Preparing for next vaccine phase, Montgomery Co. urges more sign-ups to boost equity

Health officials in Montgomery County, Maryland, say they plan to start putting hundreds of recently authorized Johnson & Johnson coronavirus vaccine doses into arms as early as this week.

As they prepare to soon expand eligibility at county-run clinics for residents 65 and older, county officials are also urging community groups to help make sure as many people are registered as possible — saying it’s key to the county’s equity efforts to make sure distribution of the shot isn’t done in a scattershot, first-come-first-served manner but in a way that targets the most vulnerable, including Black and Latino residents and those in communities hard-hit by the pandemic.

Officials provided the vaccination update during a Montgomery County Council meeting Tuesday.

Both officials with the county as well as council members sharply criticized Gov. Larry Hogan’s administration and the Maryland Department of Health over what they perceive as failings in the administration’s plans for distributing vaccines across the state equitably.

Urging pre-registration

As the county prepares to soon begin vaccinating county residents 65 and older, health officials are making a big push to get people pre-registered in the system.

The county’s health officer, Dr. Travis Gayles, said there are still “significant gaps” in race and ethnicity in terms of residents who have already pre-registered compared with the county’s population. For example, while Black people are just shy of 20% of the county’s population, they make up just 8% of those pre-registered on the county’s list. Hispanic residents make up 20% of the county’s population but are just 10% of those on the county’s list.

White residents, meanwhile, are overrepresented on the pre-registration: 66% of the names on the list, compared with 43% of the population.

“I know everyone is working to look at opportunities to stand up clinics and vaccine opportunities and partnerships,” Gayles said of efforts by community organizations. “We support building that infrastructure, but where we really, really, really, really, really needs folks’ help right now is getting people pre-registered. That’s where we need folks engaged right now.”

Montgomery County residents can sign up for the county’s pre-registration list online. Residents without internet access or who need help over the phone can call 240-777-2982 for help getting pre-registered.

There’s still no firm timeline as to when the county will move into additional phases of the vaccine rollout — but it’s expected to be soon.

The county, which has continued prioritizing its 4,500 weekly doses to vaccinating the county’s oldest residents, is finishing up sending out invitations for vaccine appointments to all residents pre-registered who are 75 and older.

Gayles has previously said the county wants to at least offer a vaccine appointment to everyone  on the 75-plus list before moving into additional tiers of the vaccine rollout plan.

“We’re working hard to get those folks in as quickly as we can so that we can anticipate moving to the next prioritization groups,” Gayles said.

The additional tiers of Phase 1b include front-line essential workers; Phase 1c includes county residents 65 and older.

Johnson & Johnson vaccines going out this week

Federal authorization of the Johnson & Johnson one-shot coronavirus vaccine over the weekend means there are now three different vaccines in the mix.

Overall, Maryland is slated to get 49,600 of the new vaccine doses. Of that, 1,600 are headed to the Montgomery County Health Department, according to a tweet from Mike Ricci, spokesman for the governor.

Gayles, the county health officer, said the county’s shipment hadn’t arrived yet, but there were already plans to put them into use this week.

Gayles said the one-shot vaccine is safe and viable, and he sought to dispel what he referred to as myths around the vaccine, including that it is an inferior option compared with the Pfizer and Moderna vaccines.

The Johnson & Johnson vaccine was tested in South Africa, where a concerning variant of the coronavirus was first identified. Yet it was still shown to be 66% effective against moderate-to-severe illness and 85% against severe disease. Most importantly, it was shown to be 100% effective at preventing death and hospitalization. “No one who got the vaccine died from COVID-19,” Gayles said, “so just want to emphasize that.”

Some of the data indicated the vaccine’s efficacy may be lower in people older than 60 with underlying medical conditions. Gayles said, however, there are concerns about the strength of that data, and the Advisory Committee on Immunization Practices hasn’t yet released any further guidance.

Each vaccine site will likely only use one type of vaccine at any given time, said Earl Stoddard, director of the county’s Office of Emergency Management and Homeland Security Management.

“It gets very risky mismatching those,” he said, “particularly in a setting where sometimes you’re getting first and second doses already, then you throw in a second vaccine and — that’s how mistakes can happen.”

Continued push for mass vaccination site

County officials told lawmakers they continue to push the state to open a mass vaccination site in the county.

Maryland opened a mass site at Six Flags America in neighboring Prince George’s County last month, and several more across the state have either already opened or are in the pipeline.

The county has previously offered up the fairgrounds in Gaithersburg as one option, but the state is sticking with its original plan for mass vaccination sites, for now.

The county is considering launching its own version of a mass vaccination site at the Germantown campus of Montgomery College that would operate as a proof-of-concept for the county to show state officials they can handle such a site, Stoddard said.

Stoddard’s team and members of the public health team have already completed walk-throughs of the site. Stoddard estimated it would have the capacity to do 3,000-6,000 shots a day based on parking and square footage, although he acknowledged that staffing to that level would be challenging.

During a news conference later Tuesday, Hogan said the state is in active discussions with counties that have have expressed an interest in hosting a mass-vaccination site. Opening more sites, however, is dependent on more supply of the vaccine doses.

Criticism of governor, calls for accountability

Members of the Montgomery County Council had strong words for Hogan and the state Health Department over their handling of efforts to ensure the vaccines are distributed equitably.

Council member Craig Rice, who represents District 2, criticized the state for continuing to allocate more doses to retail pharmacies and other private providers instead of local health departments.

“Our private providers, pharmaceutical companies are out there doing whatever they want. It’s the wild, wild West in terms of dissemination of vaccine,” Rice said.

A bulletin issued by the state Health Department last week called on pharmacies to allocate at least 50% of their doses to vulnerable populations.

Rice said that doesn’t go far enough, and that the perception that the system is unfair is suppressing sign-ups for the vaccine.

“Those that are connected continue to get the vaccine, and those that are poor and those that are Black and brown are the ones that continue to be left by the wayside,” Rice said. “That is what they’re seeing. And so I cannot blame them for not wanting to register for a system that is working against them.”

Stoddard, the county’s director of emergency management, agreed that he thought the state was conflating two separate issues: vaccine hesitancy on the part of some people skeptical of getting the shots and broader equity concerns.

“If you treat them as the same thing, it shows a fundamental misunderstanding of the issues,” Stoddard said. “I support the state addressing issues around vaccine hesitancy, but you can’t use that as a surrogate for actually providing equal access and fair and fair and equitable access.”

In late January, Hogan named commander of the Maryland National Guard, Brig. Gen. Janeen Birckhead, to lead the state’s newly created vaccine equity task force.

But Montgomery County officials said too much of the state’s equity efforts have been focused simply on placing a mass-vaccination site in Prince George’s County, for example, a majority-Black county and the second-largest jurisdiction in the state.

According to data presented by Acting State Health Secretary Dennis Schrader earlier this week, just 3,500 of the 25,000 total shots administered at the Six Flags site went to Prince George’s County residents.

Gayles, the county’s health officer responded: “What’s missing from the conversation is accountability and effective leadership. And I recognize in making this comment, I may put my job at risk, because I’m a state employee. But, quite frankly, enough is enough.”

He said there is already the perception that the state hasn’t assented to a mass-vaccination site in Montgomery County because of local officials’ criticism of the governor.

“At the end of the day, it’s about accountability and effective leadership, and standing up and being able to acknowledge when there are problems in a system,” Gayles said. “And if things aren’t working, you have to acknowledge and say, ‘Maybe we should change the approach that we’re taking and do something differently.'”

WTOP requested comment from the governor’s office.

In an email response, Ricci, the governor’s spokesman said: “I expect that we will continue to make progress and prove the members of the council wrong. You’ll recall that not too long ago, they were saying that no one in the county would want to drive to Six Flags, and Montgomery County residents account for about out of three appointments. So we will just keep doing the work, and they can keep doing the opining.”

WTOP’s Kate Ryan contributed to this report. 

Jack Moore

Jack Moore joined as a digital writer/editor in July 2016. Previous to his current role, he covered federal government management and technology as the news editor at, part of Government Executive Media Group.

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