Monday, January 11, 2021

Beshear 'cautiously optimistic' vaccine rollout will get up to speed and meet first goal; Stack says feds made unrealistic projections

Walgreens pharmacist Tera Hayes gave licensed practical nurse
Angela Williams a coronavirus vaccine at Somerset Nursing and
Rehabilitation Dec. 22. 
(Photo: Caleb Lowndes, Commonwealth Journal)
Kentucky Health News

Gov. Andy Beshear said Monday that he is "cautiously optimistic" that Kentucky will meet its self-imposed goal of Feb. 1 for starting the second phase of vaccinations against the novel coronavirus, despite problems getting the shots up to speed, especially in long-term-care facilities.

"I’m not satisfied with the pace, but it has picked up significantly," Beshear said at a news conference. But he said the real test will come when many more people become eligible after the second phase, which is designated for people 70 and older, first responders and K-12 school personnel.  He said some places have already started that phase.

Most doses in the first phase of vaccination are earmarked for long-term-care facilities, with the shots being given under federal contracts by CVS Health and Walgreens, which have experience running flu-vaccination clinics. But the novel coronavirus is not the flu, and long-term care companies have been staggering employees in groups to get their shots, in case of negative reactions that could keep them from working at a critical time.

“In some cases, we have had to make 10 to 12 phone calls’’ to lock down a schedule for a visit, Larry J. Merlo, chief executive of CVS, told The Washington Post, which reports, "Part of the reason for slow uptake has been hesitancy among staff members, with only about 30 to 40 percent willing to get shots, according to officials and executives."

The rest of the first phase is for health-care workers, with hospitals taking the lead, but they have had problems, too. Hospital executives also highlighted as cumbersome the prioritization tiers for vaccine imposed by different states, with large numbers of employees not responding to emails inviting them to get vaccinated and others opting to wait until after the holidays.

"The delayed and disjointed vaccine rollout is the product of poor coordination between the federal government and the 50 states and additional jurisdictions tasked with carrying out the most ambitious immunization campaign in history," says a story by seven reporters at the Post.

"Late last year, Health and Human Services Secretary Alex Azar and other top administration officials spent weeks predicting that 20 million people would be immunized by the end of 2020. But by the time the New Year’s Eve Ball fell, just over 3 million doses had been administered, prompting a blast of criticism from dismayed public health officials who said the Trump administration used the vaccines’ development as a political tool in a bid to win reelection without planning sufficiently for their rollout."

One surprising aspect of the slow rollout is hesitancy by health-care workers, some of whom "have rejected the shots out of unfounded fears about their safety — problems that veterans of immunization campaigns worldwide say could have been addressed through comprehensive, centralized planning and communication," the Post reports. Trump administration officials blamed the delays on states and health systems "too rigidly adhering to guidance about who should receive priority for shots."

Azar told the Post, “It was always . . . agreed to that we needed to use and leverage existing systems of vaccine administration through the United States, with the states playing the leading role. . . . We bought the vaccine. We’re paying for the distribution costs. We’ve kitted the syringes, needles and [personal protective equipment] for it.” He said the estimate of 20 million was "accidentally used shorthand" for an estimate of 10 million getting an initial dose and a booster shot.

But 3 million is far short of even that, and "The public perception is damaging," the Post reports, quoting Kentucky Health Commissioner Steven Stack.

“Had we just projected realistic quantities, the public wouldn’t have seen this as a shortcoming,” said Stack, a former president of the American Medical Association. “They would have recognized it for the incredible accomplishment it was to even have this much vaccine this fast.”

Unnamed federal health officials said part of the problem was that Azar's agency sidelined the more cautious and less political Centers for Disease Control and Prevention, which has been "the nation’s premier organizer of vaccination drives," the Post reports. "Had the CDC played a bigger role, those officials said, forecasts about the number of doses would have been tempered, along with public expectations."

There is also vaccine hesitancy among school employees. "Someone has got to reach them. Someone has got to tell them it's OK to take it," Bobbie Lester, Indian Trail Elementary School nurse, told Jess Clark of Louisville's WFPL, regarding getting her co-workers to get a vaccine. Clark reports, "The vaccine is not mandatory, and around 6,000 JCPS employees and contractors haven’t signed up. 1,900 employees declined the vaccine, and about 4,000 did not respond to the vaccine survey."

Meanwhile, thousands of people who didn't meet priority criteria for vaccinations will get them anyway because Baptist Health's scheduling tool for health-care workers allowed anyone to sign up. "More than 6,000 Kentuckians created appointments using the new online portal that was intended for use by health care professionals, who are prioritized in Phase 1A of the state's vaccination rollout, the Courier Journal's Emma Austin reports. Baptist Health said, "While the state website linked to a page that clearly outlined that the vaccines are available for Phase 1A healthcare personnel, the scheduling tool did not include this information." Now it does.

UPDATE, Jan. 12: The Post's vaccine tracker says 3% of Kentucky's population has been vaccinated, ranking it 20th among the states.

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