More than 2 million Michigan residents become eligible for the COVID-19 vaccines as of January 11, but how and when those individuals will receive the vaccines remains uncertain, with many details still to be resolved.
Teachers, childcare providers, first responders and all Michiganders 65 and older are now among those eligible for vaccination, state officials announced on Wednesday.
Who is eligible for the COVID-19 vaccine and what else to know about expanding the program
This is welcome news for many.
“Question # 1 that I get every day from everyone is ‘When can I get my vaccine?’” Said Todd Belding, pharmacy manager at Sparrow Health in Lansing. “People want this.”
He and other hospital officials are applauding the state’s announcement amid calls to increase the pace of administration of the vaccine.
As of Wednesday, January 6, the state had sent 725,850 doses of vaccines to hospitals, local health departments and other entities that administer vaccines. But only 174,749 vaccines have been applied, according to data from the Michigan Department of Health and Human Services.
Among the reasons for this gap: Vacations complicated the scheduling of vaccination clinics; not all eligible in the initial round agreed to a chance; a third of the vaccine doses have been sent in just the past few days, and there are delays in notifying the vaccine administration. Still, there is a general consensus that the pace of vaccine administration needs to be accelerated and that the gap needs to be closed.
Michigan is among the worst states in the country to administer the COVID-19 vaccination, according to CDC data
Opening the vaccine program to large populations, such as teachers and the elderly, is the best and easiest way to increase Michigan vaccination numbers, said Belding.
“Large groups will be much easier to mobilize than some of the smaller groups”, such as dentists and optometrists, said Belding. “This is the way to do this, if we want to move quickly.”
Even though the implementation is complicated, time is of the essence and the main objective is to vaccinate as many Michiganders as soon as possible, experts agree.
“What I like about the state’s strategy is that they have been very clear about their values,” said Marcus Cheatham, health officer for the Mid-Michigan District Health Department, who oversees Clinton, Gratiot and Montcalm counties. “The main value is: Use the vaccine. Put that on people. Because even a few days can make a difference to save a life. “
But the short term of a dramatic expansion that will begin next week has prompted local health departments, hospitals and other vaccine providers to strive to implement it quickly.
Among the details that need to be addressed: Will the local health departments maintain mass vaccination clinics? Or hospitals and other health care providers? Both? How and where do people register for consultations to receive vaccines? Will there be a screening to verify eligibility or will it be on the honor system? Will these rules be defined at the state or municipal level, or at the entity that administers the vaccine?
“The general lines are well defined,” said Cheatham. “Companies are making the vaccine. It is reaching hospitals and public health departments. People will search for information about vaccines online. They will sign up and receive the vaccine when it becomes available. This is very clear.
“But the moment, what day you take the photo, where it will be, who will give you the photo – these details have not been resolved,” he said. “At the moment, today, most people are unable to register. Most people don’t even know where to apply. But that will all be fulfilled ”in the coming days.
In addition, the expansion of the vaccine program will start slowly simply because the demand for the vaccine is likely to exceed supply.
“It is important to note that the vaccine available in the state is limited and therefore there will be a limited number of consultations available,” said a press release from the Michigan Department of Health and Human Services. “As more vaccines become available, the state will be able to move through priority groups more quickly.”
Provides the limiting factor for coronavirus vaccinations, even in Kalamazoo County, where it is done
That said, hospital officials say they are ready to move from vaccinating their own employees to the general public.
“We are ready to begin the expansion,” said Dr. Jeffrey Fischgrund, head of clinical care at Beaumont Health in the Detroit metropolitan area. “It is really exciting.”
So, what happens next?
Public health officials are being inundated by phone calls and e-mails from people who want details.
Those details will be released soon, they say.
The state’s coronavirus vaccine web page will soon begin providing links to local health departments as soon as they start scheduling vaccinations. The elderly can also consult the website of the local health department online, as some have started to write down names of people seeking a vaccine.
Specific vaccination clinics are expected to be set up for essential workers through their employers, as well as flu clinics in the workplace.
For the elderly, vaccination clinics will be set up by local health departments, hospitals and other health care providers, although details are still being worked out.
Public health departments and hospitals can also contact eligible individuals using state lists of, say, licensed teachers or child care providers to invite them to schedule an appointment.
Michigan Medicine will start vaccinating patients 65 and older on Monday
For example, Beaumont is planning to reach everyone 65 and older in his patient database and encourage them to get a vaccine through Beaumont, said Fischgrund.
“We just have to get the message out to the community now and determine how they can sign up for appointments, so that’s no small feat,” he said. “Realistically, it will be sending out invitations and then the first to arrive, first to serve, as they respond to the invitation.”
Challenges ahead
Health officials do not underestimate the challenge ahead.
Trying to vaccinate the entire adult population as quickly as possible “is something we’ve never done before, nobody has done it before,” said Fischgrund.
And it’s not just the scale of the program.
“These are unusual times in unusual circumstances, with an unusual vaccine,” said Joel Strasz, public health officer for Bay County. “It’s not like we can just align people and analyze them.”
He and others say these challenges include:
- Uncertainty about the vaccine stock. “I found out on Monday how much vaccine I am getting on Tuesday of that week,” said Belding.
- The unique vaccine storage and handling requirements. The Pfizer vaccine, for example, must be stored in special freezers at very low temperatures and must be used within six hours after reconstitution.
- The need to schedule appointments vs. having an outpatient clinic because of the six-hour window and the lack of vaccine doses. “You don’t want to have to throw away any vaccine, which would already be a disaster,” said Strasz. “But you don’t want a ton of people to show up and then go without a vaccine, because then you will have people who are angry.”
- Difficulty scheduling appointments due to uncertain vaccine availability. “The state told us, frankly, they don’t know each week how much vaccine they are getting, so they cannot promise us how much we will receive,” said Cheatham. “In order to be able to schedule things, but they may have to be canceled. Or we may suddenly have an extra vaccine and then have to recruit more people to be vaccinated. So, it will be difficult for everyone, but we will try to provide as much information as we know. “
- Organizational issues surrounding the planning of vaccination clinics that maintain social distance and ensure that recipients meet the criteria for receiving vaccines.
- Because each person needs two photos, ensuring that people have a second appointment with reminders sent.
There is also the fact that the vaccination program is largely decentralized, with local health departments overseeing much of the coordination. That means “you have 83 counties coordinated in 83 different ways,” said Strasz.
“It is a good question, a fair question as to why there is no more centralized strategy for registration and distribution,” he said. “But even with the best efforts at the state level, it really is about individual decisions at the local level.”
Brian Brasser, chief operating officer at Spectrum Health West Michigan, said Spectrum is working closely with health departments in its 13 county service area.
It helped considerably, he said, to be part of the West Michigan Vaccine Collaborative, which is a network of local public health agencies and health care providers from Berrien to Kalkaska counties.
“This has been invaluable, even though we may not end up with the same processes or the same priorities,” said Brasser.
“We don’t see this as a competitive advantage,” he said of coordinating with other health organizations. “It is about meeting the needs of the community. And I really have a feeling that everyone is in the same boat, and that everyone is pulling in the same direction, although there are some unanswered questions that we are waiting for. “
Strasz said the vaccination program has already yielded a series of surprises and he hopes there will be more.
“We were surprised that we did it before the end of the year,” he said. “So there was a surprise at how difficult it was to actually distribute due to storage and handling requirements. He was surprised that people didn’t want to catch it at first, and now there is a surprise with the demand. “
But he also predicts that the process will smooth out quickly. “I know this from my experience with the H1N1 vaccine, how quickly and efficiently we were able to complete the process in a few weeks,” said Strasz.
Rapid implementation will mean a somewhat confusing process at first, with health departments and healthcare providers outperforming themselves as each entity maximizes its reach, said Cheatham. “This thing is going to advance on several fronts. And it will be confusing. “
But the faster the program starts, the faster the more people will be immunized, said Cheatham and others.
“The people who want it, really want it,” said Belding. “They see it as the light at the end of the tunnel, and I really believe it is.”
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