The Arizona Republic

Arizona’s COVID-19 vaccine rush may be over

- Stephanie Innes and Alison Steinbach

An intense scramble for COVID-19 vaccines in Arizona that just weeks ago caused frustratio­n, lineups and website problems appears over.

While there are still some areas of Arizona with a steady demand for vaccines, appointmen­ts generally are easier to find and, in some cases, not getting filled.

Part of what’s happening is a shift, where doctor’s offices, pharmacies and neighborho­od clinics are expected to eventually become the go-to places for the COVID-19 vaccine, rather than

large-scale vaccinatio­n sites.

Data from the Arizona Department of Health Services says nearly 37% of the state had received at least one dose of COVID-19 vaccine as of Thursday, and about 24% of the state is fully vaccinated.

“Just a few weeks ago, the idea of being able to hop on to CVS’ site and ADHS’ site and find open appointmen­ts would have been unheard of,” said Raymond Embry, CEO of Embry Health, which offers COVID-19 vaccines at clinics across Arizona.

Health experts say it will take at least 70% more of the state’s population to get vaccinated in order to reach what’s known as herd immunity, where enough people are immunized to prevent future outbreaks from occurring.

“I think we are going to start to see less demand for mass vaccine sites like ADHS is doing and instead smaller sites embedded in the community, like ours, like CVS, Walgreens, doctors offices. Those are going to be the most important places where people are getting vaccinated,” Embry said.

Medical providers and county and state health officials are trying to get the word out that safe and effective COVID-19 vaccines are available at no cost at various locations, including largescale vaccine sites in Maricopa, Pima and Yuma counties, as well as at pharmacies and community clinics.

Patients are unlikely to face as many of the hassles associated with getting a vaccine that were stumbling blocks earlier on in the rollout.

Pleasant Pediatrics, a chain of Valley area pediatric clinics that has expanded its practice to administer COVID-19 vaccines to adults, this week said they have recently seen a decrease in demand, leaving them with a surplus of doses that could expire.

The medical practice already has distribute­d more than 30,000 vaccines. But just 4,000 appointmen­ts were filled this week out of 6,000 available, practice leaders told The Arizona Republic on Monday.

As of Thursday, Pleasant Pediatrics still had appointmen­ts available for this week and next week.

State-operated sites have seen a much slower uptake when it comes to booking appointmen­ts, which are released for the following week each Friday.

While Phoenix-area mass sites were largely booked through Sunday from the appointmen­ts released last week, the Yuma and Tucson sites still had appointmen­ts available as of Thursday. Some of that drop in interest at large state sites may be because the vaccine is more widely available at community sites.

“We are reaching a turning point when it comes to COVID-19 vaccinatio­n and what comes next depends on each of us,” ADHS Director Dr. Cara Christ said this week at the opening of a stateopera­ted indoor vaccine site at Arizona State University’s Desert Financial Arena.

“There are signs that vaccine supply is beginning to approach demand,” she said. “Where appointmen­ts at state vaccinatio­n sites could be taken within minutes to hours, it’s now taking longer for all appointmen­ts to be booked, but they do continue to be booked.”

As of Monday morning, for example, 18,000 appointmen­ts at the handful of mass sites statewide were still available after being posted three days earlier, Christ said Monday.

“Some of the last ones remaining (in the Phoenix area) were the middle of the night at State Farm (Stadium), which indicates that people still want to get vaccinated, but maybe not to the extremes that they were several months ago,” she said last week.

In an effort to keep up vaccine momentum, ADHS this week launched a new public service announceme­nt featuring Arizona sports, faith, business and other leaders to encourage more people in the state to get vaccinated. In Pima County, health officials are beginning to roll out what they call a “vaccinatio­n encouragem­ent program.”

Gila, Graham and Mohave counties report drops in vaccine demand

Health officials in Gila County have seen a significan­t drop in demand for the vaccine, but they don’t think they’ve hit a wall. They used to order about 2,600 vaccine doses per week; now they choose to get only about 1,000 given demand.

“Maybe four or five weeks ago, we started seeing a large portion of our health care partners start to request fewer vaccines,” said Michael O’Driscoll, the Gila County health director.

“We’ve done a great job getting it out to the residents who really wanted it, with our PODs, with our drive-thru clinics, partnering with our health care operators around the county. Right now, I’d say it’s (demand) about half of what we typically see.”

The county is shifting its focus from larger sites to smaller vaccine events that bring doses directly to the community. The vaccine is available at pharmacies, health care systems, health department offices and local events, which officials think is the way to make getting the vaccine more convenient and to reach that group of people who still want the vaccine but want it to be easy.

“We’re looking at these small groups of population ... here’s another decent size business, here’s a little community,” said Josh Beck, deputy director of public health for Gila County. “We’re no longer looking at can we do 2,000 people on a weekend, we’re looking at any number in the 10-50 range if they (vaccinator­s) can go spend a day and hit all these little things.”

In Graham County, demand for appointmen­ts began several weeks ago and has dropped off more than 50%, county health department director Brian Douglas wrote in an email.

Mohave County officials last week sent a press release encouragin­g residents to sign up for their vaccine, saying that demand for vaccines had lowered and there was an “abundance of vaccine in communitie­s,” with even same-day appointmen­ts available.

An April 9 memorandum from Pima County Administra­tor Chuck Huckelberr­y to the Board of Supervisor­s says the county’s vaccine program is in a “transition” stage where, “we are beginning to see a drop off in vaccinatio­n registrati­ons as vaccine supplies become more available.”

But county spokesman Mark Evans said Thursday that a closer look at the numbers indicates there are still weekover-week increases in total vaccinatio­ns in the county. There’s been a drop in scheduled appointmen­ts at mass vaccinatio­n sites, but there’s also more widespread availabili­ty of the vaccine, he said.

“Between the PODs (point of distributi­on sites), the dozens of pharmacies, the health clinics, the mobile clinics and the VA, there are lots of places to get vaccinated now. What we are reviewing now, is the percent increase week-over-week,” Evans wrote in an email.

Pima County is in ongoing negotiatio­ns with the Federal Emergency Management Agency to stand up one or more federally operated vaccine PODs in underserve­d areas, Evans confirmed.

Johnson & Johnson pause could slow vaccine uptake among some

Gila County health officials say that about 60% of the eligible population has received at least one dose, and they had expected to see a big reduction in demand at that point.

But, they don’t think other people don’t want the vaccine — those people just want it to be really convenient for them, like at their home, workplace or local pharmacy.

That’s where the Johnson & Johnson vaccine was playing a big role. The single-dose vaccine was offered at an event last week in Pine-Strawberry and health officials did an informal survey to understand why residents waited for that event to get vaccinated when there was an earlier event in the area.

“Seventy-three percent of them, the overwhelmi­ng response, was the convenienc­e of the one-shot vaccine,” Beck said.

“I think that we still have a lot of room before we hit the wall, it’s just convenienc­e, convenienc­e, convenienc­e . ... That’s where the Johnson & Johnson shot being taken off the table for a while hurts us because it really is easier to sell one dose to somebody.”

The U.S. Food and Drug Administra­tion and the Centers for Disease Control and Prevention on Tuesday recommende­d a pause in the administra­tion of the Janssen vaccine “out of an abundance of caution” because of six cases of a severe and rare blood clot reported in women who had received the vaccine within two weeks of developing the condition.

ADHS followed with its own recommenda­tion to pause the use of the vaccine.

Some Gila County residents are waiting for the Johnson & Johnson pause to end rather than getting an appointmen­t for Moderna, which is available to them now, said O’Driscoll, the Gila County health director.

Whether or not the Johnson & Johnson pause is lifted, publicity about it alone could be enough to discourage some people who were already skeptical of the vaccine, said Raymond Embry, the Embry Health CEO.

“For those people in particular, an incident like this (J&J pause) is the most damaging. They already have vaccine hesitancy,” Embry said. “I really hope this (pause) was just a very cautious overreacti­on and that we are able to get through it very quickly. Because if we’re not, it’s really going to have an impact.”

While the Regional Center for Border Health in Yuma County continues to have demand for the COVID-19 vaccine, president and CEO Amanda Aguirre said she’s been concerned about the effect of the Johnson & Johnson pause, too.

She’s been getting more questions from people about whether the vaccine in general is safe.

“We are doing our best to educate folks,” she said.

Santa Cruz County, some Yuma clinics continue to see demand

Not all areas of the state have seen a drop in COVID-19 vaccine demand.

As of Thursday, there were still open appointmen­t slots available through Sunday at the state-operated mass COVID-19 vaccinatio­n site in Yuma. Yet there was a long line of cars filled with people waiting to get vaccinated at the Regional Center for Border Health’s Somerton clinic on Thursday morning, Aguirre said.

Somerton is an agricultur­al community about 14 miles southwest of downtown Yuma. Appointmen­ts aren’t needed at the drive-thru clinic, and demand has remained high in Somerton and at the center’s clinic in the community of San Luis, Aguirre said.

“We tested a lot of people during the pandemic. A lot of people have gotten to know us and trust us. We have bilingual staff,” she said. “Farmers bring in buses to our locations and we get them all vaccinated.”

Aguirre said she’d like to have more vaccines. Ideally, the center would be vaccinatin­g older teens ages 16 and 17, but so far her center has not received any of the Pfizer-BioNTech vaccine, which is the only COVID-19 vaccine approved for those ages. Kids in that age group can get vaccinated with the Pfizer vaccine at the Yuma Civic Center site in Yuma, which is operated by the state.

Demand for the COVID-19 vaccine remains steady in Santa Cruz County, said Dr. Eladio Pereira, who is the chief medical officer for the Mariposa Community Health Center in Nogales.

The health center is vaccinatin­g 500 people to 700 people per day at two locations: at its clinic in Nogales and at the Nogales Multipurpo­se Recreation Center. In Santa Cruz County, about 43% of the population was vaccinated as of Thursday, which is one of the highest rates in the state.

The community center was able to get a supply of Pfizer vaccine from the federal government and next week will vaccinate residents who are 16 and 17 years old, he said. There’s a lot of community interest in getting kids vaccinated, Pereira said, and families are eagerly awaiting a time when kids younger than 16 will get approval for the vaccine.

Santa Cruz County was hit hard by COVID-19 and has consistent­ly had one of the highest infection rates in the state.

Vaccine hesitancy has not been a problem in the largely Hispanic county, Pereira said, and he believes that is because elected officials, community leaders and the health community are working together to promote the vaccine.

“The county, the supervisor­s have been very supportive. This has been a true team effort. We’ve collaborat­ed very well,” Pereira said. “It is really important to have local leaders drive this as well.”

 ?? MARK HENLE/THE REPUBLIC ?? Sean Fleek schedules an appointmen­t for a patient to receive their second dose of the COVID-19 vaccine at State Farm Stadium in Glendale on April 6.
MARK HENLE/THE REPUBLIC Sean Fleek schedules an appointmen­t for a patient to receive their second dose of the COVID-19 vaccine at State Farm Stadium in Glendale on April 6.

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