The Morgan County Health Department is administering COVID-19 vaccines first-come, first-served this week for those 75 years old and up, instead of by appointment, in part because of failures in the state’s vaccine appointment hotline.
Vaccine concerns also triggered the Alabama Education Association on Monday to ask the Alabama Department of Public Health to prioritize K-12 teachers in receiving the vaccines.
Not only have people struggled to get through on the Alabama Department of Public Health vaccine scheduling phone line, the appointment process utilized by those manning the phone lines has caused problems, according to Michael Glenn, assistant administrator of the Alabama Department of Public Health Northern District.
“The call-in system has been challenging, to be kind,” Glenn said Monday. “We had patients scheduled on the wrong days and after hours or on the weekend.”
State Health Officer Dr. Scott Harris said Thursday that an online vaccine appointment scheduler would be up within “a few days,” but Glenn on Monday said it would be “unveiled next week or the week after. … Hopefully with this new online system people don’t have to be repeatedly dialing a phone number and being put on hold.”
Harris on Friday said he was aware the phone number for scheduling vaccinations has not gone smoothly.
“We have about 165 phone lines that vendor is using to staff that,” he said. “Clearly that hasn’t been enough in every case.”
The hotline received 1.1 million calls in its first day of operation, and Harris has said more than half of its call volume has been from people who are not yet eligible to be vaccinated.
ADPH did not respond Monday to a request for information on the identity of the vendor handling the vaccine scheduling hotline or the amount of money it has been paid.
Harris said it was critical that the online scheduling portal be activated before vaccine eligibility is expanded.
NIC Alabama will be handling the online vaccination scheduler for ADPH. Kara Cowie, director of corporate communications for NIC, said her understanding is that NIC’s contract with the state on scheduling starts Monday, and it "is working closely with ADPH to bring the scheduling system online as soon as possible. ... We’re standing up a solution that will hopefully make the scheduling process a lot easier for people.”
Doses in arms
While Glenn said the Morgan County Health Department has enough vaccine doses on hand to supply all the walk-ins it can handle this week, Decatur Morgan Hospital — which is providing vaccines solely by appointment — has received only one 1,800-dose allocation.
“We’re trying to get more,” said Decatur Morgan CEO Kelli Powers. “We put in orders the week before last, last week and we’ll put in another order this week. We hope to get some maybe this week to continue with the appointments.”
She said the hospital will run out of doses today if it does not receive a shipment.
Payless Pharmacy is also an authorized vaccine provider. While a Payless representative did not return a phone call Monday, Powers and Glenn said it was their understanding Payless has run out of vaccine.
Glenn said the Health Department vaccinated 1,600 Morgan County residents last week. Decatur Morgan Hospital administered about 900 doses last week and Powers said 250-300 would be administered Monday.
Powers said the hospital, which has a vaccine clinic at its Parkway campus, hopes to ramp up to 500 doses per day if vaccine supply allows it.
Both Powers and Glenn said vaccine supply is the main limitation they face in increasing vaccinations. The state receives 1.4% of the doses distributed nationally, and then distributes them to counties based primarily on population. The state has been receiving a combined 50,000 to 60,000 first doses of Moderna and Pfizer per week so far. Both vaccines require two doses.
At the current rate of vaccine deliveries, it would take more than two years to vaccinate the state's adult population.
Pfizer vaccines must be stored at ultra-low temperatures, and the Moderna vaccine must be stored below freezing.
Dr. Anthony Fauci, the federal government's top infectious disease expert, said over the weekend he expects a Johnson & Johnson one-dose vaccine to obtain emergency use authorization from the Food and Drug Agency in the next few weeks. Glenn said that would be an important development.
Logistically, he said, a one-dose vaccine simplifies and expedites vaccinations. The presence of a third type of vaccine would also increase supply, and it does not have as rigid temperature requirements as the other two vaccines.
“We’re doing the 75 and older age group, but there are some in that age group that just can’t get leave their homes,” Glenn said. “This vaccine’s not so hard to take care of, which means it can be taken into the homes and in different settings, and into rural areas where there might not be a large population.”
Vaccines for teachers
State and national problems with the vaccine rollout has the Alabama Education Association pleading with Harris and the ADPH to accelerate vaccinations for education employees.
AEA Associate Executive Director Theron Stokes sent a letter to Harris on Friday.
“I am writing to you today regarding the fact that education employees have been bumped down the list of individuals to receive the COVID-19 vaccine,” he wrote. “This is unacceptable and will lead to more education employees lost to this terrible disease.”
He noted that four Montgomery Public Schools educators recently died of COVID-19 over the course of 48 hours.
“I implore you to direct local health departments to vaccinate education employees as soon as possible,” Stokes wrote. “Education employees are dying on an almost daily basis because of COVID-19 and complications therefrom. Other than closure of schools, the only way to prevent this or slow this is to provide for the widespread vaccination of education employees.”
In a statement Monday, ADPH reiterated that vaccine supply is preventing it from expanding the categories of people eligible to be vaccinated.
“Vaccine supply is limited and does not meet demand at this time for the current numbers of persons identified as health care workers, first responders, fire, police, and persons 75 and above,” according to the statement. Harris on Friday said 600,000 Alabamians fit into these categories.
Health care workers are in the highest ”1a” priority for vaccines. Teachers are in the next highest category, 1b, along with first responders and people 75 and older. The state on Jan. 18 began vaccinating some in the 1b group but because of limited vaccine supply few teachers have been vaccinated, with the focus instead being senior citizens. Harris on Friday said increasing eligibility to include education employees would add 100,000 people, with no increase in vaccine supply expected in the short term.
While the vaccine rollout has been rocky statewide and nationally, Glenn and Powers both noted that local COVID-19 trends are improving.
Powers said at a Monday news conference that Decatur Morgan has 58 confirmed or presumed COVID-19 inpatients, well below its peak of about 100 COVID-19 inpatients. Twelve of those are in intensive care and on ventilators. The ICU is full, and even some of the ICU patients not currently testing positive for the virus are suffering from complications from the virus, she said.
Glenn noted the percentage of people testing positive for the virus has also dropped significantly in recent days.
He said he suspects increased awareness of the severity of the disease after a post-Thanksgiving spike may have prompted people to limit gatherings, social distance and use masks over the Christmas and New Year’s holidays. “If we were going to see something from Christmas and New Year’s, it would have already occurred,” he said.
He worries, however, that the favorable trends will lead people to stop taking the precautions necessary to limit transmission of the virus.
“I think that’s just human nature. As we see the train pass, we’re more comfortable getting back on the tracks again,” he said. “Those people that are on the fence seem to go back to their old habits again as positive news come out. We definitely don’t want that.”