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Baltimore councilman criticizes health department for reallocating doses to partners, including 3,500 to Mercy

Thousands of COVID-19 vaccine doses designated for the Baltimore City Health Department have been reallocated to partner organizations tasked with getting shots into arms, city data shows.

Of the nearly 25,700 total doses the city health department has received, about 5,000 have gone to alternate providers. Those partner organizations then receive guidance as to whom they should prioritize for vaccinations, Baltimore health commissioner Dr. Letitia Dzirasa said, with older adults, educators and people experiencing homelessness among those prioritized.

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The partners include several area hospitals, the Maryland branch of Health Care for the Homeless, mobile response teams and federally qualified health centers.

“Part of that is [because of the] clinical capacity that a local health department has on staff. They’re not hugely staffed, compared to a hospital system,” Dzirasa said Tuesday during a virtual committee meeting of the Baltimore City Council. “We’re not always the most trusted partner. It’s just making sure there is vaccine available through as many channels as possible.”

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Of the partner organizations, Baltimore’s Mercy Hospital has received at least 3,500 of the reallocated doses — more, by far, than any other partner organization, data shows. The next highest allocation, 600, has gone to federally qualified health centers, followed by Greater Baltimore Medical Center with 400 doses and MedStar Health with 400 doses.

Much of the Mercy’s initial allocation, 745, went to adults 65 and older. It also had vaccinated at least 200 educators as of last week, city data shows. Of those teachers, 35% are city residents.

The hospital is working with about 15 private schools to distribute vaccinations, Mercy officials said last month. It also is working with eight city public schools, officials said.

The state health department has instructed local jurisdictions to set aside at least 100 doses per week for educators in their counties until they have fully vaccinated their educators. Dzirasa acknowledged that the city is often doing more than 100 educators a week.

City Councilman Isaac “Yitzy” Schleifer, who chairs Baltimore’s rules and legislative oversight committee, which held the meeting, said siphoning off doses to third parties creates more confusion for city residents as they scramble to find appointments, and allows the health department to evade accountability when it comes to ensuring equity.

His criticisms follow an appointment overbooking problem that led to hundreds of residents showing up at the city’s vaccination clinic for first doses, only to be turned away.

Due to supply limitations, the city has not rescheduled those appointments, Dzirasa said, though those individuals could be served by the partner organizations, including Mercy.

“People who have been turned away are awaiting lifesaving surgeries, people with cancer, elderly people, nurses. These folks really want to know who got their vaccines,” said Schleifer, who represents parts of Northwest Baltimore in District 5, in an interview. “Why not commit to getting these folks appointments? Whose lives are more important than theirs?”

The health department blamed the overbooking incident on the state’s scheduling system, PrepMod, which did not stop confirming appointments for people even after it reached the weekly limit.

To ensure there are enough doses to complete the two-shot regimen necessary for both of the authorized vaccine products available in the United States, the health department’s clinic at the Baltimore City Community College is only administering second doses for the rest of the month.

Dzirasa, along with four other local health officers, wrote a letter last week to the Baltimore City Council expressing their frustrations with PrepMod, such as “random system outages, challenges registering new vaccinators, and inability to control or modify automated appointment reminder emails to account for a location or other change.”

Still, Schleifer, in a series of questions posed to Dzirasa, asked how the partner organizations were prioritizing their vaccine recipients. He said the PrepMod problems alone did not explain city residents’ inability to secure appointments.

“I can’t necessarily dictate who is to be prioritized among a large pool of people who are eligible at this point,” Dzirasa said. “We’ve given them special requirements and asked them to report back to us.”

Local health departments across Maryland have been allocated about 35% of Maryland’s vaccines to administer, with the rest going to hospitals, pharmacies, retail partners and federally qualified health systems, according to the state.

The health departments — often small and under-resourced — have been hampered by inventory shortages, as well as money and manpower issues, as demand continues to exceed supply, and as the number of doses they receive fluctuates week to week.

When Maryland Gov. Larry Hogan expanded vaccine eligibility in January to include older adults, educators, groups of essential workers and people with certain health conditions, the departments raced to accommodate the flood of calls and emails they received by setting up preregistration lists and call centers. Their role is expected to diminish to vaccinating targeted populations as more mass vaccination sites, pharmacies and retail partners come online, Dzirasa said.

City figures show that more than 48,000 Baltimore residents have received a first shot as of Tuesday, representing about 8% of the population. Dzirasa said the department will aim for at least 80% of the city to be vaccinated by 2022.

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