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Limited Supply Hampers Expanded COVID Vaccine Eligibility

Courtesy of MU Health Care
MU Health Care Acute Care Pharmacy Manager Drew Jett unloads and stores MU Health Care’s first allotment of the Pfizer-BioNTech COVID-19 Vaccine at University Hospital on Tuesday, Dec. 15, 2020 in Columbia, Mo.";

Last Thursday, Governor Mike Parson announced Missouri would enter Phase 1B of COVID-19 vaccine distribution, making millions of Missourians eligible for vaccination. But the vast majority of those eligible still have to wait to be inoculated. That’s because supply of the two vaccines approved for distribution — from Pfizer and Moderna — hasn’t mirrored the growth in eligibility. 

Sara Humm is with the Columbia/Boone County Public Health and Human Services department. She says the department is still prioritizing 1A — health providers and long-term care facility residents — and the first tier of 1B, which includes emergency responders. "“The state said that we could start working on tier 2," Humm said. "The reason we haven’t is we do not have enough vaccine to do so.” 

Vaccine distribution is decentralized — a variety of approved vaccinators including hospitals and pharmacies — can request vaccine doses from the state department of health and human services. That means it’s even harder to gauge the supply.

Credit Bram Sable-Smith / KBIA
The Columbia/Boone County Public Health and Human Services department is still working through vaccinating people in Phase 1A of the state's distribution plan.

“These approved vaccinators have all gotten different amounts of vaccine at different times, at different intervals which makes it really hard to be able to tell who has gotten what and when,” Humm explained.

Phase two of Tier 1B, which the department is holding off on, includes an estimated 2.5 million Missourians; among them anyone 65 and older and adults with certain complicating health conditions. According to the Centers for Disease Control and Prevention, Missouri has received more than 500,000 doses of vaccine, both of which require two doses per person. That would account for some 250,000 people, or *half* of the estimated 500,000 people eligible in Phase 1A.

Not everyone eligible for the vaccine is interested in getting it though, and state officials say they have increased eligibility to give vaccinators more flexibility so they can use all the doses they get. 

While vaccine supply is currently limited, health providers are gearing up for an anticipated uptick in doses in the coming month.

Dr. Margaret Day is a family physician at MU Health and co-chairs the system’s COVID-19 vaccine committee. "So far we have administered over 8,000 individual vaccines, that’s including both dose one and dose two," Day explained. 

She says in the space between the expanded eligibility and increased supply, MU Health Care is doing what it can to prepare. The system is laying the groundwork for a major vaccination clinic at Faurot Field and has published an online survey to gather information about people interested in getting vaccinated. “So we are then able to contact you whenever it’s most appropriate, whenever your phase is called, for example,” Day said.

The Public Health and Human Services Department has a similar survey it launched a week and a half ago, and Boone now also has a system for people to pre-register for vaccinations. The parallel systems between the three different entities reflects the decentralized model of vaccine distribution the Parson administration has pursued.

Humm, from PHHS, says vaccine rollout looked different during the last pandemic. “In the past, when these types of things have happened, for example H1N1, the local health departments were in charge of distribution and the rollout of the vaccine and things like that,” Humm said.

According to the allocation for next week listed on the CDC’s website, Missouri is set to receive enough doses to fully vaccinate some 76,000 people. Last week, state officials said just under half of vaccines shipped to Missouri had been used, although all were allocated. Shipments of both vaccines have tailed off since the initial rollout, but the incoming Biden administration has set a goal of carrying out 100 million vaccinations in its first 100 days.

Still, it’s unclear how much federal policy will impact vaccinations in the state, which has broad control over distribution.

Sebastián Martínez Valdivia is a health reporter and documentary filmmaker who focuses on access to care in rural and immigrant communities. A native Spanish speaker and lifelong Missouri resident, Sebastián is interested in the often overlooked and under-covered world of immigrant life in the rural midwest. He has a bachelor's degree in broadcast journalism from the University of Missouri and a master's degree in documentary journalism at the same institution. Aside from public health, his other interests include conservation, climate change and ecology.
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