A day after President Joe Biden directed states to make all adults eligible for COVID-19 vaccinations by May 1, Maryland officials said they were ready to heed the call.
“We’ve built the infrastructure, we’ve stood up the technology, we’ve stress tested the supply chain, we’re ready,” said Michael Ricci, a spokesperson for Maryland Gov. Larry Hogan, in an email.
But Ricci said the expansion of eligibility in Maryland also would hinge on the vaccine supply. He acknowledged that states had difficulty meeting the demand for vaccinations after expanding eligibility criteria to include adults over 65 at the end of January.
“States absolutely do not want to run into the same situation we did in January, when federal guidelines opened up eligibility to everyone 65 and over, but the promised increase in supply did not materialize,” he said. “We continue to survey providers on how many individuals they have left to vaccinate in priority populations, to help determine the timing of next steps.”
It was not clear if Biden would formalize his call for expanded eligibility into an executive order, or if states had the jurisdiction to move ahead or behind the president’s timeframe.
Maryland’s vaccine rollout has been marked by criticism and calls for “course correction” from lawmakers, elected officials and other state officials, who say the overly balkanized process favors the able-bodied and digitally savvy at the expense of the most at-risk communities.
Some have criticized Hogan’s executive order in January that opened eligibility to all adults over 65, as well as educators, people with certain health conditions and some groups of essential workers.
State acting Health Secretary Dennis R. Schrader said Monday the expansion sought to rectify inequities in vaccine distribution by correcting for racial disparities in life expectancy in the 75-and-older age bracket, which tends to be dominated by white people.
Still, the decision forced vaccine providers — local health departments, hospitals, pharmacies and other distribution sites — to face several competing priority groups all clamoring for scarce appointment slots. And, rampant link sharing allowed people who did not qualify for vaccinations to get appointments ahead of schedule, furthering constricting the available supply for those most at-risk of contracting severe disease.
Dr. William Moss, a professor of epidemiology and immunology at the Johns Hopkins Bloomberg School of Public Health, and executive director of the International Vaccine Access Center, called Biden’s directive both ambitious and realistic.
But he stressed that not every adult will be vaccinated by the end of May, and that states needed to increase their capacity in the weeks ahead.
“It’s a signal that we have sufficient doses to vaccinate all adults who need it, but moves us away from the necessary but complicated process of deciding who gets vaccinated,” Moss said during a virtual event hosted Friday by Johns Hopkins University. “We’ve seen a lot of heterogeneity among who is getting vaccinated.”
On Friday morning, a coalition of groups dedicated to “hunting” for vaccines for Black and Latino communities, as well as seniors and school employees, said they had secured as many as 5,000 appointments for those who felt excluded by the decentralized, online booking system in Maryland. State data shows wide disparities between Black and Latino people who have gotten immunized compared to white people.
Members of the Maryland Legislative Latino Caucus joined the coalition’s virtual event, with one caucus member referring to Maryland’s immunization’s campaign as “vaccine apartheid.”
State Del. Gabriel Acevero, a Democrat who represents Montgomery County, cited a new poll conducted by Goucher College showing similar attitudes toward getting vaccinated among white people and people of color, which contradicts previous statements made by Hogan, Schrader and others who pointed to vaccine hesitancy as a reason for low immunization rates in majority-minority counties.
“It showed our communities not only want the vaccine, but trust it,” Acevero said. “The problem is, we are not getting it.”
And while the vaccine equity groups have helped connect people with appointments, they said some people had experienced what they perceived as racial profiling incidents at immunization sites.
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One woman, Lucia Rodriguez, said through a Spanish-to-English translator that the vaccine hunters had helped her father — a construction worker who doesn’t speak English — secure an appointment at her local Giant Pharmacy. But he was turned away after being deemed ineligible.
Rodriguez said the pharmacist did not question anyone else’s eligibility like they questioned her father’s, which left her feeling humiliated and “like an alien.”
“The vaccines are for everyone, and we should not leave the choice of who gets vaccinated to a Giant employee,” Rodriguez said.
Daniel Wolk, a Giant Foods spokesperson, said the company was aware of incident, and denied the man an appointment because construction workers were not deemed eligible in Maryland yet. He said the family was welcome to come back once the rules changed.
Still, members of the vaccine hunters groups said vaccination sites having different standards than others makes the rollout more confusing. State-run mass vaccination centers, for example, do not require people to show documentation confirming their eligibility, though some might be asked to sign affidavits confirming that their information is true.
Hogan has acknowledged that white people are overrepresented in the state’s vaccine data. Earlier this month, he said the state was “not where we need to be” in reaching people of color for immunizations. State-run equity programs, including a new mobile vaccination effort and increased focused on hard-hit communities at some mass vaccination sites, have been added to help allay the equity concerns.
Friday afternoon, the state health department also announced a partnership with Health Care for the Homeless to provide a daily vaccination clinic for people experiencing housing insecurity in Baltimore.