On a recent Saturday morning, Peggy Hoon got behind the wheel of the 2011 Toyota RAV4 and made the 300-mile round trip to Charlotte from her home in Raleigh.
After weeks of waiting or hearing about COVID-19 vaccination events only after they were filled, the 65-year-old Wake County resident finally received a blow. She considers herself lucky and worries about the equity issues that leave other seniors unable to find precious doses of vaccine.
State officials say the main barrier to vaccine launches has been a shortage of supplies. However, the NC Watchdog Reporting Network found that in some cases, health workers give doses to people who do not yet qualify, according to guidelines from the NC Department of Health and Human Services.
And that means people like Hoon, among those most at risk of serious injury or death from illness, are left waiting.
“That takes a vaccine away from someone, because it might make a difference if they received COVID, rather than the person (who will pass it) through the back door,” Hoon said.
According to DHHS guidelines, only group 1 – health care workers and residents and long-term care staff – and group 2 – those aged 65 and over – qualify for the vaccine. When a young person jumps in front of an older person with higher risk factors, the result could be literally deadly. Those aged 65 and over represent only 14% of all COVID-19 cases in the country, but 81% of all deaths, according to the Centers for Disease Control and Prevention.
The reporting network found that speed and fairness conflict with each other, a problem exacerbated by the rapid expiration of the vaccine and the near impossibility of controlling each vaccine clinic.
In short, the vaccine distribution system works largely on the honor system, and some have benefited, risking the health of other North Carolinaers.
Millions in need; still limited doses
In Ashe County, at least a dozen people under the age of 65 have been vaccinated. Staff at AppHealthCare, the health department in three counties that includes Ashe, took out doses of the vaccine to administer outside the office.
The NC Watchdog reporting network confirmed that dozens of doses of the vaccine had been taken from the health department against the protocol. A spokeswoman for the department has repeatedly refused to confirm details about who received the vaccine doses and where they went.
Initially, a spokeswoman for the health department rejected the vaccinations outside the office as just an effort to throw away the remaining doses at the end of the day.
“Our staff has used up to 10 doses on various occasions when a bottle of 10 was not in use and was about to expire,” AppHealth spokeswoman Melissa Bracey told the network in an email Wednesday. .
But he followed up a day later after the network asked DHHS about the situation, saying the local health department is now investigating.
One week later, Bracey said in an email that the department’s investigation found that a total of 40 doses of the vaccine had been given outside the agency’s protocols and 13 doses outside of groups 1 and 2, but did not explain how.
Clinics across the country and the country have been instructed not to let any vaccine go to waste, even if it means giving a dose to a younger person.
There were other examples of state regulations:
In New Hanover, county commissioners all received a vaccine after a January 13 commission meeting, despite the fact that the state is still in group 1.
In Chapel Hill, two UNC basketball coaches managed to get the vaccine.
In Charlotte, Atrium Health has scheduled meetings for non-health workers.
In Durham, some sheriff’s deputies were vaccinated, the Durham County Public Health Department confirmed. A spokeswoman said they had scheduled meetings in accordance with previous vaccine priority guidelines and were allowed to keep their appointments after changing the guide.
In almost all cases, the spokespersons for those who administered vaccinations had what they considered valid reasons for not following the state guidelines in the letter of the law.
Coronavirus vaccinations in NC
A spokesman for the new Hanover County said the commissioners received the vaccine because there were additional doses and later said they had been vaccinated because of their position as elected leaders.
“Commissioners are leaders in this community, elected by our constituents to govern New Hanover County, and we have been vaccinated in our public office and not as private citizens,” said President Julia Olson-Boseman. “I definitely want to keep everyone on board as safe as possible, because they are required to meet in person as a group and go out into the community to do the job that people have chosen us to do.”
Local and local health officials say these cases are the exception, not the rule. The main reason why elderly people looking for a vaccine do not find a place online, they say, is simply due to the lack of a vaccine.
“We have millions of people who need him, but only thousands of photos,” Governor Roy Cooper said in a recent press briefing.
Groups 1 and 2 combine for about 1.7 million people. So far, only 1.4 million first doses have been allocated to the state, and not all of them have reached the state. People aged 65 and over account for more than two-thirds of all first doses given, a figure that does not include the vaccination program for staff and residents of long-term care institutions.
The need for cold storage requires the use of doses quickly, and many of the vials actually contain an extra dose beyond what is scheduled. The CDC and state health officials have strongly urged clinics not to waste any doses at all, but this leaves clinics uncertain how many doses they will be able to offer.
“Some vendors have implemented waiting systems, sometimes requiring people to wait outside in line,” said Julie Swann, head of the department of industrial and systems engineering at NC State University, which analyzed the health impact of COVID-19. public. “And the people who are best suited for that, may be younger populations, who can be noticed if it’s cold or raining.”
What to do with tens of thousands of “remaining doses”
Analysis of DHHS data shows that there were over 60,000 doses remaining administered in North Carolina. But even these should not be out of order, according to DHHS recommendations.
“Getting out of a priority order should be a very unusual circumstance. It shouldn’t be what happens every time,” said DHHS Secretary Dr. Mandy Cohen. “But we don’t want the vaccine to be wasted, so we recognize that there are some places where we just want to make sure we get the vaccine in our arms and not waste it.”
Triangle health systems say they have implemented backup plans to distribute additional doses fairly.
Dr. David Wohl, an infectious disease expert at the University of North Carolina who oversees the distribution of vaccines at the Center Friday, described what they call the “power hour” at about 4 p.m., when clinic staff estimates how many doses at the end. of the day will also have the way in which they could be best distributed.
Vaccine tracking has gaps in reporting, monitoring
In some ways, the clinic staff relies on people to be honest about their eligibility. Staff have been overworked for a year and it is not their responsibility to police vaccine seekers. Wohl said his staff is trying to verify eligibility, but acknowledged that it is at least somewhat based on self-identification of patients.
“But I would tell you, the vast majority of the people we see here don’t cross the line,” Wohl said. “These are people who walk in wheelchairs, you know, sticks. We reach the right people. ”
In the long-term care program, there are fewer public disclosures that could reveal violations of the protocol. The federal government contracts directly with Walgreens and CVS to distribute vaccines in long-term care facilities. Spokesmen for both pharmacy chains said that individuals must “certify” their eligibility. In most cases, people are required to have an identification card to confirm their identity, although this does not necessarily prove eligibility for people under the age of 65.
Similarly, state DHHS leaders said they do not monitor thousands of individual vaccine recipients introduced into the state’s computer system.
In December, Atrium Health in Charlotte scheduled to be vaccinated employees who worked in non-health care roles. In response to public outcries, the hospital said the state has approved those employees who receive the vaccine.
But DHHS said that’s not true.
After the news about the hospital’s appointment in turn, the employees went out in turn, state officials contacted the Atrium and dozens of appointments for non-health workers were canceled.
This story was reported and jointly edited by Laura Lee and Frank Taylor of the Carolina Public Press; Tyler Dukes, Adam Wagner and Jordan Schrader of The News & Observer; Nick Ochsner of WBTV; Michael Praats of the WECT; Ali Ingersoll and Travis Fain of WRAL; and Jason deBruyn of WUNC.