At bottom of state’s priority list, county has little info, no control over when more vaccines will arrive
Editor's note: We have new information at the bottom of this story about additional vaccine availability.
A closed road and a detour couldn’t stop Beth Edwards of Ouray from getting her first COVID-19 vaccine.
With no assurance as to when she might be able to get her first dose in Ouray County Edwards made a 5 1/2-hour drive over the Continental Divide to receive the shot. When she received an inquiry from her insurance provider last week asking if she wanted to sign up for the vaccine, she jumped at the chance.
Edwards, 71, is covered through Centura Health in Denver, which is where she lived when she signed up for the insurance plan. Though she moved to Ouray three years ago, she continues to make the 300-mile drive for health care.
While she’d rather get the vaccine locally, she not only wanted to get vaccinated as soon as she could to start building antibodies, but to save one of Ouray County’s few vaccines for a local resident who doesn’t have the same option she does – to get the vaccine somewhere else.
“In a way, I almost felt a little guilty ... where I’m getting it before some other people that are older than me who should be getting it,” she said.
Right now, Ouray County Public Health is the only place to get a vaccine in the county. And because the state has based its prioritization of vaccines on a variety of factors - including county populations and where hospitals and long-term care facilities are located - Ouray County sits at the bottom of the list. With fewer than 5,000 residents, no hospitals and only one primary care doctor’s office, it’s currently receiving only too doses at a time, and no one knows exactly when they’re coming.
At this point, the county is administering vaccines as fast as they receive them, but with no control and limited information about when more doses will arrive, it’s impossible to know how many people can be vaccinated each week and how long it will take to reach all residents over 70.
“We were told we’ll get more first doses this week, but we haven’t seen them yet,” Health Department Director Tanner Kingery said Tuesday. He said the county’s plan was to administer second doses to first responders who received their initial shots last month on Wednesday and Thursday.
The Moderna vaccine, which Ouray County is providing, requires a booster shot 28 days after the first to provide about 95 percent protection from the coronavirus.
Kingery is hoping to hold another vaccine clinic for people 70 and older on Friday, if more vaccines arrive in time.
Uncertain delivery, reserves exhausted
Gov. Jared Polis reiterated Tuesday his goal of having 70 percent of Coloradans over 70 vaccinated by the end of February, which he said is achievable if the vaccine supply to the state remains steady. He hoped the federal supply of vaccines would increase to speed up administration, but learned last week that the federal vaccine reserve had already been exhausted.
The state received about 8o,000 doses of the vaccine this week, Polis said Tuesday, and also released about 40,000 doses that were being held back as second doses to instead be given as first shots to people 70 and older. Those second doses will instead be allocated as they become necessary from future shipments to the state, he said.
Ouray County has so far received three shipments of the vaccine, each containing ioo doses, with another ioo expected but not guaranteed by the end of the week, Kingery said.
He’s requested support from the state to administer more vaccines, which he received: nurses and data assistants were sent to the county last week and are scheduled to be back on Thursday. Having extra staff makes it possible to give more shots throughout the day, but that doesn’t address the underlying problem of not having enough vaccines to give out or the uncertainty of when the vaccines will be available.
“What makes it hard is we don’t know how many doses we’re going to get,” Kingery said. “It’s hard to schedule those folks, I don’t want to waste their time if we’re not going to have doses.”
Like Kingery, Polis said there’s been limited information about the supply of vaccines coming to the state, making it harder to determine when and how much providers and health departments will receive.
New federal guidance last week urged states to include 65- to 69-year-olds in the same phase as those over 70, but that instruction came before states learned that the reserve was exhausted and that the supply of vaccines to states would not significantly increase.
“We were led to believe just a few days ago the federal government was going to release their stockpile of second doses,” Polis said Friday. “That would have equated to about 3 weeks’ supply in one week for Colorado, about zao,000 or so doses, and that was unfortunately not true.”
On Tuesday, he said the priority for now remains vaccinating those over 70, because that age group makes up 78 percent of people who have died from COVID in the state.
“The biggest challenge to setting a specific date now, for 65 and up, is we don’t know our supplies and how many vaccines we’re even going to get next week,” he said. More visibility is needed in the supply chain to get a better understanding of when the state can begin vaccinating people from 65 to 69, as well as move into the next phase of vaccinating essential workers, he said.
Polis said Colorado has the staff and structure in place to vaccinate three to five times as many people each week if the supply to the state increased.
In Ouray County, Agency is the only distributor of the vaccine, but due to the statewide supply limitations, it’s not clear that adding more distributors would accelerate the rollout. While questions have been raised about bringing in volunteers such as retired nurses to help give injections, the limiting factor hasn’t been a shortage of people but a shortage of vaccines.
Limited distribution centers for vaccine
Elsewhere in the state, healthcare providers like Centura are administering some vaccines to their patients, like Edwards. Some pharmacies have also joined in as vaccine providers. Long-term care facilities and nursing homes are receiving vaccines through a partnership with CVS and Walgreens, overseen by the federal government.
Ridgway’s Mountain Medical Center did not apply to receive and administer the vaccines due to compliance and capacity limitations, Dr. Joel Gates said.
At this phase, my biggest problem is lack of staffmg,” he said. The nine-person staff can’t handle a vaccine clinic while keeping up with existing patients, COVID testing and responding to acute care needs. “It’s just a huge manpower issue!
There are requirements for receiving and distributing the vaccine that the medical center can’t meet either, he said, including having data loggers on all the freezers holding the vaccines, submitting digital temperatures to the state and having backup generators for the freezers. He’s reached out to the state recently for more information to see if some of those compliance rules have changed, but even if they have, staffing would remain prohibitive, he said.
Space is also a concern, Gates said, because starting vaccinations would mean potentially mixing healthy people coming in for shots with sick people coming in for testing and patients coming in for other appointments. “The complexity of all of that takes not just manpower but also thinking through how do you achieve all that and keep everybody safe,”
The office is fielding lots of vaccine-related questions already, Gates said. “’Do I have allergies that mean I shouldn’t have it? Should I get it? How do I get it? I can’t find that webpage, won’t you call them for me?’ So already our staff is strained trying to help the community answer questions for the basic things,” he said.
The office’s recorded answering message instructs people to call the Ouray County COVID hotline, which has also been swamped with calls to the point of Kingery asking the county for help from other employees or volunteers to manage them. The county has an online form for people to sign up for vaccines, but many are still calling to register, to check if their form was received or to ask when it will be their turn. As of Tuesday afternoon, i,800 people had signed up, Kingery said.
“We’re doing the best that we can here,” Gates said. “We’re certainly not trying to withhold and restrict the flow of opportunity for people in the community.”
Kingery said even if the county demonstrated it could successfully give out more doses each week, it’s not clear that the state would send more.
Having another vaccine distribution point in the county could actually reduce the number of vaccines the county can administer - instead of receiving more vaccines, the state might allocate part of the county’s share to the other provider. “Even if we added another provider right now, I don’t think we’re going to get more total vaccine supply for the whole county.”
For now, the county is working through the list of online sign-ups to schedule appointments, and checking that with a list of registered voters over 70.
The goal is to vaccinate the oldest residents first, but some slightly younger people in that age group have also been vaccinated if they’re caregivers bringing in older relatives, Kingery said. That has created some confusion and prompted calls to the Public Health an to get the vaccines administered efficiently and eliminate unnecessary repeat trips to get vaccinated.
“I hope people understand that if someone is a caregiver and has to help them get there, and they’re also in that age group, there’s no reason we should be turning them away. We’re not going to miss an opportunity to get a vaccine in the arm,” he said. “I don’t want to have this paralysis by analysis type of situation, where we analyze so much that we’re not getting doses out.”
Anyone can register online to be notified when the vaccine is available to them by visiting ouraycountyco.gov. You can also email email@example.com for a direct link to the form. CLICK HERE TO ACCESS THE FORM FOR OURAY COUNTY ONLINE.
As of this weekend, some local grocery store pharmacies started offering the COVID-19 vaccine. These include pharmacies at City Market locations in Montrose, Delta and Grand Junction and other select areas. However, the vaccine is still prioritized for people aged 70 and older, as well as first responders or healthcare workers. Anyone who is in these priority groups can make an appointment to get the vaccine for free. To sign up for an appointment at a City Market pharmacy in the region, visit this link.
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