Health care workers report trouble getting vaccines in Delaware

Delaware officials are still struggling to make sure the state’s front-line health care workers are vaccinated before moving on to more widespread vaccinations.

Gov. John Carney on Tuesday said the state’s vaccine rollout has been slow to start, but the infrastructure is in place to quickly ramp up distribution. According to the state’s vaccine tracker, less than half of Delaware's doses have been administered.

Officials said vaccinations for phase 1B, which includes people over 65 and some essential workers, could begin in the last week of January. With more than 200,000 people in that category, the challenge of distributing the vaccine will be amplified.

State officials are beginning the use of "high throughput" events in Delaware that can vaccinate a large population at once, which they hope will speed up the process in future phases. 

Private health care providers who fall under the state’s first vaccine rollout phase because their work exposes them to COVID-19 patients have reported difficulty arranging vaccines for their staff and communication issues with the Division of Public Health over the first month of the vaccine rollout.

As several states in the region this week announced plans to move to later phases of their vaccine rollout, in accordance with new guidance from the Centers for Disease Control and Prevention, Delaware officials reaffirmed their commitment to vaccinating health care workers and long-term care residents and staff before moving on.

"The imperative for me is to amp up the throughput in vaccinations," Carney said. "Right now, we have more supply than we’ve been able to distribute."

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So far, most of the state’s vaccine supply has been sent to its major health care systems to vaccinate front-line workers routinely exposed to COVID-19, along with some workers not directly involved in patient care but potentially exposed to contaminated surfaces or air.

Some employers in private practices are frustrated that non-front-line employees are receiving vaccines before their staff, who conduct COVID-19 tests and treat patients with the disease. As they’ve tried to get the vaccine, they say, they’ve encountered a disjointed system that leaves the onus on small practices to become vaccine providers themselves or to track down vaccines through their own individual connections.

"We’re a forgotten group," said Dr. Sherin Ibrahim Howett, who oversees a nine-person staff at Pearl Health Clinic in Millsboro. "It’s a free-for-all."

For smaller private practices, the state has said one of the best ways to receive vaccines is to become an enrolled provider, which requires cold storage equipment and CDC training because of the delicate nature of the COVID-19 vaccines.

Christopher Miller, a registered nurse at Infusion Solutions of Delaware, said it took his Dover office about a month to complete the registration.

Since becoming one of the first private practices in Delaware to administer vaccines on Jan. 5, three weeks after the state administered its first doses, Infusion Solutions has been inundated with calls from nurses, medical assistants and physician assistants in private practices anxious to get vaccinated. The practice is vaccinating 80 to 90 per day, Miller said.

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The state says it has 190 providers enrolled to deliver vaccinations. As of Wednesday, 103 of them have begun giving vaccines.

"The difference is attributed to the number of pharmacy sites that are now enrolled that will begin vaccinating very soon that have not been a part of the federal long-term care facility program, and recent enrollees who are going through the vaccine assignment process," wrote a Division of Public Health spokesperson in an email.

For those who don’t want to or can’t administer vaccines, Dr. Rick Hong, the Division of Public Health official in charge of vaccine rollout, said practices “can always partner with other practices or other providers that are already enrolled in the process.”

A.J. Schall, the director of the Delaware Emergency Management Agency, said Tuesday that the state is playing "matchmaker" for providers unable to vaccinate their own staff. Leaders and employees of private care practices who spoke to Delaware Online/The News Journal say they have not experienced this in the past several weeks.

"All of them have done at least some people," Schall said. "But we are actually increasing or redirecting allocations of vaccine to help speed that up. … By the end of this week, each hospital system is going to have multiple clients on the books to help make this happen."

Carney acknowledged Tuesday state partners including hospitals were "a little bit slow to start as were we" in vaccinating people outside their facilities. He said now they’re ready to "rock and roll."

After trying for several weeks to become a vaccine provider, Howett said she got her staff vaccinated  Jan. 9 through a chance conversation with the Millsboro Fire Company.

Howett said the fire chief on told her his team had been vaccinated at their firehouse, less than a mile from Howett’s clinic. They had leftover doses that were taken to Kent County, she said.

After connecting with the Harrington Fire Department, Howett and her staff drove roughly an hour north and received the vaccine there.

The Millsboro Fire Company declined to comment, saying they weren’t authorized to discuss vaccine distribution.

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"You shouldn’t have to know somebody who knows something to get it," Howett said.

Dr. Nadiv Shapira, an 80-year-old surgeon in Wilmington, received the COVID-19 vaccine Monday night after his friend Dr. Robert Walter of Brandywine Pediatrics called him saying his practice had an extra dose after vaccinating his staff.

Shapira had been trying to get the vaccine through the state for three weeks. The state said he should become a provider. 

"That’s not my job," Shapira said. "It's not a part of my office. I just wanted to sign up for the vaccine."

Carney said the solution to finishing phase 1A lies in increasing the number of "high throughput" events in Delaware that can vaccinate a large population at once, similar to the state’s testing sites. Delaware is hosting six drive-thru clinics this month aimed at first-phase workers.

At an event at the Georgetown DMV last week, 650 first responders were vaccinated in two hours. Officials expect these upcoming drive-thru events to surpass that number because they will go on from 10 a.m. to 4 p.m.

To vaccinate health care workers, a number of pharmacy clinics are also opening in the next three weeks, officials said.

• This week: 6 Rite Aid stores and Camden pharmacy
• Week of Jan. 18: 60 Walgreens and Giant stores
• Week of Jan. 25: 11 Albertsons (Acme/Safeway) and CVS

There isn't a central place for health care workers to sign up for a shot from these clinics. The state says that health care practices that haven’t gotten their vaccination plan should email vaccineplanning@delaware.gov, and the Division of Public Health will connect people directly with a participating pharmacy. Health care workers can fill out this online form and send it with the email.

The state is still managing a small number of vaccines. Officials have said previous shipments were smaller than what the state had initially planned for. According to the state’s vaccine tracker, Delaware went five days last week without receiving a new shipment. 

Dr. Karyl Rattay, the director of the Division of Public Health, said the state’s allotment during that time went to long-term care residents and staff. Those vaccinations are being handled by a federal pharmacy program in which the pharmacies receive the doses directly.

As of Tuesday afternoon, 42 of the state’s 188 long-term care facilities have started vaccinations (4,685 doses administered). Rattay said almost all facilities will be visited by the end of the month.

The state estimates there are around 70,000 who qualify for the first phase. About 4 in 10 people in that group have been vaccinated roughly a month into the process.

Delaware’s vaccine administration totals, which officials say could actually be higher due to reporting delays, mirror the nation’s slow start to the vaccine rollout. 

In an attempt to speed up the process, the Trump administration on Tuesday said vaccines should no longer be held back for second doses and states should start offering vaccines to people over the age of 65.

The reversal from the administration’s previous strategy came days after President-elect Joe Biden announced similar plans to release nearly all the vaccine supply. Biden introduced a $1.9 trillion COVID-19 and economic relief plan Thursday that includes speeding up vaccine distribution.

Pennsylvania, New Jersey and New York were among several states that expanded their recipient pool after the Trump administration announcement.

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Delaware officials said the science still points toward holding back second doses to make sure they are available when needed, even though the CDC said vaccine manufacturing is now stable enough that availability for second doses shouldn’t be an issue.

Carney said he expects Delaware to receive more supply soon from the Biden administration. 

When asked how many people the state aims to give initial doses to on a weekly basis, a spokesperson for the Division of Public Health said there is not a simple answer.

"It’s important to emphasize that our goal is based on supply and will increase as we receive more doses and enter into the next phase of distribution," the spokesperson said in an email. "Ultimately we want to use up our weekly allotment using traditional vaccine delivery channels and mass vaccination sites. Once these access points are up and running, supply will dictate number of vaccinations distributed each week."

It's unclear exactly how many people in the state need to be vaccinated for the population to be considered by state health officials as achieving herd immunity, though scientists have said true herd immunity ranges from 70% to 90% of people.

Those in the next phase are still seeking answers regarding how they will receive the vaccine. Several residents who qualify for the next round of vaccinations said the state’s vaccine hotline directs them to their primary care providers, who haven’t received clear information from the state.

"We do plan to make this super clear for people in the near future," Rattay said. "What we’ve been trying to communicate is there are going to be multiple options for you to get vaccinated. It’s not time yet for people over 65 and we promise that we will have instructions around those options."

Delaware does not have a way of registering for notifications around when it will be your turn to receive the vaccine, as is the case in other states. Rattay encouraged residents to check the state’s coronavirus website and press releases for updates on pharmacy availability and vaccination events.

The urgency is growing as Delaware reports record infections and hospitalizations and multiple states in the country have reported a new variant of COVID-19 that is more contagious. While Delaware has yet to report the variant’s presence in the state, it’s likely only a matter of time before it’s confirmed, Rattay said on Tuesday.

"If and when we begin to see spread of it, it’s certainly possible that we’ll see a higher level of infectious spread in the state, so there’s potential for another surge with that," she said, adding that it’s only more reason to speed up vaccinations.

Contact Brandon Holveck at bholveck@delawareonline.com. Follow him on Twitter @holveck_brandon. Contact Sarah Gamard at sgamard@delawareonline.com. Follow her on Twitter @SarahGamard.