Members of the Missouri National Guard hosting Missouri’s first mass COVID-19 vaccination site in Poplar Bluff on Jan. 22 (photo courtesy of Missouri Governor’s Office).
WASHINGTON — State health officials from around the country had a clear answer when asked Tuesday what they need to better vaccinate their residents: more doses, more information to guide their planning and more money to pay for the mammoth undertaking.
That guidance from state leaders came during a U.S. House Energy and Commerce subcommittee hearing, which delved into how to smooth out a bumpy, two-month-old national vaccine campaign, in which states have complained of changing information and too little federal support.
“What we need at the federal level is a larger and consistent vaccine supply, as well as additional funding to specifically address barriers to access,” Dr. Joneigh Khaldun, chief medical executive and chief deputy director for Michigan’s Department of Health and Human Services, told the panel.
The number of doses headed to states and the advance notice on the number of incoming doses are two areas that the Biden administration has sought to improve during its initial days.
Last week, Biden’s COVID-19 task force announced that states would see a 16% increase in vaccine doses, and would see at least that amount for at least three consecutive weeks.
As Tuesday’s House hearing was underway, the administration announced another slight boost in the number of doses that will be distributed — a total of 10.5 million across the country next week — as well as plans to begin shipping directly to a limited number of pharmacies, in addition to the doses sent to state-designated locations.
Under the new program, vaccines will be available initially at about 6,500 stores nationally, eventually scaling up to 40,000 retail pharmacy locations.
Retail pharmacies CVS and Walgreens have been involved in a partnership created under the Trump administration to vaccinate nursing home residents and workers, a top priority group due to the high rates of infections at those facilities. Those chains agreed to pay three visits to every participating nursing home.
In some states, however, that program has been receiving more doses than vaccinators have been able to get into arms. New data from the Centers for Disease Control and Prevention this week showed only 38% of nursing home staff accepted shots when they were offered, suggesting some vaccine hesitancy and unused doses.
Dr. Courtney Phillips, secretary of the Louisiana Department of Health, told lawmakers Tuesday that Louisiana has been able to pull back unused doses from the nursing home program, boosting the state’s allotment for other residents.
“Doing so has allowed us to be able to push more into the community, and not have vaccines sitting anywhere, so that added flexibility has been greatly appreciated,” Phillips said.
All of the state officials appearing Tuesday said their states have been boosting vaccinations, and have the capacity to administer tens of thousands of additional doses each day if the supplies were available.
Phillips described how Louisiana has focused on recruiting more providers to administer shots, going from 700 in the initial week to more than 1,900, even though only one-third of those providers are receiving shots due to the limited supplies.
Khaldun, of Michigan, praised the Biden administration’s efforts to boost vaccine supplies and add transparency on the number of doses coming in future weeks. That information is “incredibly helpful” to local officials attempting to schedule appointments, she said, adding that the additional doses allow them to better target some shots to high-poverty areas.
But Khaldun added they need additional funds to ease the burden on staffing and other infrastructure, describing how contact tracers and public-health staffers who typically work on other health areas have been pulled into the massive vaccine effort.
Those strains of attempting to scale up staff quickly follow decades of underfunding public-health systems, said Jill Hunsaker Ryan, executive director of the Colorado Department of Public Health and Environment.
“Trying to hire and onboard and train, get everybody an email address and coordinated during a pandemic is so hard, so we need to ongoingly support our public health system,” Hunsaker Ryan said.
The Biden administration has sought to direct more money to state and local governments, directing the Federal Emergency Management Agency to fully reimburse states for the cost of having the National Guard help with vaccine clinics.
On Tuesday, the administration announced retroactive reimbursements to states for other pandemic costs, including masks, gloves, emergency feeding actions, sheltering at risk populations, and mobilization of the National Guard, going back to the beginning of the pandemic.
The administration estimated the reimbursement effort would cost $3 billion to $5 billion, adding that the $1.9 trillion pandemic relief bill that Biden is seeking would send $350 billion to aid states with their mounting costs.
List of the participating retail partners that will receive direct vaccine allotment (not all will be active in every state in initial phase):
- Walgreens (including Duane Reade)
- CVS Pharmacy, Inc. (including Long’s)
- Walmart, Inc. (including Sam’s Club)
- Rite Aid Corp.
- The Kroger Co. (including Kroger, Harris Teeter, Fred Meyer, Fry’s, Ralphs, King Soopers, Smiths, City Market, Dillons, Mariano’s, Pick-n-Save, Copps, Metro Market)
- Publix Super Markets, Inc.
- Costco Wholesale Corp.
- Albertsons Companies, Inc. (including Osco, Jewel-Osco, Albertsons, Albertsons Market, Safeway, Tom Thumb, Star Market, Shaw’s, Haggen, Acme, Randalls, Carrs, Market Street, United, Vons, Pavilions, Amigos, Lucky’s, Pak n Save, Sav-On)
- Hy-Vee, Inc.
- Meijer Inc.
- H-E-B, LP
- Retail Business Services, LLC (including Food Lion, Giant Food, The Giant Company, Hannaford Bros Co, Stop & Shop)
- Winn-Dixie Stores Inc. (including Winn-Dixie, Harveys, Fresco Y Mas)
- Topco Associates, LLC (including Acme Fresh Markets, Associated Food Stores, Big-Y Pharmacy and Wellness Center, Brookshire’s Pharmacy, Super One Pharmacy, FRESH by Brookshire’s Pharmacy, Coborn’s Pharmacy, Cash Wise Pharmacy, MarketPlace Pharmacy, Giant Eagle, Hartig Drug Company, King Kullen, Food City Pharmacy, Ingles Pharmacy, Raley’s, Bel Air, Nob Hill Pharmacies, Save Mart Pharmacies, Lucky Pharmacies, SpartanNash, Price Chopper, Market 32, Tops Friendly Markets, ShopRite, Wegmans, Weis Markets, Inc.)
- CPESN USA, LLC
- GeriMed (long-term care and retail pharmacies)
- Good Neighbor Pharmacy and AmerisourceBergen Drug Corporation’s pharmacy services administrative organization (PSAO), Elevate Provider
- Health Mart Systems, Inc.
- Innovatix (long-term care pharmacies)
- LeaderNET and Medicine Shoppe, Cardinal Health’s PSAOs
- Managed Health Care Associates (retail and long-term care pharmacies)
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