Maryland will accelerate the expansion of its coronavirus vaccine distribution, allowing elderly Marylanders, teachers and some others to get the shots next week and all older residents in less than two weeks, Gov. Larry Hogan said Thursday.
But even as Hogan announced the expanded eligibility, the Republican governor warned that not everyone would be able to get vaccinated immediately. He cautioned that it will take some time for vaccines to arrive and for appointments to become available.
“Not everybody is going to get an appointment until we have enough vaccines,” Hogan said. “And we do not have enough vaccines.”
Under the plan announced Thursday, residents age 75 and older can get vaccinated beginning Monday as part of Phase 1B of the state’s vaccination plan. Teachers and school staff, child care providers, residents of assisted living facilities, those in group homes and other congregate living facilities, as well as high-risk inmates and jail detainees also will become eligible Monday to receive either of the two currently approved vaccines.
The state will open up the eligibility further one week later, on Jan. 25, to Phase 1C: Residents age 65 to 74, more public safety and health workers, and essential workers in grocery stores, food production, labs, manufacturing, public transit and the postal service.
For teachers and school staff, the state superintendent has given directives to local school systems for how to roll out the doses.
The new timeline moved up when all those groups will first be eligible to receive the shots. Initial state plans anticipated getting to those groups much later, after vaccinating the highest-priority Phase 1A group, which includes health care workers, first responders and nursing home residents and staff.
“We want to stress to all the vaccination providers that as part of our, what we call a Southwest Airlines distribution model, they do not need to finish all of the people in one group before moving on to the next one,” Hogan said. “Our primary goal is for them to get more shots into the arms of more people in our vulnerable populations as quickly as they can.”
"The Maryland National Guard and volunteer health workers who have been recruited will help bolster vaccination efforts," Hogan said.
However, Hogan added, there currently are not enough doses available to inoculate everyone as soon as they are eligible. About 1.5 million Maryland residents will be eligible after Jan. 25 for vaccination under the full Phase 1, a total that far outstrips the number of doses that state expects to receive by then.
“This is going to take a long time, a great deal of patience and a lot more vaccines,” he said.
Few details were offered on the logistics of signing up for vaccine appointments, though Hogan said Maryland residents can now enter their information into covidvax.maryland.gov for details on vaccine clinics. Information eventually will be available through local health departments as well.
Dr. Jinlene Chan, acting deputy secretary of the Maryland Department of Health, said eligible Marylanders will be asked to supply some information when booking an appointment, which will be verified on-site at a clinic.
The vaccine rollout has been frustratingly slow for many Marylanders. The state has received more than 560,000 doses of the Pfizer/BioNTech and Moderna vaccines, but just 178,000 residents had received the first of two required shots as of Wednesday morning, according to the federal government.
Some of that is because providers were holding back required second doses for those who already received their first.
Hospitals have administered 35% of their doses to their staffs and local health departments have used 41.2% of the doses for their staffs and first responders.
Tammy Bresnahan, associate state director of advocacy for AARP Maryland, which lobbies on behalf of older adults, welcomed the accelerated eligibility.
“We are happy that he is prioritizing the older, more vulnerable population,” said Bresnahan, noting the majority of deaths from COVID-19 have been among seniors. “Our phone has been ringing off the hook from our members, wanting us to advocate to open up the phases. Many seniors have preexisting conditions, they are more at risk for death or hospitalization.”
Some facilities were slow to get their vaccine programs up and running, and in some cases, those eligible for the shots have declined to get them, something that Hogan said left him “a little surprised.”
Now that eligibility is expanding, Hogan pledged that he’ll get the vaccine himself soon and hoped that his example — along with other well-known Marylanders — might encourage more people to get vaccinated themselves. He said he didn’t want to get the vaccine until after it was made available to front-line health care workers and nursing home staff and residents.
Democratic President-elect Joe Biden’s health advisers began pushing for a change in policy to release all doses for immediate use — without holding back doses to ensure enough supply for the required second shot of the vaccines — and Republican President Donald Trump’s administration followed suit.
Hogan cautioned that going forward, the “limiting factor” will be the availability of the vaccine. The state currently receives about 10,000 doses per day.
“We are far outpacing that supply,” Hogan said Thursday, noting that more than 16,000 people got their first shot Thursday.
Part of Biden’s strategy is to roll out 100 million doses of the vaccine in the first 100 days of his term, which begins Wednesday. That includes releasing almost every available dose the moment it’s ready instead of saving some for second-round shots.
Dr. Celine Gounder, a Biden adviser and New York-based infectious disease specialist, said the president-elect’s coronavirus advisory board is confident that plan won’t lead to a pileup of people needing their second doses.
“We are confident that we’re not going to have issues with supply to meet second doses, barring a major manufacturing snafu,” Gounder said Thursday during an online briefing hosted by the Johns Hopkins Bloomberg School of Public Health. “If you look at the timeline for production, they’re going to be releasing more and more over time, and that opens things up significantly.”
Expanding the pool of those eligible to get the vaccine, with a focus on seniors, is a good step, said Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health.
But the former Baltimore City health commissioner added that there needs to be outreach and education in communities that aren’t showing up at vaccination clinics, but are at risk of complications from COVID-19, such as seniors in group living centers and African Americans, who have been disproportionately affected by the pandemic.
“It’s really important, in addition to opening the criteria for people who really want the vaccine, for there to be outreach to communities that need to be vaccinated,” Sharfstein said.
“We have to use the vaccine we have, but also pursue those groups for this to be equitable,” he said. “If we wait for people to show up, we will miss them. The strategy has to be more than just opening it up to such a large group.”
State health officials have discussed having a culturally sensitive public outreach vaccination campaign for months; Hogan said Thursday that it would be coming soon.
To speed up Maryland’s program, Hogan previously ordered hospitals and other facilities to use up 75% of their doses or risk having their future allotments reduced.
Hogan also issued an order for facilities to report shots administered within 24 hours, a response to reports that CVS and Walgreens, which are inoculating nursing home workers and residents under a federal contract, were slow to report data.
Some Maryland National Guard members have been assigned to help local health departments run vaccine clinics, and the state has recruited volunteer retired health workers to help as well.
Now the state is working with local health departments to send them vaccine doses for community clinics, Hogan said. Local health departments will be allowed to move through the phases even faster, so long as they prioritize senior citizens and the most vulnerable residents in their communities.
The state also is planning with the Maryland National Guard and “private sector partners” to open up mass vaccination sites around the state.
And a limited number of pharmacies in Giant, Martin’s and Walmart stores will start offering the vaccine Jan. 25 as part of a pilot program. More pharmacies are expected to come online as the vaccine supply expands.
The Maryland National Guard and volunteer health workers will help bolster vaccination efforts, Hogan said. Additionally, health workers with out-of-state licenses will be allowed to do vaccinations under a state order, Hogan said.
Rona Kramer, the state’s secretary of aging, said “essentially all of Maryland’s most vulnerable population” will be eligible for the vaccine in coming weeks.
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CVS and Walgreens will distribute the vaccines in long-term care facilities.
“There is no need for anyone in a long-term care facility to leave the facility in order to obtain the vaccine,” Kramer said. “The vaccines will come to you.”
There’s still not an indication when the vaccines would reach the majority of Marylanders who are not vulnerable due to their age or occupation.
Phase 2 includes adults at risk of severe COVID-19 illness due to health conditions and more essential workers, including those in transportation, utilities and food service. A total of 1.1 million Marylanders are in this group.
The general adult population would be able to get the vaccine in Phase 3.