Some local health officials say they're not ready to vaccinate those 65 and older yet
Technically, Michiganders 65 and older, as well as some frontline essential workers, are eligible to receive the COVID-19 vaccine starting Monday, January 11th.
But that’s not going to get them an appointment any time soon at the Kent County public health clinic.
“We’re booked now,” says spokesperson Steve Kelso. “I can’t fit you in, even though you ‘know a guy’ [in the health department,]” he said, referring to some of the many, many phone calls they’ve been receiving.
That’s because those appointments are already filled through the end of January with members of the “1A” group: healthcare workers, EMS responders, and public health staff, Kelso said.
“The best we can do right now is say, ‘please stay patient,’ because vaccine supply is very limited right now, and it’s gonna continue to be limited for [the immediate future.]”
Similar messages are coming from health departments around the state, who say they were given just 24 hours notice before Governor Gretchen Whitmer’s public announcement Wednesday.
On Thursday, Oakland County officials released a statement pleading for patience from the public, and more supplies from the state.
“We urge the State of Michigan to increase Oakland County’s vaccine allotment while expanding the number of providers administering the vaccine,” county Executive David Coulter said. “Meanwhile, our Nurse on Call line is flooded with questions about appointment availability. Please visit our vaccine webpage for the latest on our vaccine supply and scheduling appointments.”
State under pressure to get shots in arms faster
The state has been facing increasing pressure to speed up: as of Friday morning, the CDC’s website ranks Michigan’s vaccine administration in the bottom half of all US states and territories, when adjusted for population size. That’s despite receiving more vaccines from the federal government than all but 6 other states.
Earlier this week, at least one major health system and a few local health officials told the Whitmer administration they were nearing the end of vaccinating the first group in the state’s prioritization plan: healthcare workers. (Vaccinations for long term care residents and staffers, who are also in the “1A” category, are being handled by large chain pharmacies in partnership with the CDC.)
They warned the state health department that vaccine could end up sitting in storage, if they weren’t able to start administering it to those in the next phase soon: senior citizens and frontline essential workers.
Indeed, even before Whitmer’s announcement, at least one county had already started vaccinating a few of those workers - mostly firefighters and police.
“As soon as our appointments started slowing down for the vaccine we had on hand, we did actually start ‘soft opening’ to some of the 1B groups,” Ingham County health officer Linda Vail said Tuesday. “We’re vaccinating roughly 350 people a day. And [last week] we had only 40 appointments scheduled for Wednesday. So I said, ‘Well, it’s time to let law enforcement and fire departments know that it’s coming.’ And then that filled up, and we vaccinated 410 people on Wednesday.”
On Tuesday, state health officials gave counties and health systems a heads up that, just 24 hours later, Governor Whitmer would announce the state “is entering a new phase in our vaccinations.”
“By January 11th, all counties may begin vaccinating Michiganders who are 65 and up,” Whitmer said Wednesday. “This will include some essential workers who will also be vaccinated; workers like our school and childcare staff, frontline local, state and federal first responders, and staff in our jails and prisons and shelters.”
But the governor also asked for patience, stressing that supplies remain limited and some areas are still only able to vaccinate healthcare workers.
“So we asked Michiganders to recognize these efforts, and the limitations because of the federal government allotments.” Whitmer said.” And we ask that you be patient, but you make your plan. Every shot in the arm is a step closer to ending this pandemic.
But multiple health officials say they’re not ready.
Conflicting messages: “make a plan,” but that’s not easy
The drumbeat from Whitmer’s administration to the general public has been the same for weeks now: “make a plan” to get vaccinated. “Get vaccinated as soon as possible,” the state’s chief medical executive Dr. Joneigh Khaldun urged Wednesday. “...[But] you should not just show up to any vaccination clinic without first making an appointment.
“If you're over the age of 65, you should first check our DHHS website to find out what health departments may have vaccine appointments available for you. And that list will be expanding, and we'll be sure to update it as more health departments are able to accommodate you for appointments.”
Khaldun told frontline essential workers, meanwhile, that “state and local health departments will be working with your employers...You will get vaccinated and you will start to learn more about that in the upcoming week.”
But anyone who did go to the state’s website this week would get conflicting information.
“If your local health department is ready to schedule vaccinations, a link is provided below,” instructions read. “If there is no link for your local health department, you can check back tomorrow, as this page will be updated regularly.”
As of Friday, only two health departments are listed on the site: the LMAS (Luce, Mackinac, Alger and Schoolcraft County) Health Department, and Ingham County.
Clicking on the LMAS Health Department link takes you to their website, with a January 6th statement on the home page, asking those coming for vaccination appointments...to wait.
“We know you have many questions about the process, when it will be your turn, and how will you be notified. If you are in a critical infrastructure/essential worker role, your communication will come through your employer. If you are a person age 65 or over (or you have a family member in that category), please pay close attention to updates through local radio, newspapers, social media to learn how you can schedule an appointment in your county. Unfortunately, we cannot give you exact timelines right now due to staffing resources, and uncertainties about vaccine supplies at any particular time.”
Ingham County’s site directs users interested in getting a vaccine, to fill out a survey with their personal information. “When we reach your prioritization group, you will receive a link to schedule an appointment,” it reads.
County health officer Linda Vail says this next phase of vaccinations will be an unprecedented logistical challenge: she estimates there are about 54,000 county residents who’ll need to be vaccinated in the first part of this 1B group.
“But I also get [only] 2,000 vaccines a week,” Vail says. “Now that's going to change. But for people who think that they're going to get vaccinated, like, on Monday...that’s just not going to happen. Not only that, but I hope people can understand that ethically, just like we did within the 1A group, we must prioritize. Because we only have so much vaccine.”
Hospitals, health systems gear up for vaccinations on a new scale
In the wake of Wednesday’s announcement, some health systems say they’re equipped to take on the brunt of the next phase of mass vaccinations. And given the burdens on local health departments, experts say that will be critical.
“We’re not going to be the agency that puts the majority of needles in arms,” says Kent County health spokesperson Steve Keslo. Large health systems have “much, much bigger staffs,” and have gotten experience in recent weeks with vaccinating thousands of healthcare workers.
On Thursday, Michigan Medicine said it expects to be able to vaccinate all 200,000 of the health system’s patients over the age of 65 “in the next two to three months,” according to a press release. Thus far, the health system has been allocated just 21,000 doses.
One lesson they’ve learned, says the health system’s president, Dr. David C. Miller, is that it’s a constant balancing act: you don’t know how much vaccine you’re going to receive on a week-to-week basis, so you don’t want to overschedule your appointments. But you also don’t want to have too many openings, because then too many doses are just sitting in storage.
“You want to try to find that [balance where you’re administering] 90% within seven days,” Miller said. “And so it's a constant balance between monitoring how much has been scheduled, being prepared to potentially release more invitations for scheduling, and knowing who the next group of patients that you can release those to are. And be able to reliably and quickly communicate. And so all of those are the kind of complex operational factors that are coming together in this process.”
If all goes according to the state's current plan, this initial phase of vaccinating those over 65 and frontline essential workers should be mostly completed by the end of April. At that point, depending on vaccine availability, state officials say they hope to begin vaccinating the remain essential workers, and anyone age 16 and older with pre-existing conditions that put them at greater risk.