70,000 COVID vaccine doses a week to Publix’s central distribution hub in Lakeland in Central Florida, without knowing exactly where the shots will end up, or even which counties they are destined to reach, a Miami Herald analysis of state vaccine distribution data from the past five weeks and interviews with state officials found.
The grocery chain — a major financial
supporter of Gov. Ron DeSantis — is the state’s single-largest vaccine supplier and receives nearly a quarter of the state’s available doses without providing state officials a storespecific distribution plan ahead of time, according to Jared Moskowitz, the director of the Florida Division of Emergency Management, the agency leading the vaccination campaign.
What’s unusual is not that a retail chain with pharmacies is involved in distribution efforts but that in Florida, Publix made unilateral decisions about distributing 23% of the state’s weekly doses, the most received by any provider in the state for the past six weeks, distribution data obtained and analyzed by the Herald show. Public health officials do not know which specific stores receive vaccines until after the shots are administered, Moskowitz told the Herald. The chain reports “shots in arms” to the Florida Department of Health through a different portal only after the fact.
Moskowitz said Florida’s arrangement with Publix is “imperfect” but prioritizes getting as many people vaccinated as quickly as possible.
“My mind-set is about speed,” he said.
After publication, Moskowitz contested the description of Publix’s decision-making on where to distribute weekly allotments of vaccines as “unilateral,” but could provide no details about the state’s involvement in shaping those plans.
Experts interviewed by the Herald say Florida’s arrangement with Publix underscores a lack of public health principles guiding the state’s vaccination campaign.
“Publix is not a public health entity. It should not be relied on to make decisions about the geographic distribution of vaccines,” said Thomas Hladish, an infectious disease expert at the University of Florida. “That is something that should be informed by current transmission and the history of the pandemic in the different parts of the state. You should be targeting places that have more susceptible people.”
Florida’s weekly allocation data include specific locations for vaccines headed for hospitals, major vaccination sites such as Hard Rock Stadium and Tropical Park, for example, and include the destination county for smaller “mission-focused” deliveries of doses to places like Black churches. Publix was the only exception, and shows a lump sum given to the chain without even a county-level distribution breakdown.
The Herald’s analysis of Florida’s vaccine distribution did not account for about 30,000 doses shipped to hospitals in the month of February, which were set aside for healthcare workers and the medically vulnerable.
While many retail chains in Florida are receiving vaccines, Publix is the only one receiving doses from the state government. The federal government separately supplies vaccines to Publix, Sam’s Club and Winn-Dixie. The state distribution data provided to the Herald do not include vaccines distributed by the federal government.
A spokesperson for the
Centers for Disease Control and Prevention said that the weekly vaccine allocation for the federal pharmacy program is divided per capita and then allocated to the retail chains, who decide “in close coordination” with federal health officials how many doses will be shipped to each location based on supply, how much capacity the stores are estimated to have, and demand.
In response to questions about its distribution decisions for the doses provided by the state, Publix spokesperson Maria Brous said in an interview last week, “Doses vary by location and many factors go into that decision process.” She provided no further details in response to follow-up questions.
Moskowitz conceded that not knowing ahead of time makes it difficult for DOH to achieve its goal of dividing the state’s total weekly supply among the state’s 67 counties based on each county’s portion of Florida’s 65-and-older population, the most vulnerable to severe infection.
“What’s going to Publix comes out of the equitable distribution based on the 65+ older population,” Moskowitz said. “If I didn’t take into account Publix’s [doses] … the county that had Publix would be getting more doses if it didn’t count against the 65+ distribution.”
With nearly one of every four of Florida vaccines’ final destination unknown, the calculations for allocating the remaining doses are guesswork rather than informed public health decisions.
Depending on the week, Moskowitz said, the state has based its plan for the remaining available doses on everything from an assumption that Publix would distribute the vaccines equally between stores to building spreadsheets that use store-specific vaccination administration data from the previous week to make educated guesses as to how Publix plans to use the next week’s supply.
The dizzying churn of Publix pharmacies offering vaccines across the state would undercut even DOH’s best predictive model. By the last week of February, Publix had stopped giving vaccines at 80% of locations offering shots at the beginning of the month, according to a Herald analysis of Publix vaccine location lists from Feb. 1 and Feb. 23. Twenty counties lost all of their Publix locations, while the chain opened vaccine locations in stores in 13 new counties.
The lack of locationspecific distribution plans from the grocery chain leaves DOH unable to account for any of those changes until after they happen and could cause the state to unintentionally undersupply some counties with vaccines while oversupplying others. In counties where Publix closed all vaccine locations by Feb. 23 for example, only half saw an increase in the portion of total vaccines sent to their other locations that week — a bump in supply that would be expected under an allocation plan that successfully accounts for whether Publix locations are offering vaccines in the county.
The guessing game around the distribution of nearly a quarter of Florida’s total vaccine supply might help explain why different parts of the state have varied so significantly with vaccine coverage. A handful of counties have vaccinated 70% or more of their 65-and-older population, while most of the rest of the state hovers around 50%, according to data published by the Florida Department of Health.
Zinzi Bailey, a research professor at the University of Miami who studies healthcare inequities, said that a successful vaccine campaign depends on transparency and accountability. The state should be sending more doses to health officials who have the ability to target people most at risk for getting or spreading COVID, and less to a private partner with no publicly available distribution plan, even if that partner has experience in distribution and logistics, Bailey said.
“There shouldn’t be a question about where those doses were administered,” she said. “... If there is a discretionary fraction of vaccines, that should be the smallest fraction.”
The Herald found that less than 4% of the state’s total vaccine supply went to vaccination initiatives through churches and other community outreach centers, which officials have said are a critical part of the efforts to reach underserved communities.
“I am a little bit worried about that level of accountability for almost a fourth of the vaccine allocation in the state compared to 4%, which would be going to mission-oriented work,” Bailey said.
OTHER STATES HANDLING IT DIFFERENTLY
Although no two states are handling vaccine distribution in exactly the same way, Florida’s handsoff approach to distributing vaccines through Publix differs from other states.
The grocery store chain Giant provides vaccines at stores in Delaware, Maryland, Virginia and Washington, D.C.
Delaware tells Giant how many doses the chain will be getting and asks how many should be sent to each specific store, according to Samir Balile, pharmacist and Giant’s clinical programs manager. Other states simply send doses directly to individual stores, he said.
“It’s important that jurisdictions work with their retail pharmacy partners to make sure vaccines are equitably distributed and allocated to communities in need,” Balile said.
In Pennsylvania, Rite Aid, Topco and CVS all receive vaccines to specific stores based on an allocation plan designed by public health officials, according to Maggi Barton, deputy press secretary for the Pennsylvania Department of Health.
Barton said the health department makes its distribution plan based on providers’ current allocations, amount on hand for distribution, amount administered, population, percent positivity and death rates.
Hladish, the UF epidemiologist, said there is no one simple answer as to the best way to distribute vaccines, but that like Pennsylvania, Florida health officials should be creating statistical models that consider, for example, which parts of the state have generated more transmission, population density, the age distribution of various areas and the prevalence of the disease there, as well as how many deaths a place has endured.
“I don’t think that a grocery store chain has the capability to do that kind of analysis,” Hladish said.
In Florida, Publix has worked independently of county health departments running vaccination sites overrun with demand.
“We basically have knowledge of [Publix] giving vaccines, but we don’t have the intricate knowledge of how many,” said Jeff Tambasco, the director of emergency management in DeSoto County. But he said he’s not concerned. “We know the vaccines are being administered. At the end of the day, that’s the most important part.”
CONCERNS ABOUT UNEQUAL ACCESS
The race to vaccinate Floridians is a multipronged effort by necessity. Retail chains across the country have filled in gaps in public health infrastructure.
“Some of these Publixes have really filled a need, getting into communities in a convenient way,” DeSantis said at a press conference on Feb. 5.
But Publix has not served all Florida residents equally.
In February, Publix offered vaccines first in areas that tended to be both wealthier and whiter than average, according to an analysis using data from the U.S. Census Bureau and lists of Publix stores offering vaccines from Feb. 1 and Feb. 23.
At the start of February, none of the 324 Publix stores offering vaccines were in Florida’s eight counties where census data show over 25% of residents are Black. By Feb.
23, Publix had opened 36 vaccine locations in two of those counties. The others still had none.
The funneling of so many doses to Publix comes with a backdrop of months of stark disparities in how people from wealthy ZIP codes are getting vaccinated at higher rates than in poorer ones. The Miami Herald has also found that the state’s vaccination campaign is leaving behind Black residents of South Florida, who have disproportionately low rates of getting shots.
In Palm Beach County, which initially received vaccines solely through 67 Publix locations, the Sun Sentinel reported in January that county commissioners voiced concern that the locations of the stores privileged some residents over others.
“I use the term ‘vaccine desert,’ ” said County Commissioner Melissa McKinlay, the Sun Sentinel reported. “We’re moving all of this into the hands of Publix.”
Health experts say even without the ambiguities brought on by Publix’s lack of transparency, Florida’s simple, age-based model leaves out important public health considerations.
Michael Lauzardo, a pulmonary disease specialist with the University of Florida, said the state has thus far distributed the vaccine like a commodity, based on demand, rather than a public health resource.
“You’ve got to generate demand and get more supply to meet that,” Lauzardo said. ”We can’t just treat this like a commodity. It’s a necessity.”
Doses should be distributed to parts of the population in a given county that might be more vulnerable to the disease or more prone to spreading it, he said. Otherwise, he said, as demand starts to tick down, certain demographics — young people, those living in rural areas and African Americans, specifically — will have less coverage.
“We need a strategy to be able to engage those groups because we don’t get to herd immunity without them, and nobody gets left behind,” Lauzardo said.
Bailey, the research professor at the University of Miami, stressed that the state needs to demonstrate that its resources are being allocated fairly in order to quell concerns in the very communities they are seeing fall behind in vaccination rates.
“Otherwise, we are fueling further distrust in the process,” Bailey said. “Distrust in vaccination, distrust of the medical system, and distrust of government systems.”
In Florida, it’s becoming increasingly difficult to tell the difference between a Republican leader and a fascist.
Or, more to the point, to tell the difference between a GOP lawmaker and something we know all too well in Miami: a freedom-stifling representative of the Cuban government.
Nothing highlights the comparison better than state Republicans’ latest bid to ideologically manipulate education by steering students away from a liberal-arts education that might teach them to think critically.
Alarm bells should be going off for every parent in the state, given that Senate Bill 86 would force students to choose only state-sanctioned subjects of study in college — or risk losing their Bright Futures Scholarships.
Florida students are awarded this financial aid based on merit and hard work, paid for by Floridians’ investment in the state’s lottery. This aid is most accessible to a larger number of students, especially minorities.
Let me spell out exactly what’s going on: Republican Sen. Dennis Baxley, of Ocala, wants to force your child to choose the course of study he, and if the bill passes — the state — think would be best.
That is s-o-o-o 1960s Fidel. After all, the infamous dictator’s education system did just that: told students and parents what school choices to make.
The Cuban state assigned students’ careers, and if they wanted to study something else, they were told, “Sorry, no slots open for that.” If a student was deemed ideologically unsuited for a career, it was also taken off the table.
We all know the disastrous results of the failed Cuba experiment: engineers driving taxis to make a living; medical workers serving cocktails in hotels for dollars; millions fleeing the country.
As with Florida’s proposed crackdown, Cuba’s ultimate goal was dogmatic. The Republicandominated state Legislature has been trying for years to turn Florida colleges and universities into graduation mills for conservatives.
In the minds of people like Baxley, a funeral director by trade, nothing good ever comes from a degree in English literature — or sociology.
He told the Tampa Bay Times that his bachelor’s degree in sociology, with a minor in psychology, has helped him better understand people, but it gets you “two bucks and a cup of coffee in most towns.”
Yet, he seems to have successfully raised a family and made a good living burying Ocala’s dead for five decades.
Baxley argues that his intention with SB86 is to steer students to money-making majors and jobs. He’s only responding to the needs of industry, he says. But economic reasons don’t make his edict any less of an imposition on personal choice.
Plain and simple, by blacklisting majors, he and the Republicans who back him are messing with the freedom students and their parents have in this country to make their own educational decisions.
Real conservatives working on behalf of smaller government, the bill’s backers are not.
But the fascist streak isn’t surprising. With each legislative session, state Republican lawmakers’ actions take on an uncanny resemblance to Cuba’s repressive brand of rule. There’s no area of our lives these Republicans don’t want to legislate into submission.
During this session, which officially opened Tuesday with Gov. Ron DeSantis’ State of the State address, Republicans also will consider — at the behest of the governor — bills to suppress access to public information, make it harder to vote, and stifle free speech with anti-protest laws designed to have a chilling effect on activists.
Baxley is also sponsoring a bill that restricts vote-by-mail requests to one election cycle instead of the current two and requires everyone who voted by mail in November to reapply in 2022. He can dress it up anyway he wants, but it’s a move to make sure the high turnout of minorities we saw in 2020 doesn’t repeat itself when dog-whistling DeSantis is up for reelection.
All of these measures are major assaults on liberties. Cuba’s “Ley 349,” which criminalizes artistic expression and activism that deviate from governmentestablished norms, comes to mind.
Given their constant vigilance over Cuba’s affairs, you would think that Miami’s Republican state lawmakers might be sensitive to having Floridians’ rights curtailed.
But, oh, the silence.
It’s all galling, but particularly so, with legislators like Sen. Manny Diaz of Hialeah, who has made a career of funneling state funds to private education in the name of “school choice.”
Now, an education bill threatens to cut in half Bright Futures for students who don’t pick a major the state finds worthy, and they’re OK with sticking it to South Florida’s diverse student population if it pleases The Party.
Silence is one way to kill democracy. Another is not knowing what you’re voting for and being duped, election after election, by Republicans who spread lies that equate socialism with the Democrats — then foist repressive laws on us.