City got most vaccines in state
75% of Baltimore’s allocation through Feb. went to hospitals
As Maryland officials released the most comprehensive data about the state’s COVID-19 vaccine allocation strategy to date Thursday, Gov. Larry Hogan continued to clash with Baltimore Mayor Brandon Scott, whose city received more first doses than any other jurisdiction in the state over the first 11 weeks of vaccination.
Hogan, a Republican, touts Baltimore having received 125,110 initial vaccines from mid-December through the end of February. That’s about 14,000 more doses than the county with the next highest allocation, Montgomery, which is Maryland’s most populous jurisdiction with more than 1 million people. Baltimore has 593,000 residents — the fourth-largest jurisdiction by population.
But the same statistics released by his administration showed 93,277 doses sent to Baltimore — or nearly 75% of the city’s allocation — went to the city’s 11 major hospitals, whose employees, many of whom live outside of Baltimore, were prioritized first in the state’s coronavirus vaccination campaign.
With fewer than 40% of the vaccines allocated to Baltimore having reached the arms of city residents, Scott, a Democrat, maintains that Baltimoreans are being left behind.
The new data offers some context for Hogan’s comments last week, which kicked off a prolonged back and forth. Outside of the recently opened mass vaccination site at M&T Bank Stadium in Baltimore, Hogan said the city had received “far more” doses than it was “entitled to,” remarks that infuriated many Baltimore leaders who’ve decried the vaccination rollout as inaccessible to many of their constituents.
Politicians and public health officials said doses sent to Baltimore’s hospitals
shouldn’t count against the city’s allocation, as they contend the hospitals serve the entire region.
“The allocation should reflect both population needs and workforce needs,” said Anita Hawkins, assistant dean of the Morgan State University School of Community Health in Baltimore. “Hospitals meet a large population, but they do not necessarily meet a large Baltimore population. There’s nothing necessarily wrong with it, but the issue is it didn’t balance out Baltimore’s allocation enough.”
After questioning last week the vaccination effort of Baltimore’s health department, Hogan said at a Thursday news conference about his administration’s new equity plan that the city health department wasn’t “utilizing” vaccines and asked the state 30 times between Jan. 26 and Feb. 26 to divert doses to providers who “could get them into the community.”
He also said Baltimore turned down about $9 million from the state to “help them with their vaccine equity effort.” Hogan accused Scott “pointing the finger” at him. “We’re doing everything we can every single day to provide more assistance,” Hogan said. “And he needs to talk to his health department.”
Within an hour of Hogan’s news conference ending, the Democratic mayor called his own. Scott rebuked what he described as “false and misleading” statements by the governor. Scott said that rather than accepting $8.8 million in funds through the state for vaccinations and associated supplies, the city is seeking reimbursement directly from the Federal Emergency Management Agency in hopes of recuperating 100% of the money it has spent. Baltimore is seeking reimbursement from FEMA for $61 million in expenses related to the coronavirus, city officials said last month.
Meanwhile, Baltimore Health Commissioner Dr. Letitia Dzirasa said her department never “refused, or rejected or returned” doses.
Rather, she said, it asked to reallocate vaccines to other clinical partners to meet constituents where they are, so elderly residents could avoid “a ‘Hunger Games’-style competition” presented by a maze of online registrations for vaccine appointments.
Her department’s strategy, she said, “allows us to ensure our doses are going to city residents who are eligible but who have been left behind by the state’s rollout to date.”
Statewide, local health departments have been tasked with administering about a third of the state’s total vaccine supply.
The Baltimore City Health Department got 19,900 first doses, about 16% of those sent by the state to the city, according to the state data released Thursday.
That does not include 11,000 first doses the health department asked the state to divert to city hospitals, Hogan’s spokesman, Mike Ricci, tweeted Thursday. Those are included in the hospitals’ 125,110 doses, he said.
Health departments, Baltimore’s included, tend to be small and historically underfunded, making complex vaccine distribution difficult. Hospitals have more capacity and are better staffed, Dzirasa said at a City Council meeting last month.
Baltimore and the counties of Charles and Prince George’s have administered the smallest proportions of first doses of the two-shot vaccines to their residents. Those three jurisdictions are majority Black. In Baltimore, more first shots have gone to white people than to Black people, although Black residents make up about 62% of the city’s population. “It’s important to focus on the numbers, and the numbers don’t lie: Communities of color, particularly in Baltimore, and Prince George’s counties, aren’t getting vaccinated at a rate we’re seeing in other points of Maryland,” said state Sen. Clarence Lam, a physician who sits on the legislature’s Vaccine Oversight Workgroup. “That points to an equity issue.”
Scott agreed. Hogan’s comments sought to distract people from the “completely inequitable vaccine distribution process” that created such disparity, Scott said.
“While the governor continues to go back and forth about petty politics, people are dying from the virus,” the mayor added.
Morgan State’s Hawkins said Hogan and Scott ought to resolve their dispute promptly.
For starters, Lam said, the state should own up to its shortcomings and solve problems. “The state has the supply, it’s entirely a state decision,” Lam said. “The responsibility lies with the state to address these inequities.”
After Baltimore City and Montgomery County, Prince George’s County, the state’s second-most populous jurisdiction, received the most vaccines through the end of February: 85,815.
Baltimore and Anne Arundel counties, the third- and fifth-most populated counties in Maryland, had the next most doses allocated, with 78,846 and 50,850.
Maryland leaders say they’ve been dividing the vaccine among the state’s 24 jurisdictions based on their populations, though they’ve declined to make public a comprehensive picture of the allocation.
Full transparency from the state about how the state is divvying up its vaccines and how efficiently providers are administering doses would benefit everyone, said Dr. Leana Wen, a George Washington University professor of public health and a former Baltimore health commissioner.
“Imagine a dashboard with how much vaccine is being allocated to each entity and how quickly they are being distributed,” Wen said. “We could all look at the dashboard and see distributions by health departments, Mercy Medical Center, Walgreens and others in the city and see who is doing the best job reaching city residents.”