Officials in Montgomery County, Maryland, say they are putting the finishing touches on a plan to make sure communities hardest-hit by the coronavirus have access to COVID-19 vaccines by allowing residents age 75 and older from certain ZIP codes to move to the front of the line for appointments.
The county’s “equity framework” is about making sure vaccine doses aren’t distributed in a first-come-first-served free-for-all, officials said.
Instead, starting next week, the county will prioritize residents 75 and older from the ZIP codes most ravaged by the virus, based on coronavirus case rates over the past 90 days and death rates since the start of the pandemic.
“Our framework is designed to ensure that vaccines are made available to those who have been most severely impacted, and also to make sure that we are attacking virus where in the county it is attacking us,” said Dr. Raymond Crowel, the head of the county’s Department of Health and Human Services, during a media briefing Wednesday afternoon.
Crowel first debuted the outlines of the county’s equity plan during a county council hearing Tuesday.
The county hasn’t released a list of the specific ZIP codes; Crowel said the list would be made public likely next week.
However, a map released by the county health department of coronavirus cases per 100,000 residents over the 90 days shows infections clustered in certain parts of the county.
The list of priority ZIP codes also includes some areas where a combination of case rates and death rates are higher for communities of color, which may not be reflected in the overall figures.
“Within those top-priority ZIP codes, the county doses will be allocated based on case rate and death rates by race and ethnicity for folks living in the ZIP codes that have been disproportionately impacted,” Crowel added.
Remaining doses will be made available to residents across the county, Crowel said.
The prioritization plan is “not cutting out any of the other ZIP codes, it is just prioritizing our attack and targeting our attack,” Crowel said of the equity plan.
Crowel also said those priority ZIP codes will likely change over time, “depending on where the virus is spreading and how quickly we’re able to vaccinate within a particular area,” he said, pledging to follow the data.
Montgomery County is not alone in seeking to prioritize vaccine doses for those communities hardest-hit. The District also set aside vaccine doses for particular ZIP codes.
Officials said the point of the equity plan isn’t to pit communities against each other in a competition for vaccines but to ensure equitable access to them.
“If it’s a competition, we know who is going to win that competition: People with more digital access, more time to be able to spend on the internet looking for appointments,” said Earl Stoddard, the county’s director of the Office of Emergency Management and Homeland Security.
He added, “It’s that competition, frankly, that is the thing that we’re trying to avoid by ensuring that we’re targeting not just from a racial equity standpoint, but from a public health standpoint, the areas where the virus is most spreading, and thus, where the vaccinations will have the most degree of protective power to reduce our overall community transmission rates.”
However, the equity plan officials have drawn up only applies to doses of the coronavirus vaccine administered by the county health department.
Overall, those doses make up just a fraction of overall vaccine supply in Maryland’s most populous county.
This week, the number of vaccine doses distributed overall to all providers in the county, which includes retail pharmacies and hospitals, totaled 12,275 doses. The Montgomery County Health Department’s share of that was less than half the total amount — 5,500 doses.
“We are encouraging other vaccination providers and the state to adopt an equity framework,” Crowel said. “So far, we’ve not heard a clear reaction or response to that but I’m hoping that they are actively considering doing something similar.”
As it stands now, the county is still focusing only on vaccinating those 75 and older, given the limited supply. Last week, about 11,000 residents in the 75-and-older category were vaccinated in Montgomery County, including by the county and through other providers. Overall, there are 85,000 county residents who are 75 and older who have preregistered for a vaccine appointment.
At that pace, it will take at least four weeks to get through the bulk of the county’s 75-and-older residents, Stoddard said.
Obviously, if the doses increase, we will go faster,” Stoddard said. “If they don’t increase, we will not go faster.”
County officials expressed concerns about the increasing doses going to private providers in the county, such as hospitals and retail pharmacies.
County Executive Marc Elrich said he was on a call last week with other county executives, local health officials and state health officials. “Pretty much all of us were asking them not to give any doses to pharmacies, but to continue to send them to the counties, because we have the capacity to put out whatever you’ve got.”