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A day after state health officials announced 2,400 doses of the COVID-19 vaccine had expired under lax oversight by the Shelby County Health Department, one employee was fired, another took his retirement and drumbeat increases for state and federal investigations.
At a press conference on Wednesday February 24, Shelby County Health Department Director Alisa Haushalter admitted she was considering resigning but decided that her duty as a leader required her to be “transparent about what had happened ”.
“It is my responsibility to be responsible for what happened, to go to the state when I knew there were wasted doses, which I did, to work closely with the “State to determine what the problems were and resolve those problems in a systematic and organized manner,” she said.
US Representative David Kustoff is calling for a more in-depth investigation, which he believes could reach the federal level.
“Due to gross negligence and potential mischief, the executive branch of the Shelby County government mismanaged and wasted thousands of vaccines, ultimately causing our local community to fail,” Kustoff said in a statement. Wednesday.
Fortunately, the Tennessee Department of Health is working with the City of Memphis to achieve an effective and efficient distribution process. There is no doubt that local officials should be held accountable, ”he said. “I welcome the further investigation by state authorities and possibly federal authorities into this fiasco.”
When the state announced its findings on Tuesday, it said it expected federal partners to investigate as well.
Haushalter said on Wednesday that local efforts to break state policy and vaccinate teachers early had started the ball rolling, with thousands of doses set aside for them.
When rumor spread that the Department of Health was saving doses for a low-priority group, it sparked more unrest in Nashville.
“Storage for a later phase is not permitted,” Health Commissioner Lisa Piercey said Wednesday evening, “and this action has unnecessarily barred high-risk seniors from receiving their fair share of this limited and vital resource. . “
When state officials told the Department of Health that it was not until early March to vaccinate teachers, some 50,000 doses were available.
When the ice and snow arrived and the doses were nearly expired, the health ministry opened up indoor sites and expelled 2,000 doses, but that was not enough, Haushalter said.
Storms and then low water pressure worsened the situation, closing vaccination sites for 10 days.
Most of the waste took place on Wednesday February 10 or Thursday February 11, Haushalter said, including a large tray of Pfizer vaccine that was thawed and expired before it could be used.
Another 700 doses were thrown away on Monday, February 15, because they were not used at a clinic quickly set up for teachers in Shelby County schools to receive doses.
Snow and ice made it difficult to access council headquarters on Avery Avenue.
A variety of factors can cause doses to be lost, including being thawed and expired before use, left out after clinic sessions, or returned after clinic but had to be be destroyed due to temperature changes, Haushalter says.
She learned that some 1,300 doses had expired on Saturday, February 13.
The Department of Health employed a contract pharmacist, Marilyn Bruce, as director of pharmacy services. His responsibility was to manage and prepare the inventory of vaccines for injection.
Bruce lost his job. Dr Judy Martin, head of immunization in the health department, retired in a crash.
Haushalter said she was sure the mistakes were not intentional. One change that has already been identified is that more than one employee will have a pharmacy key to monitor inventory levels.
“It’s a very complicated vaccination campaign and the Pfizer vaccine in particular is very difficult to manage, controlling the temperature, when it can be in one type of storage and the days it can be in another type. of storage, and we had several lots to come. ”Haushalter said.
“My own belief is that the trays were drawn for events that happened in the future and that a set expired without notice that we had to release this vaccine to the public,” she said.
When the weather struck and sites were to be closed for days, Haushalter halted shipments from the state on Friday, February 19 to prevent inventory from continuing to rise.
She alerted the state’s health department that doses were lost on Saturday, February 13 and heard nothing back, she said.
“I made additional attempts throughout the week to reach Dr (Michelle) Fiscus, (medical director of the state health department’s immunization program), without a call back.”
Ultimately, Haushalter said, she called Dr Tim Jones, a doctor in the state’s health department, to alert her to the waste.
That call sparked the state’s review of the processes here, which began on the night of Friday, February 19 and is continuing.
By the end of this week, the Shelby County Health Department will have a plan to work with the state to address deficiencies in local processes. The hope, she said, is that the Department of Health will once again be able to receive and distribute vaccines.
For now, the city of Memphis has control of the COVID-19 vaccine and all other vaccines provided by the Department of Health, including measles and influenza. Doses are stored at Regional One.
In the meantime, the city’s health partners, including hospitals and clinics, will manage vaccination sites within the city’s borders with the city government.
Baptist Memorial Hospital and Christ Community Health Services have identified sites where they could grow rapidly. The question, in light of Tuesday’s health ministry reshuffle, is how many vaccines should they expect to receive.
“We can’t know exactly how to prepare until we know what kind of vaccine allocation we will receive,” said Keith Norman, vice president of government relations for Baptist Memorial Health Care.
“We understand from the investigation that has taken place that some changes are underway,” he said. “Health care partners, hospitals and other community partners will play a bigger role.
The allocation decision will likely be made at a community meeting of partners, said Doug McGowen, City of Memphis chief operating officer, on Tuesday.
In a move that was expected for weeks, Christ Community and the city of Memphis opened a drive-thru site at the Greater Imani Church on Wednesday, with appointments to give 1,000 hits a day.
“We are a contract operator for the city,” said Shantelle Leatherwood, CEO of Christ Community. “We provide all clinical services – the actual immunization – and the city provides support through volunteers and FEMA to help with registration, checkpoints and data entry.”
As a management partner, the city provides trailers, tents and portable toilets. It also covers the costs of Christ Community, including labor.
“We are under contract with the city until they tell us that they no longer need our services. They basically shared with us that we have to, frankly, run at full capacity over the next few weeks to fill all the vaccinations that were scheduled for last week, this week and for the next two weeks, ”Leatherwood said.
She also offered the Christ Community clinics on South Third Street and Hickory Hill as major sites in medically underserved areas.
“We have the space and sufficient parking to handle the load at these sites,” she said.
The challenge will be how far the partners can expand.
“I think we can manage two sites at the same time; I’m not sure we can do three, ”Leatherwood said.
For Baptist, the problem comes down to the number of doses he could receive, which could increase dramatically in a week. On Wednesday, the FDA said Johnson & Johnson’s single-dose vaccine appeared to be reaching the threshold for emergency use clearance.
If approved, the Biden administration is set to roll out 3-4 million doses of the J&J vaccine next week.
“If they only gave us a hundred more doses, we would probably stay in the hospital,” Norman said. “But if we were given another 1,000, we could probably really step up some services where it could be a convenient and easy process to help people in a dignified way, as we love to serve our constituents.
Baptist has several mass sites in mind.
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