How Michigan residents will find out when to get COVID-19 vaccine

Karen Bouffard
The Detroit News
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Michigan is still months away from offering COVID-19 vaccines to the general public — and it's unclear how or if people will know when it's their turn to get the shot.

The Michigan Department of Health and Human Services has an initial goal of vaccinating 70% of people 16 and older, or about 5.6 million people, by the end of 2021.

Wayne County Deputy Health Director Jennifer Floyd receives the first dose of the Pfizer COVID-19 vaccine on Dec. 18, 2020 at the Wayne County Health Administration Building in Wayne.

State health officials have developed a two-phase plan to prioritize who gets the vaccine first, starting with health care workers and nursing home residents. They will be followed by people in other essential jobs and groups at greatest risk of severe illness based on their age or health conditions.

While people in the United Kingdom are notified by mail when it's time to get their COVID-19 vaccine, the best way for Michigan residents to learn when it's their turn will be to check the state's COVID-19 vaccination website at www.michigan.gov/covidvaccine, according to state health officials. Information on where to find the vaccine will be posted at VaccineFinder.org, a national website that lists locations where vaccinations are available. 

"When we start opening up vaccine administration to more groups, we will post clinic locations on our website or on Vaccine Finder," Michigan Department of Health and Human Services spokesman Bob Wheaton said Thursday. 

"Until then, MDHHS, along with local health departments, will be reaching out to specific populations to be vaccinated since it will be a targeted approach. Also, we will communicate via the media as we move to vaccinating different priority groups."

Meanwhile, some experts worry information on the availability of the vaccine will be too hard to get for some and they won't get vaccinated, slowing efforts to inoculate enough people to establish "herd immunity" to the virus in the United States. 

"A lot of people could be left out because they don’t have a proper notification," said Tingong Dai, a Johns Hopkins University Carey Business School associate professor and expert on medical supply chain issues.

"My concern is that many patients might not come here to get their vaccine."  

Dr. Joneigh Khaldun, the state's chief medical executive, has said she expects the vaccine to be available to the general public by late spring — but Michigan, like states across the country, appears to have gotten off to a slow start.

In Michigan, 86,636 of 337,875 vaccine doses shipped to the state were administered to patients as of Thursday — nearly 26%, according to figures from the Michigan Department of Health and Human Services' COVID-19 Vaccine Dashboard.

Across the country, about 22% of initial vaccine doses had been given to patients, according to federal statistics. 

But questions remain for Michigan health care providers about who will be involved in the vaccination effort going forward.  

"How this rolls out is dependent on the availability of vaccine and the priorities established by MDHHS," Henry Ford Health System spokesman David Olejarz said when asked what role primary care doctors will play. 

And scarce information already has presented planning challenges for hospitals, said John Karasinski, spokesman for the Michigan Health and Hospital Association. 

"When it comes to vaccine distribution, there has been a lack of certainty for the first few weeks about vaccine allocation, the timing of when those actual shipments will arrive, so that has made it more challenging logistically for our hospitals because they have to schedule hundreds or thousands of employees to receive the vaccine," Karasinski said.

Ad campaign planned

In Michigan, people will be notified "in a variety of ways" when it's time for them to get their COVID-19 vaccine, the state health department's Wheaton said. 

Communication to let people know when and where to be vaccinated as the state moves through the phases of its distribution plan will be coordinated through the state health department and local health departments, he said.

Dr. Kathleen Cowling, an emergency physician with Covenant for over 25 years, raises her hands in the air after receiving the Pfizer-BioNTech COVID-19 vaccine, Thursday, Dec. 17, 2020, in Saginaw, Mich. Dr. Cowling is one of the first Covenant HealthCare employees to get the vaccine.

A statewide advertising campaign will start in January to reassure the public that the vaccine is safe, and direct people to the state's vaccine website at Michigan.gov/COVIDvaccine for the latest vaccine information, Wheaton said.

The $1.5 million campaign will continue through late spring to early summer and include radio, television, print and digital advertising. 

"In addition, health care providers will be reaching out to their patients in the priority groups as that group begins to be vaccinated," Wheaton said. 

Michigan's health department also has had a $5 million contract since January 2020with Brogan & Partners to provide vaccine-related advertising and outreach through September. The contract initially focused on the flu vaccine but shifted to COVID-19 as the pandemic emerged, Wheaton said.

Phillip Bergquist, health center operations officer with the Michigan Primary Care Association, said federally qualified health centers his group represents will play a significant role in providing COVID-19 vaccinations in rural areas of the state, as well as with hard-to-reach populations in urban areas, such as the homeless. 

"I think we're all in the boat of wishing we knew a little bit more at this point," said Bergquist when asked if the association is well-informed about the role it will play. 

"I think we know everything we can know from a state communications perspective. But there are just the uncertainties of vaccine delivery schedules and how much will be allotted to Michigan from the federal government at any given point in time, or what federal funding will look like." 

Why questions linger 

Pfizer and Moderna have already churned out millions of doses of their two-dose vaccines. But the federal government has been slow to provide them with information on where to ship doses, said Dai, the Johns Hopkins medical supply chain expert.  

And the lack of a centralized system to match supply and demand for the vaccine has slowed the state-level process of matching doses to health care providers, such as hospitals and clinics, he said.

"By now, most states have received far more doses than they have administered," Dai said. "The speed of administering doses, whether to health care workers or to nursing home residents, appears to be the bottleneck right now." 

Officials with Operation Warp Speed, the public-private partnership founded by the Trump administration to swiftly develop a vaccine to end the pandemic, downsized their estimates of the number of doses to be distributed by the end of 2020 from 40 million in mid-November to 20 million in early December.  

Cindi Jenkins, the health unit manager at the Kinross Correctional Facility, became the first Michigan Department of Corrections employee to receive the Pfizer COVID-19 vaccine. She got the shot on Wednesday, Dec. 30, 2020.

Multiple states, including Michigan, learned on Dec. 16 that they would be receiving far fewer doses of the Pfizer vaccine by the end of the year than was previously indicated.

An outcry over the reduction prompted an apology by  Army Gen. Gustave Perna, the chief operating officer for Operation Warp Speed. Perna said the numbers previously told to the states were based on a "forecast" and the government ended up with fewer doses available to ship than expected. He apologized for what he called a "miscommunication" and a "planning error." 

In a Thursday interview on NBC's "Today" show, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said health leaders are considering whether to provide a first dose of the two-dose Pfizer and Moderna vaccines to a greater number of people.

The federal government is currently holding back some vaccine to provide second doses, which are required 21 days after the first shot of Pfizer's vaccine and 28 days after the initial dose of Moderna's vaccine.

Nationwide, about 11.4 million doses of vaccine had been distributed to the states as of 9 a.m. Monday, far short of that 20 million goal. And 2.1 million of those doses had been given to patients — about 18.5%, according to data from the federal Centers for Disease Control and Prevention.

Some states, such as Ohio, haven't begun administering their vaccines yet, according to Dai. 

Under Michigan's distribution plan, health care workers who come into contact with COVID-19 patients as well as nursing home patients and staff have been prioritized to receive the first vaccine doses.

"We know this virus is a killer that prays on our most vulnerable populations," Gov. Gretchen Whitmer said at a Tuesday conference. "Which is why my administration has prioritized testing in nursing homes from the very beginning." 

"Now we have developed a (vaccination) plan that prioritizes residents and staff." 

Health care workers at the west Michigan hospital chain Spectrum Health and Michigan Medicine, the University of Michigan's health center, became the first people in Michigan to be vaccinated on Dec. 14. 

Beaumont Health has announced it has been vaccinating 1,600 front line health workers every day and is moving on to vaccinate all of its staff members and affiliates.

"To keep our health system functioning for both COVID-19 and non-COVID-19 patients, we are proud to now offer vaccinations to all Beaumont employees," Beaumont CEO John Fox said in a statement Thursday.

"Some of our health care professionals are on the front line, and others are in critically important roles supporting our front-line teams."

The health system hopes to increase vaccinations to 3,000 employees per day,  Fox said. 

Wheaton, the state health department spokesman, said Michigan is not yet in Phase 1B — when other essential workers, like those who work for utilities, can be vaccinated, along with people age 75 and older.

"In Phase 1A, the hospital can vaccinate people who they need to keep the operations going in the hospital," Wheaton said of Beaumont's announcement. 

Also on Thursday, UM opened Michigan Stadium in a bid to inoculate hundreds of Michigan Medicine health care workers and students who work in health care settings with the Pfizer vaccine.

The vaccine shots are being given by appointment only for the highest priority groups, the UM health system said in a statement. Michigan Medicine has vaccinated nearly 7,000 health care workers, the health system said.

U.S. Health and Human Services Secretary Alex Azar said on Dec. 13 that all nursing home residents in the United States could be immunized by the Christmas holiday. 

But the first doses were given to Michigan nursing home residents on Monday through a partnership with the CVS and Walgreens pharmacy chains.

"They should have given it to nursing home residents from Day One, from the first hours," Dai said about the lag in vaccinations at nursing homes. "That’s totally unacceptable.

"We have hundreds and thousands of nursing home residents who have already died, and they really desperately need this."

U.K. comparison

The United Kingdom is beating the United States in the race to get citizens vaccinated, in part because it has a centralized system for keeping track of patients, Dai said.

Patients waiting to be immunized in the U.K. — a country that includes England, Scotland, Wales and Northern Ireland — receive a letter telling them when and where to get their COVID-19 vaccine. That's only possible because the country has a centralized system for vaccinating the public, Dai said. 

In America, each state has its own system for conducting vaccinations. Health care providers' electronic medical records systems can't always communicate with each other, and people can go to any number of locations to be vaccinated. So it can be difficult, if not impossible to track who's been vaccinated in real-time, Dai noted. 

Complicating matters, the Pfizer and Moderna vaccines have different requirements for storage and handling, which states need to consider when allocating doses to health care providers. 

Michigan's 91,000 nursing home workers and patients have top priority to receive the potentially life-saving inoculations.

The Pfizer vaccine needs to be kept at minus-94 degrees Fahrenheit for long-term storage, and once thawed, needs to be administered within five days. The Moderna vaccine can handle standard refrigeration.

"We don’t have the right kind of system that connects supply and demand," Dai said. "Currently, each state tells CDC where to send the shipments, so they do know how many doses are expected to arrive from which manufacturer/distributor.

"What the states don't know, however, is whom each dose is going to be given to."

kbouffard@detroitnews.com

Twitter: @kbouffardDN

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