DR. PAUL BIDDINGER, who specializes in emergency preparedness at Massachusetts General Hospital and heads the governor’s COVID-19 vaccination advisory board, says a third of those eligible to be inoculated in Phase 1 haven’t received their shots yet even as Phase 2 begins today.
In an interview on The Codcast, Biddinger acknowledged the ups and downs of the vaccine rollout. “I think there’s obviously been some significant challenges with respect to getting vaccines out and into individuals as quickly as it’s arriving,” he said.
Getting individuals educated about when they can receive a vaccine and how has been an issue, Biddinger acknowledged, adding that there are likely to be more issues that arise in the coming weeks. “The fundamental problem of course, is just that there isn’t enough vaccine to vaccinate everybody,” he said.
The state has not known week to week how much vaccine is arriving, he said. “That means that the state hasn’t been able to tell the hospitals or other vaccinators how much vaccine they’re getting until sometimes a day or two before it arrives,” Biddinger said. This creates problems with hospitals figuring out how many appointments need to be staffed and scheduled. He said the state is now getting several more days’ notice of how much vaccine is arriving each week, which will help with appointment scheduling.
Biddinger acknowledged that people feel frustrated when they have to search in multiple places for vaccination appointments rather than having a centralized booking system. “I think the number of different ways in which people can get vaccinated, whether it’s from their health care system or a mass vaccination site or their public health department or a commercial pharmacy, is a strength, but it’s also a real weakness,” he said. “I would love to weave them all together better and make it easier for people to navigate that.”
Becker’s Hospital Review recently noted Massachusetts ranked 38th in the nation for administration of vaccines, having put 48 percent of shots received into residents’ arms.
“I think there’s clearly ways to improve. There’s no question about that, but I think there are lots of ways to look at the numbers,” said Biddinger. “I think Massachusetts still is a little bit closer to the middle of the country if you just look at percentage of the population that has been vaccinated on a per capita basis.” The state has done well with vaccinating long-term care residents too, he said, ranking eighth in the country on that data point.
“What I care most about is just making sure that the vaccine is, in fact, getting out to people in an equitable and effective way as fast as it can possibly be,” he said.
Phase 1 recipients include hospital and health care workers, nursing home residents and staff, home care employees, emergency personnel, and those living and working in congregate care settings.
The decision was made to “preserve the health care infrastructure to be able to care for ill individuals,” back in October, based on recommendations from health care groups contracted by the Centers of Disease Control and Prevention. There is also significant overlap between those who work in health care settings and communities of color and other populations hard hit by the virus.
“There’s a very large home health workforce who comes typically from vulnerable communities, often communities with very high prevalence of COVID, and they go home to home. Both for equity and epidemiology reasons, the advisory group felt it was really important to include them,” he said.
Biddinger said a significant hurdle in communities of color who qualified for Phase 1 has been aversion to the vaccine stemming from misconceptions about the vaccine “causing infertility and certain kinds of allergies.” he said.
Residents in other groups, like educators and grocery workers, have decried being pushed back in the vaccination line after people 65 and older were moved up at the recommendation of the US Centers for Disease Control and Prevention.
Biddinger said he would like to see teachers vaccinated earlier because of the importance of getting kids back in school, but he pointed out that the CDC issued a “strongly worded recommendation” about how there’s not a lot of evidence for school-based transmission and social distancing and mask wearing seem to be working.
“These are some of the most heart-wrenching kinds of discussions that you can have because you know all of the individuals you’re talking about absolutely are priorities,” he said. The decision about whom to vaccinate first has centered around the “straight mortality risk” faced by older residents with COVID-19, he said, calling age the “single most important variable.”