The disparity in vaccine distributions in Maine worsens – conflict of explanations

A huge regional disparity in vaccine availability in Maine has worsened this week after state allocations have left the mass vaccination sites serving northern York County and the western suburbs of Portland operating at 50 to 80 percent of their capacity.

Meanwhile, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, spent two minutes of Tuesday’s media briefing asking Mainers aged 70 and over to schedule vaccinations at the Cross Insurance Center in Bangor, where the Northern Light Health is vaccinating more than 1,000 people a day by repeating the phone number to call. The clinic had to work hard to fill the available hours after discovering a software error.

The MaineHealth Scarborough Downs vaccination site, however, was operating at only 80% capacity due to a lack of vaccines, despite serving the most populous part of York County, which has by far the largest number of people over 70 unvaccinated inhabitants in the state: an estimated 16,500 on Monday based on census and demographic data, compared to 8,900 in Penobscot County, where the Cross Insurance Center is located.

Shah and MaineHealth have totally conflicting reports about why this is happening – and why Northern Light and other providers in Penobscot County received 8,720 doses of vaccine this week, while York County providers received 1,600 and Scarborough Downs was content with 4,000 to serve Cumberland and York counties.

Cumberland County, with Scarborough Downs at its southern end, received 9,120 doses, almost the same number as Penobscot, although it has twice the population and hosts the medical centers and vaccination sites that serve much of Sagadahoc and northern counties York.

Shah said the problem has been the lack of additional capacity in Scarborough and other mass vaccination sites in the state that have received lesser allocations than the number of unvaccinated people over 70 in their service areas would imply.

“I have been very clear about my priorities: if you are running a high-performance website like Cross Center or Scarborough Downs or Intermed and need more vaccine, we will find it,” said Shah in an interview on Wednesday. “I’m not being petty or having any special love for Penobscot County. If they have people willing to receive gun injections, I will give them the vaccine. ”

Shah said he has sought out all suppliers of mass vaccination sites and encouraged them to expand capacity quickly, as large sites have the fastest and most efficient methods for obtaining effective herd immunity in a population. Northern Light is up to the challenge, he said, expanding its capacity from 900 photos a day, when it opened on February 2, to about 2,000 today, and for that reason it received large allocations.

“I offered this to other sites,” said Shah. “If (MaineHealth) needs more vaccine, I will get more. Tell me what you can do and I will answer. “

This explanation does not apply to MaineHealth’s medical director, Dr. Joan Boomsma, who said the health care system has been seeking larger vaccine allocations for Scarborough Downs and its other suppliers. The Scarborough Downs website is ready to deliver 5,000 first vaccines a week, she said, but has only received enough vaccine from Maine’s CDC to make about 4,000 first doses a week.

“MaineHealth has the ability to vaccinate considerably more qualified Mainers for COVID-19 if more vaccine is made available,” said Boomsma in a written response to the questions.

As a whole, MaineHealth – the state’s largest healthcare network and dominant provider in Cumberland, York, Franklin, Oxford, Lincoln and Knox counties – received 8,250 first doses of the Maine CDC this week. “We could easily administer 12,000 first doses in the next week and even more in the following week,” added Boomsma.

She said that MaineHealth informed the Department of Health and Human Services leadership team via email on February 15 that it “identified the necessary staff and set up the necessary infrastructure to deliver up to 25,000 total doses (first and second) of vaccine per week . “

She also said that MaineHealth’s Westbrook vaccination site is operating at half its capacity for 2,000 first weekly doses, also due to a lack of supply, and that throughout the system the network is providing vaccines with only 35 to 40 percent capacity .

MaineHealth’s waiting list for first doses is about 30,000 eligible residents over 70, said Boomsma, some of whom have been on the list since January 26. More than half of them – about 18,000 – live in Cumberland and York counties.

“Of course, we have a significant opportunity to vaccinate Maine residents over 70 in the southern part of the state, as long as we have the vaccine for that,” concluded Boomsma’s statement.

In response to statements from MaineHealth, Shah stood firm, saying that MaineHealth had not yet reported the use of all doses that had been allocated for the week and that the hospital chain had not “communicated a specific request for more doses”.

“We continue to strive to work with MaineHealth and other systems to vaccinate as many Maine residents as quickly and fairly as possible, and look forward to the day when MaineHealth demonstrates that it can bring more injections into people’s arms in accordance with the plan. Maine vaccination, ”Shah said in an e-mailed statement late on Thursday.

Shah and Governor Janet Mills harshly criticized MaineHealth after Press Herald columnist Bill Nemitz revealed that the network vaccinated thousands of its remote employees who do not interact with patients, as well as 10 consultants from outside the state hired to help block a unionization effort by nurses from the Maine Medical Center. Shah said on February 9 that hospitals that violated the vaccination eligibility guidelines would have the vaccines removed from them.

Supply restrictions are also in place at MaineGeneral’s new mass vaccination site at the Augusta Civic Center, which opened on February 17. It serves Kennebec County, which started the week with an estimated 9,939 eligible residents aged 70 and over who have not yet received their first dose, or 58 percent of that age group, one of the worst in the state.

This week, the Maine CDC has allocated 2,100 doses to county providers, 1,440 of which are being used at the Augusta Civic Center site, according to MaineGeneral spokeswoman Joy McKenna.

“We are able to increase our weekly vaccinations to reach the vaccination rate of up to 1,000 people a day,” McKenna said in an email. “We have increased our order for vaccines, adjusting our schedule and staff to meet this goal.”

The hospital faces the chicken and egg problem: it would not allocate a large number of employees to expand the capacity of the site, unless it knew that it would receive a large increase in the vaccine. “If we received 1,000 additional doses tomorrow, it would take us a week to schedule the team and schedule patients for the vaccination clinic,” she said.

As of Wednesday afternoon, she said, there were about 5,000 people aged 70 and over on her waiting list. “As we know how many vaccines we will receive in the next week, we contacted him to schedule them.”

At Central Maine Healthcare, the parent entity of Central Maine Medical Center, which is the main vaccination site in Androscoggin County, supply is also the main constraint. “Our ability is based on the availability of the vaccine,” said CMHC’s medical director, Dr. John Alexander. “As this increases, so does our capacity.”

He said the CMHC would also need advance notice to dramatically increase capacity, as it would have to divert qualified personnel from other work.

At York Hospital, a 48-bed community hospital serving southern York County, capacity appears to be a limiting factor. Hospital spokesman Jean Kolak said that the St. Kitts Church vaccination site in York had an effective capacity of 400 to 500 doses a day, but is still working to open five days a week and has received so many how much doses can bear from Maine CDC.

The accumulation of vaccine candidates eligible for the hospital is 4,950, she said.

Northern Light announced on Wednesday that the Cross Insurance Center clinic in Bangor will be expanded from three to four days a week. Spokeswoman Suzanne Spruce said the network is still in considerable demand and that openings this week are due to a programming software problem with the system that keeps places reserved for people who need the second dose of the vaccine.

“When this was detected and corrected, a series of consultations for first doses were opened for today and tomorrow,” said Spruce by email. “We saw an increase in the volume of people registering online and over the phone at the end of the day and we appreciate Dr. Shah’s help in getting the message out.”

Some regions in eastern and northern Maine – including near Bangor – have probably reached the limit of “early adopters” aged 70 and over who were actively seeking to be vaccinated, Spruce said. “Now we have a lot of people who are looking forward to their turn – especially that group of 65 and over,” she said.

The Maine CDC may expand the vaccine’s eligibility to include people 65 to 69 years of age as early as next week. “If there are vacancies open, this is a good sign for us that we can open the categories to start filling those vacancies,” said Shah at Tuesday’s briefing.

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