The day after state health officials announced that 2,400 doses of the COVID-19 vaccine had expired under the negligent supervision of the Shelby County Health Department, one employee was fired, another retired and drumming is increasing in state investigations. and federal.
At a press conference on Wednesday, February 24, Shelby County Health Department Director Alisa Haushalter admitted that she considered resigning, but decided that her duty as a leader requires her to be “transparent about what happened” .
“It is my responsibility to be responsible for what happened, to raise it to the state where I knew there were missed doses, what I did, to work closely with the state to determine what the problems were and to resolve them in a systematic and organized manner” , she said.
US Congressman David Kustoff is seeking further investigation, which he says can reach the federal level.
“Due to gross negligence and possible misconduct, the executive branch of the Shelby County government mistreated and wasted thousands of vaccines, ultimately failing in our local community,” said Kustoff in a statement on Wednesday.
“Fortunately, the Tennessee Department of Health is working with the city of Memphis to achieve an efficient and effective distribution process. Undoubtedly, local authorities must be held accountable, ”he said. “I welcome the additional investigation by state and possibly federal authorities about this fiasco.
On Tuesday, when the state announced its findings, he said he hoped federal partners would also investigate.
Haushalter said on Wednesday that local efforts to break state policy and vaccinate teachers started the ball rolling, with thousands of doses reserved for them.
When word got out that the Department of Health was saving doses for a non-priority group, there was more unrest in Nashville.
“Storage for a later stage is not authorized,” said state health commissioner Lisa Piercey late on Wednesday, “and this action unnecessarily prohibited high-risk seniors from receiving their fair share of this limited life-saving resource” .
When state officials told the Department of Health that they should wait until early March to vaccinate teachers, about 50,000 doses were available.
When ice and snow came, and doses were almost expiring, the Department of Health opened indoor locations and distributed 2,000 doses, but it was not enough, Haushalter said.
Storms and then low water pressure aggravated the situation, closing vaccination sites for 10 days.
Most of the waste happened on Wednesday, February 10, or Thursday, February 11, Haushalter said, including a large tray of Pfizer vaccine that was thawed and expired before it could be used.
Another 700 doses were distributed on Monday, February 15, because they were not used in a clinic set up quickly for teachers in Shelby County schools to receive the doses.
Snow and ice made it difficult to reach the council headquarters on Avery Avenue.
A variety of factors can lead to missed doses, including that they were thawed and expired before use, that remained after clinical sessions or were returned after a clinic, but had to be destroyed due to changes in temperature, said Haushalter.
She learned that about 1,300 doses had expired on Saturday, February 13.
The Department of Health hired a contracted pharmacist, Marilyn Bruce, as director of pharmacy services. His responsibility was to administer and prepare the injectable vaccine inventory.
Bruce lost his job. Dr. Judy Martin, chief of immunization at the Department of Health, retired in the turmoil.
Haushalter said he was sure that the errors were not intentional. A change already identified is that more than one employee will have the pharmacy key to monitor stock levels.
“It’s a very complicated vaccine campaign and the Pfizer vaccine is particularly difficult to manage, temperature control, dates when it can be in one type of storage and days in another type of storage, and we had several batches arriving in”, said Haushalter.
“My own belief is that the trays were removed for events that occurred in the future and that a tray expired without warning that we needed to release the vaccine to the public,” she said.
When the weather hit and the sites were supposed to be closed for days, Haushalter suspended shipments from the state on Friday, February 19, to prevent stockpiles from continuing to rise.
She alerted the state Department of Health that doses were missed on Saturday, February 13, and received no response, she said.
“I made other attempts during the week to contact Dr. (Michelle) Fiscus, (medical director of the immunization program at the state Department of Health), without returning the call.”
Ultimately, said Haushalter, she called Dr. Tim Jones, a medical officer for the state Department of Health, to alert him to the waste.
That call triggered the statewide review of the files here, which started on Friday night, February 19, and continues.
By the end of this week, the Shelby County Health Department will have a plan to work with the state to address deficiencies in local processes. The hope, she said, is that the Health Secretariat will be able to receive and distribute the vaccine again.
For now, the city of Memphis has control over the COVID-19 vaccine and all other vaccines that the Ministry of Health distributes, including measles and flu. The doses are being stored at Regional One.
In the meantime, health partners across the city, including hospitals and clinics, will run vaccination sites within the city’s borders with the municipal government.
Baptist Memorial Hospital and Christ Community Health Services identified places where they could expand quickly. The question, in light of Tuesday’s riot at the Department of Health, is how much more vaccine they should expect to receive.
“We cannot know exactly how to prepare until we know what kind of vaccine distribution we will receive,” said Keith Norman, vice president of government relations at Baptist Memorial Health Care.
“We understand from the investigation that some changes are being made,” he said. “Health partners, hospitals and other community partners will play a more important role.”
The allocation decision is likely to be made at a community-wide partner meeting, said Doug McGowen, director of operations for the city of Memphis, on Tuesday.
In a move that has been planned for weeks, Christ Community and the city of Memphis opened a drive-through at Greater Imani Church on Wednesday, with commitments to give 1,000 doses a day.
“We are a contract operator for the city,” said Shantelle Leatherwood, CEO of Christ Community. “We are providing all clinical services – vaccination itself – and the city is providing support through volunteers and FEMA to help with registration and checkpoints and data entry.”
As a managing partner, the city offers trailers, tents and portable toilets. It also covers the costs of the Community of Christ, including labor.
“We are hired by the city until they tell us that they no longer need our services. They basically shared with us that we honestly need to perform at peak performance in the coming weeks to fill all vaccines scheduled last week, this week and the next two weeks, ”said Leatherwood.
She also offered Christ Community clinics on South Third Street and Hickory Hill as major locations in clinically underserved areas.
“We have enough space and parking to handle the cargo at these locations,” she said.
The challenge will be how much the partners can extend.
“I think we can handle two sites at the same time; I’m not sure we can do three, ”said Leatherwood.
For Baptist, the problem comes down to the number of doses he could receive, which could increase significantly in a matter of a week. On Wednesday, the FDA said Johnson & Johnson’s single-dose vaccine appeared to reach the limit for emergency use authorization.
If approved, the Biden administration is prepared to launch 3 million to 4 million doses of the J&J vaccine next week.
“If they just gave us another 100 doses or more, we would probably still be in the hospital,” said Norman. “But if we get an additional 1,000, we could probably actually increase some services in places where it could be a convenient and easy process to help people in a dignified way, the way we like to serve our constituents.”
Baptist has several mass locations in mind.