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Rocky start to Maryland’s COVID-19 vaccination program raises concerns

State and hospital officials offered myriad explanations for the slow start to COVID-19 vaccinations in Maryland, but the effort is drawing questions and concerns for a program that eventually needs to inoculate millions of residents.

Officials said there were holiday interruptions, complex distribution issues and a purposeful staggering of the shots that could cause adverse reactions. Delayed reporting by contractors also has been a problem. Maryland Gov. Larry Hogan plans to address the matter further during a news conference Tuesday.

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But lawmakers and observers said more information is needed to identify issues hampering the process of quickly distributing doses to top priority groups in hospitals and nursing homes, other groups at risk of infection from the coronavirus and eventually the general public.

“It’s a very complex issue, and it’s not about blame but figuring out where the barriers are so we know how to address them,” said Dr. Leana Wen, a former Baltimore health commissioner and a professor of public health at George Washington University.

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She said the state needs substantial and dedicated staffing to lead the effort, with real-time tracking of vaccines so officials know where the doses are in the system and where more resources are needed.

“It’s a very complex issue, and it’s not about blame but figuring out where the barriers are so we know how to address them.”


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Maryland is not alone in facing challenges to its two-week-old vaccination program, with New York Gov. Andrew Cuomo even threatening to fine hospitals that don’t use doses quickly enough. But state lawmakers chafed at news last week that a Bloomberg News analysis found Maryland to be the slowest state to use its vaccine.

The state appears to be closing the gap, according to an official tally by the U.S. Centers for Disease Control and Prevention. As of Saturday, Maryland had used almost 60,000 doses, or just under 29% of its federal vaccine allotment. Nationally, the CDC reported that about a third of the 13 million doses delivered had been administered.

But, the CDC data also shows Maryland has vaccinated about 991 people out of every 100,000, ahead of just eight states. Each will require a second dose.

Absent an overarching federal program, observers and critics say it’s important to have strong local leadership and the ability to quickly identify hitches in the system to ensure vaccine doses are not wasted.

State Sen. Paul Pinsky said lawmakers, like the general public, have been left in the dark about what the hold-ups are with vaccine distribution.

”Everybody is concerned. We should be in the forefront, not bringing up the rear,” said Pinsky, a Prince George’s Democrat who chairs one of the Senate committees that handles health issues.

Borrowing Hogan’s exhortation to “wear the damn mask,” Pinsky said: “Distribute the damn vaccines.”

The Hogan administration should communicate what the challenges are and set clear expectations for state residents, Pinsky said.

”What are the roadblocks? Is it transportation? Is it a database? Is it stuck in a warehouse? Do they not have enough syringes?” Pinsky said. “You hear all this fuzziness around it, this ephemeral stuff, but you don’t hear details.”

In a statement Monday, Maryland Democratic Party Chair Yvette Lewis called the state’s status as one of the worst states for vaccine distribution “nothing short of a failure.”

Mike Ricci, a spokesman for Hogan, said the Republican governor warned the launch would be slow after the federal government “was setting all kinds of expectations” about the vaccine rollout.

“Go point by point, and our phase 1A plan has hit all of its markers, beginning at hospitals on Dec. 14, nursing homes before Christmas and for first responders last week,” he said. “We will continue to push providers to get shots into arms as safely and quickly as possible.”

Del. Shane Pendergrass, who chairs the House of Delegates’ Health and Government Operations Committee, said one problem at key distribution points could local health departments that may be understaffed and underfunded.

”I think they are working short-handed and they are working with a bigger job now,” said Pendergrass, a Howard County Democrat. “Even in normal times they would be light-staffed and this is not the best of times. This is the worst of times we’ve seen in my lifetime. This is really a problem.”

Pendergrass and Del. Sandy Rosenberg of Baltimore, also a Democrat, wrote to state health officials to ask for more information on the vaccine rollout. The response they received Monday afternoon was light on details, Pendergrass said.

The letter from Acting Health Secretary Dennis Schrader said Maryland officials are working to get the initial federal allocation of 273,875 doses out to hospitals, nursing homes and first responders. Schrader wrote that the state would provide weekly updates to the public on the vaccination plans.

Pendergrass said it’s important to get more information out to the public, and she’s planning to call health officials in for a briefing before lawmakers.

”We want people to get vaccinated. I’m sure the governor wants people to get vaccinated,” she said. “But you have to translate how you get from here to there and we need to do that quickly.”

Ricci said the state plans to launch a “full public education campaign” later this month, closer to the start of the next phase of distribution. After hospital workers, nursing home residents and staff, and first responders, the state plans to vaccinate other front-line health workers, those over age 75 and those with certain underlying health conditions.

General vaccination programs aren’t expected until later in the spring or summer. There will be a method to sign up, though that is not yet available, plus tracking and reminders for people to get second doses.

The state’s counties and Baltimore City appear to have some leeway in distribution, as well as accounting for doses. Baltimore County’s health department announced Monday that it would launch a health care provider registry to make it easier to distribute information on scheduling vaccination appointments for staff. The county got its first shipment of 100 doses Dec. 30 and officials said they already used them all on first responders and front-line health care workers.

Baltimore Mayor Brandon Scott, a Democrat, plans his own news conference Tuesday to discuss the city’s distribution and prioritization plan.

Bob Atlas, president and CEO of the Maryland Hospital Association, said he expected the number of people vaccinated to rise considerably this week.

He called the vaccination rollout “a considerable accomplishment in very short order, considering that our hospitals have very high patient care demands — COVID and otherwise — and that it happened during the holiday period.”

Atlas said the first shipment of vaccines came to Maryland the week of Dec. 14, and half went to hospitals and half to nursing homes. Half of the hospitals didn’t receive any doses because the Pfizer vaccine, which requires extremely cold temperature storage, couldn’t be split into small batches. The second shipment, which also included Moderna vaccine, arrived just ahead of Christmas and the hospitals “were unable to schedule large numbers of staff to be vaccinated.”

Then, Atlas said, the hospitals had to stagger vaccinations in case of bad reactions. The hospitals also needed to pull staff from other areas to administer the doses to colleagues.

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“Now that the holidays have passed and supplies of vaccines are flowing somewhat reliably, Maryland hospitals are better able to vaccinate their workforces and affiliated providers at a much greater pace,” Atlas said. “The numbers will rise markedly this week.”

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Baltimore Sun reporter Hallie Miller contributed to this article.

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