Maryland health officials said they expect to open the state’s first two COVID-19 mass vaccination sites Friday in Baltimore and Prince George’s County, though officials already are warning there are limited doses available and to expect a wait for an appointment.
“Mass vaccination sites are a critical element in the statewide network of vaccination options that we are establishing,” said Dennis R. Schrader, acting state health secretary, in a statement. “These sites will promote equitable access to vaccines by supplementing the sites operated by local health departments, hospitals, pharmacies, and other local partners.”
The state also announced $123 million in additional federal funding for local health departments to continue their “critical role in our focus on hard-to-reach areas and underserved populations.”
But while more sites and money were welcomed by local officials and observers, the announcements sparked concerns about where the new clinics will get supplies and how people will access them. The lack of vaccine already has stymied clinics around the state and frustrated people in priority groups who have sought to get in line — any line — for a dose.
Asked recently by a panel of state lawmakers if people should be getting in more than one queue for a vaccine, Schrader could not say. Health officials still have not answered that question, but Mike Ricci, a spokesman for Maryland Gov. Larry Hogan, said Thursday the state plans to establish a central scheduling site and call center for the mass vaccination sites.
State officials also haven’t said how many doses would be available immediately at the mass clinics at the Baltimore Convention Center or Six Flags America in Prince George’s County, only that vaccines would be offered by appointment to health care workers, seniors, some essential workers and others in designated groups.
The Prince George’s site initially won’t have its own registration system, as recipients will be chosen from a health department list.
Ed Singer, president of the Maryland Association of County Health Officers, expressed concern about where the vaccine for the mass sites was coming from.
“It’s essentially a shell game,” Singer said. “With a limited number of doses, every time you give some a vaccine you have to get it from someone else.”
Singer said he “would not complain” about more money, but it wouldn’t change his role, adding: “Right now the money and the staff to be able to help us put vaccines into arms just isn’t our biggest problem.”
Until now, the state has relied mainly on hospitals and health departments to vaccinate priority groups that include more than 2 million people. Those in nursing homes and long-term care facilities have been vaccinated through a federal contract with CVS and Walgreens pharmacies. Hogan also has announced plans to add vaccinations at more pharmacies.
So far, state data shows there have been more than 600,000 doses administered out of more than 900,000 first and second doses delivered, though there likely already are appointments for many of those not yet administered.
Two vaccines have gained federal authorization, from Pfizer-BioNTech and Moderna, and both require two shots, three or four weeks apart. Vaccination of most Americans is expected to take many months, though other vaccine candidates are in the pipeline and could boost availability soon.
The latest Maryland figures show health departments getting about a third of the state’s doses, with hospitals getting about 40% and most of the rest going to pharmacies and small amounts to clinics and other providers.
Health officers and some local officials say moving doses around could spark more confusion about how to register and lead to inequitable distribution of doses.
Baltimore Mayor Brandon Scott this week asked the state to specifically set aside doses for city residents among the priority groups.
Some have testified about the issue to state lawmakers, as well as written to the congressional delegation, which in turn asked Hogan for clarity about the plan and efforts at coordination.
Singer, who is also Carroll County’s health officer, said local health departments are uniquely trained and experienced in handling vaccinations. So far, local health departments lead the state in the percentage of shots administered, he said, using guidance from previous vaccination campaigns and best lessons from the 2009 H1N1 outbreak.
He said the health departments fear losing a substantial number of doses to the state sites and officials aren’t getting enough answers from the state on supplies or how they should allocate scarce doses. County health officers are often left to decide on priority groups, shortages and long-term planning, Singer said.
Some health departments say they already are getting fewer doses of vaccine.
The Howard County Health Department, for example, only got 2,000 doses this week, a 66% drop from the week before. Combined with the wintry weather, that led the department to postpone second-dose vaccination clinics and prioritize the new-arriving 2,000 doses for educators to receive their first shots.
“We know the amount of vaccine is insufficient for the 200,000 residents who have preregistered with us,” wrote Dr. Maura Rossman, Howard County’s health officer, in a letter to the community Monday. She encouraged county residents to also seek vaccine information from pharmacies and hospitals.
Dr. Gregory Wm. Branch, Baltimore County’s health director, said the county is running an efficient operation and should be ramped up, not down.
“I can do 700 people an hour here. I can go up to 1,000 people an hour here,” he said. “You mean to tell me you wouldn’t utilize that? Does that make any sense to you at all?”
The state is guaranteeing local health departments will receive a minimum number of doses each week, from 300 to 975 doses, though the actual total number varies.
Schrader also told lawmakers this week that his team is trying to spread out the doses fairly based on population, but acknowledged that an increasing share of doses is going to be sent to private pharmacies and mass vaccination clinics to ultimately give residents more options.
When questioned by Senate President Bill Ferguson about the fairness of the minimum levels of doses — Montgomery County is four times the size of Harford County, yet they have the same minimum allocation — Schrader said he’d “look at it again.”
Ricci, Hogan’s spokesman, said the state’s goal is not to shift doses away from existing providers but to spread the vaccine around to many trusted and convenient outlets.
“I know some county leaders want a monopoly on vaccine distribution, but that is just not going to happen,” he said. “As the governor has repeatedly said and we have repeatedly emphasized, the local health department clinics will be one facet of a much broader distribution network.”
Ricci also disputed that there is not coordination, saying state officials are in regular contact with counties.
Breaking News Alerts
In the end, the fix will come from increased vaccine supplies as more vaccines are authorized, said Dr. Leana Wen, a George Washington University professor of public health and a former Baltimore health commissioner.
But she added that coordination still will be key to efficiently and fairly distributing doses.
“Mass vaccination sites are needed and community-based options like pharmacies and doctors’ offices,” she said. “Ideally, there is a centralized process way for people to sign up for vaccination, or else those with resources will be able to put themselves down on multiple lists throughout the state.”
The Baltimore Convention Center site will be operated by the University of Maryland Medical System and Johns Hopkins Medicine and will continue to offer COVID-19 testing. People who qualify for the vaccine can register for an appointment online at www.umms.org/BCCvaccine. Those without computer access or in need of assistance can register by calling 443-462-5511.
The Six Flags site will be operated with Kaiser Permanente with help from the National Guard and currently no direct registration will be permitted.
State officials said they would add another mass vaccination site at M&T Bank Stadium in Baltimore in mid-February and were planning additional mass sites in Western Maryland, Southern Maryland and the Eastern Shore.
Baltimore Sun Media reporters Ana Faguy and Pamela Wood contributed to this article.