A resident receives a COVID-19 vaccine at a county-run clinic at White Oak Recreation Center in early January. Health officials discussed their preparations for distributing vaccine to kids 5 to 11 years old at a County Council meeting Tuesday. Credit: File Photo

Montgomery County is preparing to open county-run vaccine clinics to more priority groups. But it won’t happen soon.

The county’s health department is still working its way through Phase 1A and residents 75 and older. Its primary focus is on older residents.

But county health officials said during a media briefing on Wednesday that they are preparing to move to more priority groups in Phase 1B. Those priority groups include frontline essential workers, and individuals who have developmental disabilities, are homeless, or are in detainee centers

The county and state have broken down the population into phases as they administer vaccines in stages.

County Executive Marc Elrich indicated that based on the vaccination numbers, it is “highly likely” that county clinics will soon vaccinate residents age 65 to 74.

“That will not happen this week, but we think as we begin to draw toward the end of the senior pool that we’re immediately going to turn our doses to the broader population,” he said.

Dr. Earl Stoddard, executive director of the county’s Office of Emergency Management and Homeland Security, said county officials have begun collecting lists of employees from food access providers, nonpublic schools, MCPS, transit systems, and others.


Who is eligible for the vaccine in Phase 1B?

The county’s Phase 1B is split into priority group tiers.

The first tier includes residents age 75 and older, the only people currently eligible for a vaccine from a county-run clinic in Phase 1B.

According to the U.S. Census, there are about 73,000 county residents in this group.

Tier 2 includes:
● Public transit workers (transport for seniors and persons with disabilities, etc.)
● Education sector (teachers, support staff members, etc.)
● Child care workers
● Food and agricultural workers
● Postal service workers
● Grocery store workers
● Individuals with developmental disabilities
● Individuals experiencing homelessness
● Individuals in detainee centers

At the state’s request, the county clinics have started forming a plan to vaccinate certain teachers and staff members before schools begin a widespread reopening March 15 .

The state has also requested that the county begin vaccinating child care workers. A small portion of the vaccines are provided for child care providers each week.

Tier 3 includes manufacturing workers.

Stoddard estimated that there are about 100,000 essential workers who will need to be vaccinated in those groups.

“Just because you are a part of the next grouping, does not mean there will be a vaccine available for you the first day we begin vaccinating in those new tiers. … It will take us many weeks, as it has for the [age] 75-plus population, even with increased doses available from the state, to get through those groups,” he said. “Just because we move into a new tier over the next few weeks does not mean you will instantly get vaccinated.”

Every eligible resident or worker in Phase 1B and 1C can preregister for a vaccine through the county. Preregistration places individuals’ information into the county system. Once a vaccine is available for an individual’s group, an appointment link will be provided.

Residents and workers will receive a confirmation email of their preregistration. They will not receive an appointment link until a dose is available for them.


Can you share appointment links with your family and friends?
No. If your family or friends are not eligible for the vaccine but they use your appointment link to sign up, they will be turned away from a clinic without a vaccine.

The state appointment registration system, PrepMod, will be updated with a new function that will send one-use appointment links, starting Friday.

The appointment link can only be used once to sign up for a vaccine. If you share it with someone else, and they sign up first, it will block you from registering.


How close is the county to finishing vaccinations for residents age 75 and older?
The county has vaccinated nearly 134,000 people — more than 12% of the county’s population — with a first dose, the most of any jurisdiction in the state. More than 55,000 people — or 5% of the county’s population — have received a second dose, and are now fully vaccinated

Both the Pfizer and Moderna vaccines require two doses administered three to four weeks apart.

County officials have repeatedly said they will not wait to completely finish vaccinating the older population before moving on to the next groups. But when the county moves on, vaccine appointments will remain open for older residents.


Someone is in the 75-and-older age group and preregistered for a vaccine with the county government weeks ago. Why haven’t they received an appointment link? Are the vaccines first-come, first serve?
If you are age 75 or older and preregistered, an appointment link will be sent to you. When, exactly, is difficult to answer.

Dr. Travis Gayles, the county’s health officer, said during a media briefing on Feb. 17 that the vaccines are not being administered on a first-come, first-service basis.

But each resident in that group will receive an appointment opportunity before the county moves to the next group.

Several factors determine the allocation of doses within the 75-and-older group, including the number and rate of cases in geographic locations and ZIP codes, race and ethnicity, and age.

Nearly 60% of the estimated 73,000 county residents age 75 and older have received a first dose. About 25% of residents age 65 to 74 have received their first dose from hospitals and pharmacies.

If you are waiting, a dose will be offered to you once it becomes available.


What is the plan to get vaccines to residents who are homebound?
The county is working with a community partner to launch a pilot program Friday or Saturday.

The county will test a mobile platform to provide vaccinations to older people in their homes.

After the pilot is over, the county will scale up the program and find other community partners to join.

The preregistration form for county clinics allows individuals to indicate whether transportation to a clinic is a restriction for them.


How will other priority groups get vaccines at county clinics? Will they be invited one group at a time, or is the phase opened all at once?
County officials are determining the best way to open vaccines to groups with the number of doses available.

“Right now, we are prioritizing based upon age, but all of the other sites in the county are open to everyone within the 1A, 1B and 1C platform,” Gayles said. “We are really trying to leverage and maximize the doses we receive to offer those to those who are vulnerable and have a safety net to support, complement all of the other places that individuals can get vaccines throughout the county.”

Stoddard said that if the Johnson & Johnson vaccine — which might be authorized soon for use — is sent to counties, the state might have specific guidance on how those doses should be used. They are one-dose vaccines and are more focused on addressing significant illnesses than the others, he said.

“As those come on board, we may be able to sort of have different targeted clinics within both the essential worker pools and the 65-to-74 [group]. … We’re going to be in this group for many weeks,” Stoddard said. “Each week may look slightly different based on the type and allocation of vaccines that we get. But we’re going to be doing them both, essentially concurrently.”


If a resident living in another county gets vaccinated in Montgomery County because they work there, how is that vaccination counted?

According to Gayles, the vaccination would be counted in Montgomery’s percentage of doses it has received from the state and that have been administered.

But the resident is counted as being a vaccinated resident for the county they live in.

Stoddard said the county believes that about 10,000 Montgomery County residents have been vaccinated in Washington, D.C., where they work.

Those 10,000 residents would not be counted in the county’s total of residents vaccinated.

But Stoddard said the county is working on getting data from D.C. and Northern Virginia counties through the Metropolitan Washington Council of Governments.

According to Stoddard, slightly more Montgomery County residents have been vaccinated in other counties than other counties’ residents have been vaccinated in Montgomery. That is based on data from the state.


Why does the county set up appointments week by week, instead of longer in advance?
Before this week, the county, hospitals and other providers did not know how many vaccine doses they would receive for clinics until a few days before shipments arrived.

The federal government recently agreed to provide two-week projections to the Maryland officials for how many doses they will receive each week.

In turn, state officials will provide four-week projections to local health departments and providers for how many doses to expect each week.

The county health department is expecting to receive 4,500 doses for each of the next three to four weeks.


Why isn’t there a mass vaccination site in the county?
Over the last few weeks, state delegates and county officials have repeatedly called for a mass vaccination site to be located in the county, which is the largest jurisdiction in the state.

There is still a chance one could be coming to the county. But state officials have said they won’t consider that possibility until the remaining three planned sites are opened.

Three sites are already open or close to opening across the state: Six Flags America in Prince George’s County, the Baltimore Convention Center and M&T Bank Stadium in Baltimore. The stadium site opens on Thursday.

Gov. Larry Hogan announced Tuesday that a fourth site will open no later than March 11 at Regency Furniture Stadium in Charles County. Two other locations in Western Maryland and on the Eastern Shore are being finalized.

So, Montgomery County won’t be considered for a mass vaccination site until at least six others are open.

Hogan said during a press conference on Tuesday that the state is opening enough sites as it gets enough vaccine doses to supply them. Montgomery County has the most vaccines and distribution points, as well as the highest percentage of people being vaccinated, he said.

“So, it’s not as big of a problem as some of the other areas, but certainly not something we would rule out if we get enough vaccines,” he said.

Charlie Gischlar, a spokesman for the Maryland Department of Health, wrote in an email on Tuesday that the state’s strategy focuses on developing sites in underserved and regional locations where they can serve the most residents, with the most efficiency.

The county is proposed at least three locations as potential mass vaccination sites to the state health department, including the fairgrounds in Gaithersburg. At least one site is being prepared by county officials with the needed infrastructure and planning, in hopes that the state approved it.

As of last week, Montgomery County residents made up about 20% of the people who received doses at state mass vaccination sites.


How many coronavirus cases with variants have been found in the state?
Three COVID-19 strains that have been identified are dubbed the U.K., South African and Brazilian variants.

Totaling 60 cases, all three variants have been identified in the state. The U.K variant has been among the most common of the three.

The variants tend to be more transmissible, but the severity of the virus doesn’t appear to be higher, according to state health officials.

The variants are identified in COVID-19 cases by using genomic sequencing.

Hogan announced on Tuesday that the state has entered agreements with the University of Maryland and Johns Hopkins Medicine to double the sequencing volume. The health systems will help screen and sequence more than 10% of the coronavirus cases in the state.

The partnership will increase sequencing capacity from 300 sequences per week to more than 700.


If COVID-19 vaccinations are increasing, is it still necessary to get COVID-19 tests?
You should still get a COVID-19 test if you have had any known exposures to anyone else who has had symptoms or who has tested positive — or if you have been around a large group of people or have traveled.

County officials said Wednesday that COVID-19 testing has had a dip in the last month. But testing helps the county track where and how cases are spreading.

In the last two weeks, the county has administered an average of about 5,500 tests. The week of Dec. 26, the county administered more than 11,800 tests.

County officials said the issue is being seen across the country. Residents might be focused on vaccinations, and taking the decrease in cases as a reason to not worry about getting a test, they said.


How do you find more information?

More information can be found through these resources:
● Montgomery County vaccine website: https://www.montgomerycountymd.gov/covid19/vaccine/
● Maryland vaccine website: https://coronavirus.maryland.gov/pages/vaccine
● Centers for Disease Control and Prevention vaccine page: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

Residents and workers in Phases 1B and 1C can preregister for the vaccine here.

A Preregistration Helpline for county-run clinics is available for preregistration assistance at 240-777-2982. General vaccine questions can be directed to the county at 240-777-1755.
Staff members are available to callers in English and Spanish. The call center is open every day from 8 a.m. to 6 p.m.


Have a question that wasn’t answered here?

Email your question to briana.adhikusuma@bethesdamagazine.com and include “COVID Q&A” in the subject line. We will try to answer it.
Our past vaccine Q&As are available here and here.

Briana Adhikusuma can be reached at briana.adhikusuma@bethesdamagazine.com.