Montgomery County officials are calling for the state of Maryland to establish a COVID-19 mass vaccination site in the county amid “significant concerns” about how the state is allocating a still extremely limited supply of shots.
County Health Officer Dr. Travis Gayles, who voiced his concerns about a decreasing share of vaccine doses being sent to the county health department in favor of other providers such as pharmacies, asked state health officials to consider a mass vaccination site in the county.
“We’ve got sites. Let’s have a conversation about it,” Gayles said, suggesting the county’s fairgrounds as one option for a mass vaccination site.
Gayles spoke during a county council hearing Tuesday at which Maryland Deputy Health Secretary Jinlene Chan also made an appearance.
A mass vaccination site opened Friday at the Six Flags America in neighboring Prince George’s County, and is ramping up to performing 2,000 vaccinations a day. Although shots on the first day were reserved for Prince George’s County residents, the site is now open to all Marylanders — although appointments remain limited.
“It is incredibly challenging to expect our residents to go to another jurisdiction and assume that will they have access there,” Gayles said.
As an alternative to opening a separate mass vaccination site in Montgomery County, however, Gayles also proposed setting aside a certain percentage of appointment slots at Six Flags specifically for Montgomery County residents.
Three members of the county council also pressed Chan to commit to establishing a mass vaccination site in the county.
“It’s illogical not to have something like this in the largest jurisdiction in the state,” said Council member Nancy Navarro, who represents District 4.
Chan said the state was open to considering additional mass vaccination sites but didn’t make any promises to council members.
In addition to the Six Flags site in Prince George’s County, another site opened last week at the Baltimore Convention Center.
Other sites are already planned on the Eastern Shore, and in southern and western Maryland.
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Defense of state allocations
During her appearance, Chan defended the distribution of vaccines in Montgomery County, saying that sending vaccine doses to multiple retail pharmacies and hospitals — which has had the effect of cutting doses to the county health department — is about building infrastructure for when the limited supply of doses significantly increases.
Increasing doses to Giant and Safeway pharmacies, as well as hospitals in the county “is part of our longer-range strategy to begin to establish that foundation of vaccination capacity throughout the state,” Chan said.
The state is taking a “whole of county approach” in deciding where and how much of the vaccine doses to distribute — not just to local health departments but other providers, too.
Amid concerns that vaccines are not accessible to the most vulnerable, Chan said state official took equity concerns into consideration when deciding which pharmacies to partner with to distribute the vaccines.
“We did look at where COVID-19 has impacted communities the most, as well as racial and socioeconomic status within specific ZIP codes and such, and use that to help guide some of the initial selections,” Chan said, adding, “what we are trying to do is establish multiple layers of vaccination access points.”
But Gayles said the increased doses sent to other providers at the expense of the county-controlled doses is concerning, because, he said, data shows local health departments have a better track record than retail pharmacies at getting shots in people’s arms.
This week, the county has seen its supply of vaccine doses cut from 5,500 to 4,500.
Last week, the county was receiving more than 7,000 first doses of vaccines in some weeks.
Is Montgomery Co. getting its fair share?
Council members pressed Chan on the county’s overall allocation of vaccine doses, arguing that it doesn’t appear Montgomery County is getting its fair share.
Council President Tom Hucker pointed to the state’s own data which showed, he said, that the five largest jurisdictions in the state — Montgomery, Prince George’s, Baltimore and Anne Arundel counties, and Baltimore City — are all receiving the fewest doses per capita.
Five of the state’s smallest counties — Kent, Somerset, Garrett, Talbot and Caroline counties — are receiving the most doses per capita.
“This would be a big problem if we were just talking about something like transportation dollars, but it’s unconscionable given that we’re talking about vaccines,” Hucker said.
Chan said the per capita disparity stems from the early days of the vaccination effort late last year. The state set a “floor” of 300 doses per week because of limited supplies.
“It did proportionally, per capita, appear to be greater” for smaller counties, she acknowledged, but added that the state is continuing “to evolve that process.”
No single sign-up site, state says
State health officials were also urged to create a single, statewide sign-up for registering for a vaccine appointment in Maryland.
At-Large Council member Evan Glass said he’s heard of county residents registering at every hospital and pharmacy, desperately searching for an open appointment.
“Why isn’t the state taking a more centralized approach to registration, a one-stop shop, where people can enter all of their information, and then be assigned to one of the vaccine providers in their area?” he asked.
Heather Shek, deputy director of the Office of Governmental Affairs at the Maryland Department of Health, said she recognized Marylanders’ frustration in not accessing appointments. But she said only four other states are using a centralized system to schedule vaccinations.
“So, I think this notion that Maryland is different and that we should be moving towards that system is kind of misinformed because not many other states are doing that,” Shek said. “We looked into that approach, and our health care system is not set up for a centralized system.”
Shek said the four states using a centralized system are Oklahoma, New Hampshire, New Mexico and West Virginia — the last of which has been hailed for its swift pace of vaccinations.
Having multiple ways to schedule an appointment each maintained by a separate provider “allows for agility and scheduling changes,” Shek said.
“There’s no single point of failure,” she added. “When we have several options for folks to sign up for it, it moves away from a bottleneck or one large system failure from occurring.”
In the end, Shek said the state’s system is working, because vaccinations are increasing — from about 2,000 shots administered at the beginning of the effort to an average of more than 22,000 a day currently.