BOONE — AppHealthCare received no new COVID-19 vaccines the week of Jan. 25 for Watauga and Ashe counties. It was the second week in a row Watauga County received no new COVID-19 doses.

Meanwhile, Appalachian Regional Healthcare System is receiving fewer vaccines during the next three weeks as North Carolina battles limited vaccine supply, according to ARHS Senior Vice President Rob Hudspeth.

AppHealthCare spokesperson Melissa Bracey said the department has had to reschedule some appointments due to the limited number of vaccines.

“We are working very hard to get vaccines out to the community as quickly and efficiently as possible but with small amounts of vaccine, we are limited to the number we can vaccinate week to week,” Jennifer Greene, AppHealthCare health director, said in a statement. “We did not want to have to reschedule appointments, and we apologize for the inconvenience this causes for those who were looking forward to their appointment.”

For the next three weeks, starting the week of Feb. 1, AppHealthCare will receive 200 COVID-19 doses for Watauga County. AppHealthCare also expects to receive 400 second doses of the vaccine for the county.

Bracey said AppHealthCare is reaching out directly to those who had appointments. Those appointments will be moved to the following week given that AppHealthCare has vaccine supply.

Hudspeth said they share vaccines back and forth with agencies they partner with including AppHealthCare and the Toe River Health Department in Avery County.

“We are very thankful to our local hospitals — Alleghany Health, Ashe Memorial Hospital and Appalachian Regional Healthcare System — who have been willing to give us some of their vaccine supply to cover some of our appointments,” Bracey said in a statement.

For the next three weeks, as of Jan. 28, ARHS will receive 200 doses of the vaccine per week — fewer than the 400-800 vaccines Hudspeth said the agency typically gets.

“We take pride in getting vaccines into arms, and we’re just not getting the vaccines that we need,” Hudspeth said.

North Carolina was originally set to receive only 120,000 doses of vaccines the week of Jan. 27 which is about 140,000 fewer doses than the state got last week, according to North Carolina Department of Health and Human Services Secretary Mandy Cohen.

At a Jan. 27 press conference, Gov. Roy Cooper said the federal government would be upping the amount of vaccines given to states by about 16 percent.

“We’re going to go from 120,000 doses to 140,000 doses,” Cooper said. “So the staff will make decisions about giving the providers a little bit more. And they’re working through those numbers right now so that they can let providers know.”

Part of the reason some providers — like AppHealthCare — are not getting vaccines this week is because many vaccines were allotted to large vaccination events planned several weeks ago when the state was addressing the backlog in vaccinations, according to Cohen.

“Starting with this week’s allocation, North Carolina will reserve 84,000 doses of our weekly 120,000 allocation of first doses from the federal government for our local vaccine providers,” Cohen said at a Jan. 26 press conference. “Providers will be given a baseline amount of first doses that they can expect for the next three weeks.”

Cohen also said the vaccines would be distributed to counties based on population. According to the North Carolina Office of State Budget and Management, Watauga County is the 52nd most populous county with 57,069 people as of July 1, 2019.

Watauga County has administered 8,773.39 vaccines per 100,000 people which is 37th in the state, according to population and vaccine distribution data.

Bracey said that until this week, AppHealthCare did not know how many vaccines they would get until a few days before the shipment arrived. The additional estimation of how many vaccines the department will get over the three weeks will help AppHealthCare plan, Bracey said.

“While we would like to have more vaccine for our community, we know we are not the only ones who have received smaller quantities and most vaccine providers would like more vaccine than they are receiving,” Bracey said. “We are hopeful vaccine supplies will increase throughout 2021 so we can get more people vaccinated.”

The goal is for providers to exhaust all first dose vaccines before the next shipment arrives. If the state exhausts the majority of its first dose of vaccines, Cohen said the state is “in a strong position to advocate to the federal government for more vaccines as they become available.”

Hudpseth said as of Jan. 22, ARHS has a 90 percent utilization rate.

“We’ll actually reach 117 percent utilization by the end of the week by using the remainder of our current supply and because we’ve already scheduled additional clinics for vaccines that we don’t currently have yet,” Hudspeth said.

The Centers for Disease Control and Prevention ranks the state as sixth in the nation for total doses administered, 12th for first doses administered per 100,000 people and 17th for total doses administered per 100,000 people, as of Jan. 29 according to the NCDHHS.

“North Carolina vaccine providers have done a phenomenal job serving the people of our state. This is incredibly hard work, and they’ve shown that they are both up to the task and committed to partnering in new ways so that we vaccinate North Carolinians as fast as possible. These national rankings are the result of the strong work of our entire vaccine team,” Cohen said.

Problems with the COVID-19 Vaccine Management System

North Carolina uses a cloud-based COVID-19 Vaccine Management System that enables vaccine management and data sharing across recipients, care providers, hospitals, agencies and local, state and federal governments on one common platform, according to NCDHHS.

Among the different aspects of the CVMS, healthcare providers can manage COVID-19 vaccine inventory and track the number of vaccines administered.

That information allows the state to allocate vaccines to healthcare providers, send supply where needed and identify and prioritize the most vulnerable population.

Each entry into the system takes about five minutes, according to Hudspeth. ARHS and AppHealthCare have staff dedicated to do data input into the CVMS, but it’s not easy.

According to Hudspeth, the system is fairly slow and has gone offline during the past six weeks which can slow down data input.

“It’s not been easy,” Hudspeth said. “ The system slows our process. To make matters worse, an organization that hasn’t entered the data in a timely manner is effectively penalized.”

When AppHealthCare hosted a mass vaccination event at Watauga High School on Jan. 16, CVMS was down for a portion of that weekend, Bracey said.

Inputting the data into the CVMS is a top priority for AppHealthCare as well.

“We have ramped up our capacity for data entry and have about 10 to 15 staff and volunteers at any given time working on data entry, and are requesting additional surge staff who can assist as vaccine supplies increase,” Bracey said. “We have developed a process to ensure it is done as efficiently as possible, knowing the NC DHHS reports improvements planned for the system frequently.”

As of Jan. 29, Bracey said the data in the CVMS very closely matches the amount of vaccines AppHealthCare has administered so far.

Representatives respond

Both Rep. Ray Pickett (R — Blowing Rock) and Congresswoman Virginia Foxx (R — District 5) have released statements on the issues North Carolina has seen related to its vaccine rollout.

Pickett said the vaccination strategy in the state is completely unacceptable.

“I’ve received numerous calls from constituents who were concerned over redistribution of doses to the mass vaccination sites,” Pickett said in a statement. “Reducing the amount of vaccines at the rural level and prioritizing cities is unacceptable and is alienating many at risk citizens. NCDHHS leaders have promised to adjust their vaccine distribution strategy to be more equitable to rural communities and my office is here to make sure they follow through on that promise.”

Foxx released a statement saying she has been speaking to county health officials, constituents, and members of Operation Warp Speed regarding North Carolina’s progress on vaccine distribution for weeks.

“I’ve been present within countless conversations, and I’m troubled by the Cooper Administration’s previous actions,” Foxx said in a statement. “If Gov. Cooper and his health advisors are to lead the state in vaccination efforts, their volatile strategy of distribution can’t be prolonged any further. Hardworking citizens in Western North Carolina fear being left behind by their own government, and they’re beyond outraged at the efforts to date to protect them.”

Hudspeth said they have had conversations with state representatives, but problems with the vaccine rollout really rest in the hands of the federal government.

“North Carolina has a plan,” Hudspeth said. “Has it gone perfectly? I would say no, but it is well thought out. There are certainly kinks in it, we’re all learning through this process. We just need the federal government to help the manufacturers. Determine how they can supply this country with more vaccines.”

As of Jan. 29, NCDHHS recorded Watauga County as administering 4,510 first dose vaccines and 497 second doses. Avery County has 2,300 first doses and 118 second doses while Ashe County delivered 1,745 first doses and 187 second doses, according to NCDHHS.

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andy@andybrowning.com

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