Montgomery County’s state delegates on Friday pushed state officials about COVID-19 vaccine rollout decisions, including the allocation process, not having a unified registration system, and why the county does not have a mass vaccination site.
During a virtual briefing on Friday morning, delegation members questioned Maryland Department of Health officials, including Dr. Jinlene Chan, the acting deputy secretary; Heather Shek, the deputy director of the Office of Governmental Affairs; and Dr. Mark Martin, deputy director of the Office of Minority Health and Health Disparities about the vaccine rollout.
According to Shek, vaccine doses have been divided among the counties based on population. But not all of the doses went to county-run clinics, which local officials have said need to be boosted and prioritized.
The state-run clinics have been allocated an average of 11.9 doses per 1,000 people, while the county has had 12.3 for its clinics, Shek said. But of the vaccines going to the county, only about 26% are going to county-run clinics, with the rest going to hospitals, medical providers, pharmacies, and others.
The county health department has also received fewer doses from the state in the past few weeks. The department’s supply this week was 4,500, compared to 5,500 the previous week, which was a decrease from the week before.
About 79% of the doses — or 24,275 doses — administered at county-run clinics, have been given to Montgomery County residents. The rest of the doses have been given to eligible employees who work in the county.
Del. Jheanelle Wilkins (D-Silver Spring) questioned why the state was basing its allocation on total jurisdiction populations instead of the populations of eligible groups in each county.
“In terms of handing out the doses, it seems like it would make more sense to give them out based on the number of people who are actually eligible,” she said. “Because of the way you’re rolling it out, we are really struggling in terms of how many people are eligible in our county versus the number of vaccines you’re giving us.”
Chan said residents in Montgomery County could get vaccinated in other counties based on where they work, or at providers who are vaccinating all eligible residents. Shek said she was not sure why the planning team decided to allocate based on total population.
“It doesn’t really seem like there is a scientific or strong reason behind how you’re allocating it and lives are hanging in the balance. We are not getting enough vaccines in Montgomery County for the people who are eligible,” Wilkins said, adding a request for the state to review a potential change.
Del. Jared Solomon (D-Silver Spring) said the state should have chosen Montgomery County for a mass vaccination site. The closest current site is at Six Flags America in Prince George’s County.
Chan said the state can discuss the matter with the county, but the state is concentrating on making sure there is enough of a geographic spread for the doses, as well as enough doses for the current and planned sites.
Six Flags already had the infrastructure in place to be a mass vaccination site, she said.
Montgomery County officials have said they have offered multiple sites, including the fairgrounds, but the state has not discussed the use of them.
“1.1 million people in the state — a sixth of the entire state population. If there had been commitment to the county, we could have easily had a site set up. That seems crazy to me,” Solomon said.
Del. Marc Korman (D-Bethesda), the chair of the Montgomery County House Delegation, said Chan’s response was “very different” than what Acting Health Secretary Dennis Schrader gave to the Senate vaccine work group.
Schrader said “no way, no how” to the notion of a site in the county, Korman said, because the county’s residents can go to Six Flags. Korman called that an “absurd answer.”
“If a lot of people from Montgomery County are going to Six Flags, that reinforces the need for a mass vaccination site in Montgomery County,” he said.
Del. Lily Qi (D-North Potomac) said the state’s reasoning was “inadequate” and that having multiple registration systems is “crazy.”
“You’re not going to fix the problem,” she said. “Let’s not talk about vaccines. Let’s talk about the people. The system has to work for the people.
“Maryland prides ourselves on being the most technologically advanced. Why can’t we start exploring? Short of that, can we at least empower the counties to coordinate across all of the pharmacies and clinics. I just don’t accept the answer that this is not possible if we really want to do it.”
Del. Kirill Reznik (D-Germantown) said signing up for a vaccine has become a major problem for residents and workers. He referenced the thousands of people who showed up to Richard Montgomery High School in Rockville on Thursday, seeking a vaccination, including many who were not eligible.
“There was a rumor that there was an open call for immunization. … People who had appointments were delayed because of this,” he said. “The confusion stems from the fact that we don’t have a single form of sign-up.”
In statement released Friday afternoon, County Executive Marc Elrich said improvements will be made at the county-run clinics to avoid long lines again.
“We apologize for the inconvenience this situation may have caused,” he wrote. “Going forward, we will improve signage at sites, so that residents have a better understanding of their [eligibility] for vaccination. In addition, we are investigating ways to improve the check-in process to reduce wait times.”
Reznik said his wife is spending hours at a time helping his constituents sign up for vaccines.
When asked why there is not a single vaccine registration system in the state, Shek said the state looked into the option, but it wasn’t “feasible” and “appropriate” for the state.
“I know that everyone likes to compare us to West Virginia and say, ‘West Virginia did it. Why can’t we?’” she said. “There are a lot of backend IT things that I’m not even going to try to explain because I don’t understand them myself.
“But what I do know is that West Virginia has a single health care system. To coordinate across one system was fairly easy. In Maryland, we have eight large health care systems that each use different electronic medical record databases. To do the coordination on the IT side of it, we would have had to completely rebuild the system and we simply did not have the time to do that.”
Chan said the federal government has agreed to provide vaccine allocation projections, which will help the state plan for clinics and appointments more quickly. County governments will receive four-week projections of shipments.
The state health department has also fixed a problem with the PrepMod appointment system to cut down on the number of people forwarding appointment registration links to others.
The problem has caused people who are currently ineligible for the vaccine to make appointments, only to be turned away at clinics because they do not qualify.
Each appointment link sent to an individual will now be unique and can’t be shared with others. It will be a one-use registration link.
Dr. Travis Gayles, the county’s health officer, attended the meeting with the delegation. He said the county is concerned that the state has been cutting its weekly allotments, but the state kept adding additional expectations for the county on vaccinating child care providers and independent living facilities not covered by a federal partnership program.
“We are working to address those needs with the doses that we are receiving,” he said.
Del. Ariana Kelly (D-Bethesda) said she was concerned about the number of elderly residents, age 85 and older, who are not being prioritized for the vaccine. The county is currently vaccinating residents age 75 and older.
Kelly said that about 17,200 residents on the county’s preregistration list are age 85 and older, but are not getting ahead in line even though they are more vulnerable to the virus.
Many of the county’s older residents live in dense senior housing areas that are not on the state and county lists of prioritized senior housing facilities, she said.
Chan said the state would work with the county to identify the housing areas and make sure they are prioritized.
Briana Adhikusuma can be reached at email@example.com.