Disparity in vaccine distributions in Maine worsens – and explanations conflict

A gaping regional disparity in vaccine availability in Maine worsened this week after state allocations left mass vaccination sites serving northern York County and the western suburbs of Portland operating at 50 at 80% of their capacity.

Meanwhile, Dr Nirav Shah, director of the Maine Center for Disease Control and Prevention, spent two minutes of Tuesday’s press conference urging Mainers 70 and over to schedule vaccinations at the Cross Insurance Center in Bangor, where Northern Light Health has vaccinated more than 1,000 people. people a day, repeating the phone number to call. The clinic had to scramble to fill the appointment slots that opened up after the discovery of a software error.

However, MaineHealth’s Scarborough Downs vaccination site was only operating at 80% capacity due to lack of vaccine, despite serving the most populous part of neighboring York County, which has by far the largest number of people. unvaccinated over 70 in the state: an estimated 16,500 as of Monday based on census and demographic data, up from 8,900 in Penobscot County, where the Cross Insurance Center is located.

Shah and MaineHealth have very conflicting accounts of why this is happening – and why Northern Light and other Penobscot County suppliers received 8,720 doses of vaccine this week, while York County suppliers got 1,600 and Scarborough Downs settled for 4000 to serve Cumberland and York counties.

Cumberland County, with Scarborough Downs at its southern boundary, received 9,120 doses, about the same number as Penobscot, even though it has twice the population and is home to the medical centers and vaccination sites that serve a large part of Sagadahoc and North York counties.

Shah said the problem was the lack of additional capacity in Scarborough and other mass vaccination sites in the state which received allocations smaller than the number of unvaccinated people over 70 in their areas. service would suggest.

“I’ve been very clear with my priorities: if you run a high-speed site like the Cross Center or Scarborough Downs or Intermed and you need more vaccine, we’ll find it,” Shah said in an interview on Wednesday. . “I’m not the one who is stingy or that I have a special love for Penobscot County. If they have people ready to be vaccinated, I will get them vaccinated.

Shah said he has reached out to all providers of mass vaccination sites and encourages them to expand their capacities quickly, as large sites have the fastest and most efficient methods of achieving effective herd immunity in a population. Northern Light rose to the challenge, he said, increasing its capacity from 900 rounds per day when it opened on February 2 to around 2,000 currently, and therefore received significant allowances.

“I have offered this to other sites,” Shah said. “If (MaineHealth) needs more shots, I’ll get more of them. Tell me what you can do and I’ll get it. “

This explanation does not agree with MaineHealth’s chief medical officer Dr Joan Boomsma, who said the healthcare system is seeking larger vaccine allocations for Scarborough Downs and its other providers. The Scarborough Downs site is set to deliver 5,000 first shots per week, she said, but has only received enough vaccine from Maine CDC to make about 4,000 first doses per week.

“MaineHealth has the ability to immunize Mainers significantly more qualified for COVID-19 if more vaccines were available,” Boomsma said in a written response to questions.

As a whole, MaineHealth – the state’s largest healthcare network and the dominant provider in Cumberland, York, Franklin, Oxford, Lincoln and Knox counties – received 8,250 first doses from the Maine CDC this week. “We could easily give 12,000 first doses next week and even more the following week,” Boomsma added.

She said MaineHealth informed the Department of Health and Human Services leadership team by email on February 15 that it had “identified the staff needed and put in place the infrastructure to administer up to 25,000 total doses (first and second) of vaccines per week. . “

She also said that MaineHealth’s Westbrook vaccination site was operating at half of its weekly capacity of 2,000 first doses, also due to a lack of supply, and that across the system the network was not providing vaccines to 35 to 40% of its capacity.

MaineHealth’s waiting list for first doses stands at around 30,000 eligible Mainers over the age of 70, Boomsma said, some of whom have been on the list since Jan. 26. More than half of them – about 18,000 – live in Cumberland and York counties.

“It is clear that we have a significant opportunity to vaccinate Maine residents over 70 in the southern part of the state, provided we have the vaccine to do so,” the Boomsma statement concluded.

In response to MaineHealth’s claims, Shah stood firm, saying MaineHealth had yet to report using all of the doses assigned to it for the week and that the hospital network had not “communicated a specific request for more. of doses ”.

“We continue to work with MaineHealth and other systems to vaccinate as many Maine residents as quickly and fairly as possible, and we look forward to a day when MaineHealth demonstrates that it can get more vaccines in people’s arms as per. to Maine’s vaccination plan, ”Shah said in a statement sent Thursday night.

Shah and Governor Janet Mills sharply criticized MaineHealth after Press Herald columnist Bill Nemitz revealed that the network had vaccinated thousands of its remote workers who don’t interact with patients as well as 10 outside consultants hired to help block an organizing effort at Nurses at Maine Medical Center. Shah said on February 9 that hospitals that violate immunization eligibility guidelines would be denied vaccines.

Supply constraints are also at work at MaineGeneral’s new mass vaccination site at the Augusta Civic Center, which opened on February 17. It serves Kennebec County, which started the week with about 9,939 eligible residents aged 70 and over who had not yet received their first dose, or 58% of that age group, one of the worst numbers. of State.

This week, the Maine CDC assigned county providers 2,100 doses, of which 1,440 are used at the Augusta Civic Center site, according to MaineGeneral spokeswoman Joy McKenna.

“We are able to increase our weekly immunizations to reach the immunization rate up to 1,000 people per day,” McKenna said via email. “We have increased our vaccine order, adjusted our schedule and staff to achieve this goal.”

The hospital faces a chicken-and-egg problem: it would not allocate large numbers of staff to increase the site’s capacity unless it knew it would receive a big boost in vaccines. “If we were to receive 1,000 more doses tomorrow, it would take us a week to schedule staff and schedule patients for the immunization clinic,” she said.

As of Wednesday afternoon, she said, there were about 5,000 people aged 70 or older on her waiting list. “Since we know how many vaccines we will receive for next week, we are trying to plan them.”

At Central Maine Healthcare, the parent entity of Central Maine Medical Center, which is the main vaccination site in Androscoggin County, supply is also the main constraint. “Our capacity is based on the availability of vaccines,” said CMHC Chief Medical Officer Dr. John Alexander. “As that increases, so does our capacity.”

He added that CMHC would also need advance notice to dramatically increase its capacity, as it would have to divert qualified staff from other tasks.

At York Hospital, a 48-bed community hospital serving southern York County, capacity appears to be a limiting factor. Hospital spokesman Jean Kolak said the vaccination site at St. Christopher’s Church in York had an effective capacity of 400-500 doses per day, but was still striving to be open five days a week and had received as many doses as he could handle. of Maine CDC.

The hospital’s backlog of eligible vaccine applicants stands at 4,950, she said.

Northern Light announced on Wednesday that the Cross Insurance Center clinic in Bangor will be reduced from three to four days a week. Spokeswoman Suzanne Spruce said the network still has considerable demand and the slots opened this week are due to a scheduling software issue with the system reserving slots for people who need their second dose of. vaccine.

“When this was taken and corrected, a number of appointments for the first doses were opened for today and tomorrow,” Spruce said via email. “We have seen an increase in the number of people registering online and by phone later in the day and appreciate Dr. Shah’s help in spreading the word.”

Some areas in eastern and northern Maine – including near Bangor – likely hit the threshold of “early adopters” 70 and older who were actively seeking the vaccine, Spruce said. “We now have a lot of people looking forward to their turn – especially this 65+ age group,” she said.

The Maine CDC may expand vaccine eligibility to include 65 to 69 year olds as early as next week. “If there are any openings, it’s a good signal to us that we can open up the categories to start filling those positions,” Shah said at Tuesday’s briefing.

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