Should the state place a COVID-19 mass vaccination site in Montgomery County?
The County Council thinks it should have happened already and pushed state health officials on Tuesday to set one up.
Mass vaccination sites were one of several vaccine-related topics that county and state officials discussed during Tuesday’s council meeting. Maryland Department of Health officials present at the meeting included Dr. Jinelene Chan, the acting deputy secretary; Dr. Mark Martin, deputy director of the Office of Minority Health and Health Disparities, and Heather Shek, deputy director of the Office of Governmental Affairs.
Council members asked them questions about the state’s vaccine rollout, but not all of their questions were resolved or completely addressed. Some council members said later that the hour for questions wasn’t enough time to get through their concerns.
County and state officials discussed mass vaccination sites, dose allocations, equitable distribution, nursing homes, technology problems with the state’s registration system, and transparency of information and processes.
The state has two mass vaccination sites open at Six Flags America in Prince George’s County and Baltimore Convention Center. The Six Flags site is only serving Prince George’s County residents, but will be open to others on Monday.
An additional mass vaccination sites will open in mid-February at M&T Bank Stadium in Baltimore. Other locations in Western Maryland, Southern Maryland and on the Eastern Shore are being finalized.
The County Council said Montgomery County should be one of the jurisdictions at the top of that list.
Dr. Travis Gayles, the county’s health officer, said the county has asked for a site in the county and has offered multiple location options, including the fairgrounds.
“We have multiple venues in Montgomery County that would be viable sites,” he said. “I know we’ve had private conversations, but I want to publicly go on the record and say we have multiple sites here in Montgomery County that could be stood up for mass vaccination sites, including our fairgrounds and numerous other venues.”
Gayles said it is challenging to expect Montgomery County residents to go elsewhere for a vaccine. If that’s the expectation, the state should commit a certain number of appointments slots at those other sites.
“If that is to be the primary site, is there an opportunity to say ‘X’ percentage of those visits would go to those in Montgomery County?” he said.
State officials did not address the suggestion.
County Council President Tom Hucker said state officials have acknowledged that a mass vaccination site was placed in Prince George’s County to help the county boost vaccines there and that Montgomery County residents should use that site when they can.
“Obviously, these two goals are somewhat at odds,” he said. “Montgomery County is the largest jurisdiction in the state. Prince George’s is the second largest. … The state has said it is rolling out four new mass vaccination sites in the next few weeks and saying none of them will be in Montgomery County.”
But Chan said the “message is not at odds at all.”
“Six Flags was already established,” she said. “The infrastructure was already there in terms of the tents, the setup — I mean, everything was already there,” she said. “It really made sense to use that location to pivot to doing vaccinations. …
“We’re open to considering where other mass vaccination sites could exist here in the state. What we are trying to do is establish multiple layers of vaccination access points.”
Chan said the mass vaccination sites are just one aspect of community vaccinations to provide vaccines to residents where they are. She said Gov. Larry Hogan is looking at equity from a geographic standpoint, and for racial, ethnic and other vulnerable populations, when considering where the sites and other services should be.
As more vaccines become available, the state will work with the Federal Emergency Management Agency about where more potential sites could be, she said.
When asked by Hucker how residents were supposed to get to another county without access to transportation or mobility, Chan mentioned that there are other vaccine opportunities available. She said the county could use a recent allocation in state funding for health departments to do vaccine outreach.
“We appreciate the funding and we can do all the outreach in the world, but if we don’t have the doses, they won’t end up in any arms,” Hucker said.
Montgomery County has repeatedly challenged the state over how many vaccine doses it distributes each month and whether distribution is equitable among all counties.
In recent weeks, the county has received fewer doses from one week to the next, even though it has said it needs the number to increase. The state has said the county hasn’t shown that it’s using all of its supply.
Communication between state, county
Gayles said the county has raised concerns with state health officials several times on how and when the allocation decisions are made and when county officials are told how many doses they will receive.
Gayles has previously said that the county receives each shipment on Tuesdays, but isn’t told how many it will receive until the weekend before, which causes county employees to have to scramble to set up the right number of appointments.
The county does not set up clinic appointments beforehand to avoid having to cancel them if there are not enough doses from the state each week.
The county’s weekly supply from the state has decreased the past two weeks. This week, the allocation was 4,500, compared to 5,500 the previous week.
“When we’ve had conversations with our retail pharmacies and other venues, they have let us know that they are well aware of their doses for weeks to come,” he said. “We still remain hamstrung by that challenge in terms of rolling out.”
Council Member Will Jawando also said he was concerned about the “very limited transparency” on who is making the decisions on the allocations.
“Someone is making that decision and somehow the communication is not making its way to us,” he said. “That’s an issue.”
Jawando said he was concerned about the supply chain for vaccines. Some Virginia and Washington, D.C., residents are coming to Maryland hospitals to be vaccinated, taking vaccinations away from Montgomery County residents, he said.
Chan said the allocation to pharmacies is provided to companies, which decide which of their stores will receive certain amounts. If a pharmacy has a limit on how many appointments it can provide, that’s probably why it knew its allocation ahead of time, she said.
The state has been receiving notification of its own allocation of about 88,000 to 90,000 doses on Tuesdays each week. On Thursdays, the ordering system opens for jurisdictions.
“We’re usually working to then determine who is using the doses and how … will the doses be allocated. We’re looking at that equity issue across jurisdictions,” Chan said.
She said the federal government has directed state officials to discourage providers from asking about residency and restricting vaccines based on where someone lives.
Council Member Nancy Navarro said the state’s registration system, PrepMod, which allows people to sign up for vaccine appointments, has had inaccurate Spanish language translation. That leads to a complete barrier for some residents, she said.
“Specific examples have shown that the translation is absolutely incorrect,” she said. “Certain terms do not mean anything with regards to understanding this process. This is a real concern.”
Navarro listed several examples of the navigation and form errors on the system (the actual meaning of the Spanish words is in parentheses):
● “Address” is listed as “Habla a” (which means “speak to”)
● “Race” is listed as “Carrera (which is a car race)
● “Back” is listed as “Espalda” (but it’s “back” as a body part instead of for navigation)
● “Clear” is listed as “Clara” (which means “light”)
“This is not acceptable. I respectfully request that Montgomery County have a representative in your [equity] committee, in your efforts,” she said. “Because again, we are the largest jurisdiction and we mirror not only the country’s demographics, but also the global demographics.”
State officials said they are working on fixing the Spanish translation problems on the system.
Briana Adhikusuma can be reached at firstname.lastname@example.org.