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Anemic Vaccine Release in Alabama as Some Begin Vaccinating Elderly

While the state is officially still in the 1A portion of its distribution plan —reserved for health-care and frontline workers — some providers began as early as last week to consider vaccinating older adults in the 1B priority group.

by Melissa Brown, Montgomery Advertiser / January 6, 2021
Syringes used to administer a COVID-19 vaccine at a clinic setup at the East Alabama Medical Center Education Center in Opelika, Ala., on Wednesday, Dec. 16, 2020. TNS
(TNS) - The COVID-19 vaccine roll-out in Alabama, one of the slowest in the nation, has led to confusion as vaccine doses trickle piecemeal from individual counties and providers.
 
While the state is officially still in the 1A portion of its distribution plan — the most stringent level reserved for health care and frontline workers — some providers began as early as last week to consider vaccinating older adults in the 1B priority group. But confusion appears rampant among providers about when and how they can begin offering vaccines outside of the health care community.
 
As expected, there is also not enough vaccine to meet demand at this time. In Calhoun County, one of the first Alabama counties to announce it had vaccine product available to adults 75 and older, a line wrapped around the Anniston City Meeting Center in frigid Wednesday morning temperatures.
 
Organizers, who first announced vaccine availability on Tuesday, posted to social media around 9 a.m. Wednesday that they had already met their limit for the day.
 
"Is there not a better way for these older people to get their vaccine than standing in cold on walkers and wheelchairs for hours?" Denise Ramsey posted on social media in response to Northeast Alabama Regional Medical Center announcement that no more doses were available Wednesday.
 
Ramsey told the Montgomery Advertiser her mother, 85, arrived at the center at 7 a.m. today and saw a line "around the building and up the road." She didn't feel up to standing in line in the cold and planned to go back at 9, but by then it was too late.
 
"I just think there is a better way it could be done," Ramsey said. "This is two days she has not been able to get vaccine. I have a friend whose parents are in their 90s. They are not able to stand there."
 
The Calhoun County Emergency Management Agency has not returned an Advertiser request for comment.
 
By Jan 2., the most recently available data, 226,250 doses of both the Pfizer and Moderna vaccine had been allotted to Alabama, while just 42,810 had been distributed.
 
This ranks Alabama as 4th slowest in the nation in vaccine distribution, according to data compiled by the Centers for Disease Control and Prevention. Alabama has a per capita distribution rate of 821 per 100,000 people, ahead of only Georgia, Mississippi and Kansas.
 
"The supply is far less than we would like for it to be. We have to work within the allocation that we have and move the vaccine as expediently as possible. This is more complex than giving the flu shot," said Dr. Karen Landers with the Alabama Department of Public Health.
 
Landers said once a vaccine vial, which contains multiple doses, is punctured, it must all be used within 6 hours, requiring careful time management of recipients. Recipients also must be monitored for up to 30 minutes for signs of an allergic reaction, which is not common and easy to treat but requires more staffing.
 
"There's a lot to be worked through," Landers said.
 
In Montgomery County, rumors spread this week that the County Health Department were opening up vaccinations to older adults. But both the department the Montgomery County Emergency Management Agency director declined to answer any questions on the topic, referring the Advertiser the ADPH.
 
There is no centralized database or apparent public notification plan to inform Alabamians when they might be eligible to receive the vaccine. Some states, such as Tennessee, have a county-level list of which recipient category is now eligible in which county, along with contact information.
 
Landers said Wednesday there are plans for something similar in Alabama but state officials are awaiting county-level data.
 
Counties and other providers do have the green light to move past Phase 1A, Landers said, without seeking approval from state officials.
 
"There will be nuances in individual counties. There may be counties and region, based on uptake and saturation, that are able to move past Phase 1A," Landers said. "This could be on a daily basis that they could move to a subset. ... Some counties are able to do that and some aren't. This is a fluid situation, and everybody needs to understand that it's based upon the supply."
 
Alabama has not released a comprehensive list of which providers have received vaccine, citing safety and logistical concerns, though several major hospitals among the first recipients have been open about their vaccine use.
 
In Montgomery, Baptist Health has administered 1,462 vaccine doses to Baptist Health employees in addition to 761 "community healthcare employees." Jackson Hospital confirmed Tuesday they had received an allotment but did not provide specifics.
 
In Tuscaloosa, DCH spokesperson Andy North said the system should "easily use" its initial allotment of nearly 3,000 on phase 1A recipients. The hospital systems had administered nearly 1,700 by Monday evening and were nearing time to administer the second dose to the first recipients.
 
"DCH has not yet received a second shipment of doses but has indicated more are needed," North said. "It is our understanding that ADPH is to indicate the timing of progressing to later phases and we have not yet received confirmation that we can do so. We are preparing our processes with the intent to be able to manage additional external volume as soon as we have confirmation that we can proceed with the next phase."
 
Meanwhile, the COVID-19 pandemic continues to swell in Alabama. Hospitalizations broke 3,000 for the first time this week, and case positivity rates have skyrocketed across the state, reaching more than 70% in one county.
 
Laura Grill, president of the East Alabama Medical Center, said in a Monday statement she is "blown away by how so many people have become number — and even belligerent — to COVID-19" as officials across the state plead with the public to remain cautious as the pandemic threatens to overtake hospital staffing capacity.
 
"Our clinical team is tired, but they press on," Grill said. "And I know health officials are tired of pleading with people about wearing a mask, social distancing and not gathering with people outside your immediate family. This is not hard to do, but people will fight you over it. And then I am amazed how quickly these same people become believers in COVID when they are the person diagnosed, or when a family member is hospitalized with the virus and is fighting for air."
 
Contact Montgomery Advertiser reporter Melissa Brown at 334-240-0132 or mabrown@gannett.com.
 
This article originally appeared on Montgomery Advertiser: Slow roll: Alabama's anemic vaccine release spreads confusion as some begin vaccinating elderly
 
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