Every state is distributing the vaccine differently, which might be confusing people who watch the national news, said Amy Rohling McGee, president of the Health Policy Institute of Ohio.
Ohio is using a decentralized patchwork of providers — local health departments, hospitals, health centers, retail pharmacies, doctor’s offices — to distribute the coronavirus vaccine. It’s giving out doses in phases to priority groups. Each week, more people become eligible to get the shot under Phase 1B.
The state isn’t using its full capacity to distribute the vaccine. The state has tapped over 700 providers across the state but it has as many as 2,200 providers ready to distribute the vaccine, according to Ohio Gov. Mike DeWine
And area providers that have been tapped could do more clinics if supply were available. For example, Public Health-Dayton & Montgomery County could double the number of vaccines it administers in a week if it had more shots, spokesman Dan Suffoletto said.
A glimmer of hope came from the Biden administration this week. President Joe Biden pledged to give states firm vaccine allocation numbers three weeks ahead of delivery. States had been receiving one-week notice, meaning area-providers were often receiving less than a week’s notice about how many doses they would get next. That’s why area clinics have been planned no more than a week in advance and why you couldn’t schedule an appointment more than a week in advance.
Gina McFarlane-El, chief executive officer of Five Rivers Health Centers, said this earlier notice would absolutely help.
“That would be fabulous,” she said. “It gives you at least enough time to plan.”
Biden also promised an approximately 16% increase in deliveries to states over the next three weeks. Planning for the long-term, the administration said it will buy another 100 million doses from drugmakers to ensure the country has enough doses.
DeWine said this week an uptick in supply will head to Phase 1B recipients as Phase 1A recipients finish with their second doses, freeing up future supply. He also said another 77,000 doses will become available in the next two weeks because the state will no longer be setting as many aside for nursing homes.
Ohio is receiving 146,000 first doses of the two-dose regimen each week on average, according to DeWine. As Phase 1A finishes, between 110,000 and 120,000 of that will go to Phase 1B recipients.
‘I have to be my own advocate’
Meanwhile, eligible Ohioans who are desperate to get the vaccine are frustrated and confused by the decentralized system and a lack of clear messaging.
For three weeks, Kristin Kopp, a 72-year-old Centerville resident, has spent hours every day on hold on the phone and online trying to get a vaccine appointment.
“I feel like I’m in a high stakes poker game,” she said. “It’s all in the luck of the draw.”
No central scheduling system exists in Ohio. Each provider has its own procedures for signing up for an appointment and few are preregistering more than a week out or maintaining waitlists.
“And if you’re not a technical whiz-bang, having to go online and literally check … every single one of them and you know just navigating all of that — I’m not a very technical person so that’s been quite challenging and it’s been very hard,” she said.
As she broke into tears, Kopp added, “I haven’t been able to talk to a human being and get questions answered.”
Kopp has severe asthma, a heart condition and a severe neurological condition. She has been isolating at home with her friend she lives with and her cat throughout the pandemic. She hasn’t seen her children or grandchildren in person since December 2019. On Friday morning, Kopp got a vaccine appointment at a clinic at the Dayton Convention Center next week through Public Health-Dayton & Montgomery County.
Amanda Stumpff, 39, lives in Troy part-time and Fort Thomas, Kentucky, part-time while her husband works for a few years at an Army Reserve unit in Kentucky. She’s found messaging around when she can get the vaccine difficult to navigate.
Stumpff was born with a form of muscular dystrophy, putting her at higher risk if she catches COVID-19. She’s eager to get the shot. Ohioans with medical conditions like Stumpff’s were previously told they could get the shot beginning Jan. 25, but the Ohio Department of Health updated its rules shortly before then to narrow the category of eligible conditions. Only people with a developmental or mental disability and a comorbid condition became eligible on Jan. 25.
So Stumpff was surprised and frustrated when a Kroger pharmacy in the Cincinnati area, near where her family lives in Kentucky, canceled her vaccine appointment.
Now, Stumpff will become eligible with other Ohioans with severe congenital, developmental, or early-onset and inherited conditions on Feb. 15. Stumpff acknowledges that these are unprecedented times but believes the state should put out clearer messaging.
As of Thursday afternoon, the provider lookup page on the Ohio Department of Health’s website had the outdated eligibility schedule at the top of its page.
“I have to be my own advocate,” she said about finding an appointment.
Kopp said she doesn’t want to be critical of area providers who are doing their best. She wants the state and federal government to make finding a shot less challenging for individuals who need it.
Why is supply limited?
Producing biological products like coronavirus vaccines is a challenge and scaling up production isn’t easy, said Mark Jacobs, a professor who teaches supply chain management at the University of Dayton College of Business.
“Even once production is successfully brought to full scale, yields can be variable until the process is fully refined,” he said.
Some of the ingredients needed to make the vaccine have never before been produced at the sheer volume needed. And factories can’t transition to creating new kinds of vaccines overnight.
The two approved COVID vaccines are mRNA vaccines, which have never been produced before on a large scale.
Moderna and Pfizer say they are each on track to deliver 100 million doses to the U.S. by the end of March and another 100 million in the second quarter of the year. Both Moderna and Pfizer’s vaccines, the only two which are federally approved so far, require two doses taken four and three weeks apart respectively.
The U.S population is more than 330 million people.
“We hope — this is not a guarantee — but we hope that within the next month or two, another vaccine provider will be approved for emergency use authorization and then that will change the metric in terms of how much vaccine is available,” Suffoletto said. “Particularly if it’s Johnson & Johnson because Johnson & Johnson has a one dose situation so that would totally change everything.”
Johnson & Johnson announced on Friday that its single-dose vaccine was 66% effective overall at preventing moderate or severe illness and 85% effective at protecting against the most serious symptoms. The company said it will file an application for emergency use authorization in the U.S. within a week. It expects to deliver 100 million doses to the U.S. by June.
There are also a myriad of logistical challenges, including the distribution infrastructure, Jacobs said.
“We’ve not distributed at mass-scale products like these (extreme cold and short shelf life),” he said.
The Associated Press contributed to this report.
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