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Amid shortage, Maryland acting health secretary says COVID vaccine providers should conserve second doses

Maryland’s acting health secretary on Tuesday said health care providers should hold in reserve enough COVID-19 vaccine to administer second doses to people who have already received one shot — rather than using their supply to give more people their first inoculation against the infectious disease, as some have recommended.

“We are very adamant that we should not be burning through second doses as first doses, unless the federal government suddenly opens up the floodgates and we have doses coming from everywhere,” said acting secretary Dennis R. Schrader during a virtual Maryland House of Delegates committee hearing.

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“We’re being very conservative because once someone gets the first dose, we want them to get a second dose.”

Tuesday evening, the Baltimore City Health Department announced that it would offer only second-dose vaccine shots at its clinic at Baltimore City Community College until further notice.

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Schrader’s comments came a day after he told lawmakers the state is dealing with a vaccine shortfall because, he said, Maryland recently received fewer doses than expected from the federal government, putting some Marylanders at risk of not getting their second dose.

Both of the two vaccines authorized in the United States require two doses for full protection against serious illness brought on by COVID-19, though vaccine makers have said some protection is provided by the first dose alone.

The U.S. Department of Health and Human Services disputes the state’s account, saying Maryland’s shortfall stemmed from a state error. Bill Hall, a department spokesman, said state officials distributed vaccine to nursing homes that was supposed to serve as second shots for some hospitals.

“The bottom line is when … their allocation came available for second doses, Maryland decided to redirect or target some of that supply to long-term care facilities,” Hall said. “So when they went the next week, they had forgotten they carved out those doses for nursing homes.”

Hall added that the system is complicated and that the snafu is “nobody’s fault.”

The confusion surrounding the state’s vaccine supply comes as the Hogan administration has said it would open two mass vaccination sites Friday at the Baltimore Convention Center and Six Flags America in Prince George’s County. But details surrounding the mass sites — such as how to get an appointment, how many vaccines a day the state hopes to administer and why officials are confident they have enough supply — have not been announced.

In an emailed response Tuesday to questions from The Baltimore Sun, Mike Ricci, a spokesman for Gov. Larry Hogan, said only that the recent shortfall issue had been successfully resolved.

“There is no effect on this week’s allocations, including mass [vaccination] sites,” Ricci said in the email.

Ricci continued to insist the federal government had not described the matter accurately. He said federal officials had mistakenly made some second doses of vaccine available to order as first doses, and states were not informed of the discrepancy.

Neither Ricci nor representatives from the Maryland Department of Health said how many doses were misallocated, or how the state compensated for the deficit. Schrader said the vaccine distribution system had been reliable until last week, when second doses of vaccines meant for some hospitals went unaccounted for.

Appointments to get the vaccine in Maryland and elsewhere have been hard to come by as national vaccine inventory remains low. As of Monday, 455,910 people in the state had gotten at least one dose, according to state health department figures. About 2 million to 3 million doses are necessary to give one dose of a vaccine to everyone who is currently eligible in Maryland, according to the state.

The pressure on states and the federal government to pick up the pace of vaccinations has intensified as more Americans continue to die from the coronavirus, and as the health crisis takes its toll on local businesses and certain sectors of the economy. In Maryland, more than 7,000 people have died from complications associated with COVID-19.

The two vaccines currently available in the U.S. — made by Pfizer/BioNTech and Moderna — have been touted by public health professionals as widely effective at preventing severe illness and death. Maryland had fully immunized about 1.46% of its population as of Tuesday, with 462,162 people receiving at least one dose.

The state has opened vaccination eligibility to health care workers, nursing home residents and caretakers, adults 65 and over, and some groups of essential workers. People with certain health conditions also qualify for vaccines if they are receiving inpatient or outpatient treatment.

But the demand for vaccinations far exceeds supply.

State health departments, hospitals, pharmacy chains and retail partners have worked to vaccinate as many people as possible, but under tight budgets, limited staffing and lacking guidance from the state and federal government.

Former President Donald Trump’s administration, while credited for coordinating the production and development of vaccines, did not have a plan as to how to distribute them once they became available, leaving much of the work to states.

Maryland has been criticized for its decentralized approach to the vaccine rollout. But state officials point to a statewide messaging campaign, mass vaccination clinics and the expansion of immunizations into more pharmacies as signs of the process’ scalability.

Schrader, on Tuesday, also said that a statewide phone number was in the process of being tested, and would soon be deployed to make signing up for vaccination appointments easier, especially for seniors and people without computers or digital fluency.

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