NEW HANOVER COUNTY — Change-ups in the vaccination process this week have trickled down from federal to county levels. The floodgates of eligibility are widening and additional medical care providers are joining the frontline grind.
Aligning with guidance from Raleigh, New Hanover County announced Thursday future vaccine shipments will be partly allocated for residents between the ages of 65 and 74. Since Jan. 7, the county had been focusing on individuals 75 and older. The change adds approximately 20,000 county residents to the immediate eligibility list.
The county had vaccinated nearly 3,000 individuals at least 75 years of age by Thursday morning. The total 75-plus population is estimated to be around 17,000, meaning less than 20% of that demographic was inoculated at the time N.C. and New Hanover County announced expanded vaccine eligibility.
Close to 1,000 people secured appointment slots for Jan. 14-15, which could bring New Hanover County’s percentage of vaccinated 75-and-older residents closer to 25% by this weekend. The county also reported all its available doses have been allocated or administered at this point.
County estimates put the 65-plus population at 37,000 individuals. With the eligibility cutoff age lowered, it’s likely the county will continue to be inundated with calls and inquiries about shots. Vaccine shipments are procured weekly, and New Hanover County will only schedule appointments when the product is on-hand.
“So far, we expect for several months for the demand to outstrip supply,” said assistant health director David Howard. “A couple months ago we had some worries about hesitancy, and the majority of the population perhaps not wanting to receive the vaccine. So we are seeing high demand, which is a good problem to have.”
At the federal level, Health and Human Services Secretary Alex Azar announced the state-by-state allocation methodology will change in two weeks. Up until now, vaccine shipments to states have been based on the size of the adult population. The new guidelines will allocate vaccines according to the size of the state’s 65 and older population, as well as the percentage of vaccines the state has already administered.
Dr. Mandy Cohen, N.C.’s top health official, said it was “very challenging” to receive additional guidance on the fly at a press briefing Tuesday. Reporters asked Cohen and Gov. Roy Cooper about Centers for Disease Control and Prevention guidance released in days prior, suggesting the federal government would be pushing states to lower the cutoff age for immediate vaccine eligibility from 75 to 65.
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“We’re waiting for the state to digest that, and put something in writing,” Howard said Thursday morning. “Typically you’ll see something coming out in an official nature.”
He indicated an official update had not transpired by that point, but later that morning Cooper formalized the alteration to the plan, and New Hanover County quickly adjusted its own protocols.
“New Hanover County will ensure that our local vaccination plan reflects the state’s update to include this newly prioritized group in upcoming vaccine administration,” health and human services director Donna Fayko said in a Thursday afternoon press release. “We will be utilizing all of the vaccine currently available to us by tomorrow, but upon receipt of our next first-dose vaccine shipment, we will be able to work with our healthcare partners and extend the vaccine’s availability to anyone 65 and older and all healthcare workers.”
Days in advance, the county will be alerted to the specifics of its incoming vaccine shipment — which could be either the Moderna vaccine, packaged in shipments of hundreds of doses, or the Pfizer vaccine, which ships in groups of 975 doses.
“Basically we’re running an inventory management system and distribution system across the community to make sure it doesn’t sit there any longer than absolutely necessary,” Howard said.
In the press briefing Tuesday, Cohen said initially the state sought to put the vaccine into the hands of each county. Now approaching a month since the first shot was administered in the state, it’s time to focus more on distribution speed, she said.
“We have a very large population across the county to reach,” Fayko said. “And so the more partners that we’re bringing on board, we’re going to be reaching different segments of that population.”
The list of partners began to grow this week, as Wilmington Health — a “physician-owned primary care and multi-specialty medical practice,” according to its website — began vaccinating residents on Jan. 13. Wilmington Health was the first independent medical practice in the state to be approved to administer the vaccine, its CEO Jeff James said Wednesday.
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The state began to roll out the Covid-19 Vaccine Management System to some providers this week, which allows them to manage vaccine inventory and track administrations.
Jennifer Buxton, the chief pharmacy officer for Cape Fear Clinic, a preeminent medical care facility for uninsured individuals in southeastern N.C., said the facility received a green light to serve as a vaccination site in late 2020. She expected the first shipment of doses, for inoculating the clinic’s patient base, would have arrived by around this week.
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But the state did not move past its opening game plan — housing the vaccine with county health departments and hospitals — until this week. Buxton and her colleagues can now register in the state’s database, and once they pass through the final strips of red tape, they’ll be able to join the fight.
M. Kent Locklear, the clinic’s chief medical officer, previously said that after much hands-on communication with state authorities surrounding vaccine approvals, things got quiet around early January.
Buxton added that during call-in sessions with state health officials, she inquired into Cape Fear Clinic’s status, which she thinks had an impact on subsequent developments that have inched the clinic closer to full approvals.
“Last week there was a training, and I took the opportunity to ask some questions about: ‘Where were our log ins?’ and ‘Where was our vaccine?’ and ‘When will we get it?’ and all that sort of thing, which started the ball rolling forward for us,” Buxton said.
She said the situation is not a case where other providers are widely procuring vaccination approvals prior to Cape Fear Clinic, but rather that the state did not initially rush to involve entities other than the initial group: health departments, hospitals and the pharmacy chains CVS and Walgreens — which have been hustling in recent weeks vaccinating staff and residents of long-term care facilities across the country.
“Based on when they onboarded me, or started to get me ready to go, it’s been a pretty long time,” she said. “They were reaching out to me in November to have me get ready to go, and here we are in mid-January and still nothing.”
Since the eligibility requirements will be expanding, and some individuals will soon be in-line for their second shot, it is likely New Hanover County will require increased quantities of vaccine to accommodate a growing demand.
Azar, the federal health secretary, also announced recently vaccines that were originally being held as second-dose shots would be released en masse to states.
“The federal government plans to distribute more of the vaccine, but currently the vaccine supply is still coming in limited shipments weekly, and that is not anticipated to change in the immediate future,” a county spokesperson wrote in an email Wednesday.
Howard, the assistant health director, said he looks forward to involving independent clinics in the vaccination effort as the process crystallizes.
“As the phases open up over time, and become larger and larger pools of people, we will need more hands, so to speak,” he said. “More locations, more personnel, more options for people to receive the vaccine.”
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