Eligibility expanded, but availability still uncertain
The pace of COVID-19 vaccinations in Okanogan County, and throughout Washington, should accelerate in coming weeks after the governor announced the state is moving into the next phase of vaccinations and expanding eligibility to people 65 and older.
Local health officials say the supply of vaccine, however, will determine how quickly people can get vaccinated against COVID-19.
Gov. Jay Inslee announced Monday (Jan. 18) that the state is moving immediately into Phase 1B, tier 1, of the state vaccination plan. That phase previously included people age 70 and older, as well as people over 50 who live in multi-generational households, but will now include people 65 and older. The change means about 400,000 more people will be eligible statewide.
“I’m very happy about this announcement and it aligns with CDC [federal Centers for Disease Control] recommendations,” said John McReynolds, CEO of North Valley Hospital in Tonasket. “It will open the vaccine up to a lot of patients who would not otherwise qualify yet.”
“The biggest barrier to more quickly vaccinating larger numbers of people is vaccine availability. If I use all my doses this week will I get more doses next week to cover the second shots? As time goes on we know this will improve, but it will take time,” McReynolds said.
Advocating for 65
Local health officials have advocated for the state to adopt 65 as the age limit for Phase 1B, and North Valley Hospital, Three Rivers Hospital and Family Health Centers began making appointments and vaccinating eligible people Monday, said James Wallace, chief health officer for Okanogan County Public Health.
“We are glad to see our advocacy efforts worked and we got 70 reduced to 65 years,” Wallace said. Statistics show that people over 65 are at greater risk of severe illness or death from COVID-19.
Inslee announced a goal of administering 45,000 vaccinations a day statewide as soon as possible, which is more than three times the number given last week, according to the state Department of Health (DOH). It’s also more than the current allotment of vaccine given to Washington by the federal government.
Okanogan County now has five sites approved by the state to receive COVID-19 vaccines. Starting in mid-December, North Valley Hospital, Three Rivers Hospital in Brewster and Family Health Centers, headquartered in Omak, began receiving vaccines and giving shots. Mid-Valley Hospital and Confluence Health, both in Omak, hope to begin soon, Wallace said.
“We’re welcoming the speed,” Wallace said. “Forty-five thousand vaccinations per day in the entire Washington population of 7.6 million would mean 250 per day given an Okanogan County population of 42,000,” Wallace said. “We need more partners vaccinating to accomplish that, and more supply.”
Family Health Centers, which operates six medical clinics in Okanogan County, including one in Twisp, is getting a DOH-approved refrigerator to transport vaccine (which must be kept frozen until use) to transport vaccine between sites, Wallace said.
“EMS services and schools and large employers are ready to help with large-scale vaccine events, when phases allow for it,” he said. “We of course need vaccine supply to accomplish that, too.”
State restrictions
Under state guidelines, vaccinations have been restricted, until this week, to people in Phase 1A — health care workers and residents and staff of extended-care facilities. The pool of people in Okanogan County eligible under Phase 1A was smaller than the supply of vaccine, and some health care providers expressed frustration that vaccine was sitting in freezers waiting to be used while citizens clamored to get vaccinated.
As of Monday morning, North Valley Hospital had 1,140 doses of the Pfizer-BioNTech vaccine on hand, and had given 1,329 doses since mid-December, McReynolds said. With the opening of Phase 1B, the hospital expects to give 80-100 doses a day “and will open up weekend hours if demand and supply support the move.”
Both the Pfizer-BioNTech and Moderna vaccines require two shots to be fully effective, three weeks apart for the Pfizer and four weeks apart for the Moderna.
“As we ramp up for B1 the amount of vaccine we have will likely impact how quickly we can schedule patients,” McReynolds said. “We need to be confident in our ability to supply the second doses that we already have on the schedule.”
Supply uncertainty
Uncertainty about vaccine supply is the biggest concern among hospitals and other health care facilities, said Afton May, director of quality for Mid-Valley Hospital. Approved as a vaccine site, Mid-Valley has requested but not yet received any vaccine.
“We’re still waiting to hear back from the state about when we’ll get vaccine. It’s in constant flux … there are questions about how much vaccine the state is receiving from the federal government,” May said.
In collaboration with North Valley Hospital, Mid-Valley Hospital has vaccinated 91% of its staff that wanted the vaccine, May said. Staff at North Valley Hospital, which has received the largest supply of vaccine in the county, “has been amazing at trying to help everybody, bringing vaccine and staying through the event,” May said.
Three Rivers Hospital has received 700 doses of the Moderna vaccine since late December, and had given 300 doses as of early this week, said spokesperson Jennifer Best. Family Health Centers has received a total of 800 doses of Moderna vaccine and administered 150, said Wallace, chief health officer for Family Health Centers. “Now that we’re in 1B we anticipate running through our supply quickly,” Wallace said.
Vaccine sites in the county are seeing high interest among citizens wanting to get vaccinated. They have created websites where people can sign up, and are fielding high volumes of phone calls.
“The number of registration forms is increasing. So far, we’ve received a total of 647 forms through our website,” said Best at Three Rivers Hospital. After the state announced Monday the beginning of Phase 1B, 134 forms were filled out on that day alone, she said.
“I would say at this point, on a statewide level, the demand may outpace the supply, but we’re determined to help meet the governor’s goals. We all knew going into this that there wouldn’t be enough vaccine at first, due to the amount ordered by the federal government,” Best said.
Speeding up
In addition to the goal of 45,000 vaccinations in Washington per day, Inslee said the state will also require doses to be used up more quickly — 95% of allocated doses must be administered within a week after they are received. All vaccine providers must provide information daily on vaccines administered and plans for using remaining doses.
As of Jan. 16, about 294,386 doses of vaccine had been given statewide, DOH reported. That’s 42.3% of the 696,075 total doses of vaccine that have been delivered to Washington state. Last week, 14,300 doses were given per day on average, according to DOH.
Although the state does not yet have the supply of vaccine to meet the goal of 45,000 doses per day, health officials at state and local levels will work to build the capacity to meet that goal, DOH said.
DOH reiterated this week that vaccines should not be wasted. If vaccine providers have doses that are at risk of expiring (they must be used within 6 hours after preparation) because there are not eligible people available, “providers may give them to the next right person.”
The state also rolled out an online questionnaire this week called Phase Finder that allows people to determine if they are eligible for a vaccination, and can be used for proof of eligibility when people go to a vaccine appointment. The questionnaire can be found at FindYourPhaseWA.org.
Inslee also announced on Monday plans for large vaccination sites starting next week in Spokane, Kennewick, Wenatchee and Ridgefield, utilizing the National Guard to help set them up.
He said a new public-private partnership will help coordinate resources for the statewide vaccination campaign. The collaboration includes Washington corporations — including Starbucks, Microsoft and Costco — labor unions, health care groups and government entities.
“We are removing as many impediments as possible to Washingtonians getting vaccinated, we are going to deliver every dose that comes into our state,” Inslee said in a press conference. “We will still be dependent on the federal government for doses, but we are doing everything we can once it gets here.”
