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Wisconsin Spotlight  | Jan. 18, 2021

If the State of Wisconsin has received 373,100 doses of the COVID-19 vaccine from the federal government, why have only 176,165 been administered?

That was one of many questions the Assembly Committee on Health hoped to answer during an all-day public hearing last week.

Lisa Olson, assistant deputy security for the Wisconsin Department of Health Services (DHS), told committee members that the federal government is at fault. There are 1,200 vaccine providers in Wisconsin, and every week they ask DHS to send more doses than the state has on hand.

“We are not receiving enough [doses] to keep up with demand,” she said.

But that doesn’t explain why there were almost 180,000 doses last week in Wisconsin that had not been administered.

Hording doses

Olson said the state participates in the Pharmacy Partnership Program to help get the vaccine to nursing home staff and residents, part of the first wave of vaccine recipients on the state’s priority list. That requires DHS to set aside 50% of its vaccine doses for CVS, Walgreens, and Managed Health Care Associates.

Pharmacy officials told the committee DHS has not yet sent them those doses.

“Some of it was being held back for second doses,” said Dannielle Womack, vice President of Public Affairs at Pharmacy Society of Wisconsin.

The COVID-19 vaccine requires two doses taken weeks apart to vaccinate each individual. Womack said it has not yet been sent to the pharmacies. She did not provide specific numbers.

On Tuesday,  Jan. 12, the federal government told states to stop withholding vaccines as second doses. It said those should be administered right away as first doses.

Distribution problems 

Darren Rausch, City of Greenfield Health Department, told the committee that local clinics were having problems with DHS’ distribution.

Every week, DHS asks vaccine providers how many doses they need for the next week. Those requests are due by Tuesday night. DHS makes allotment decisions by Saturday. Olson said they never have enough doses to meet the requests.

What DHS is able to provide doesn’t get to the vaccine providers sometimes until the following Wednesday, according to Rausch. He said that makes scheduling appointments very difficult.

The possibility of vaccine doses spoiling due to this poor timing was not addressed.

Eligibility problems 

Another problem facing providers is they can’t give the vaccine to just anyone. Only frontline health care workers and nursing home residents and staff technically are currently eligible in the first phase of vaccine distribution. 

The list of those eligible is expected to be expanded to police officers, teachers, and state inmates this week. 

Some providers say they have more doses than people who are on the eligibility list and want the vaccine, according to Rep. Joe Sanfelippo, chairman of theAssembly Health Committee. Those providers cannot simply start giving the extra vaccine doses to people lower on the priority list, because DHS is still trying to figure out who should be on that list.

DHS gave the job of creating an eligibility list to its 12-member State Disaster Medical Advisory Committee (SDMAC), which in turn handed it over to its 17-member vaccine subcommittee.

DHS started talking about creating the subcommittee in early October when it first faced up to the possibility that “DHS will have responsibility for developing an effective and equitable strategy for distributing vaccine to Wisconsin residents.”

The first several weeks were spent selecting members, developing a framework for equitable distribution, and taking public comment. On Dec. 10, it settled on what groups of people should get the vaccine first, during “Phase 1A.” That was just in the nick of time.The FDA approved emergency use of the Pfizer vaccine on Dec. 11. The first vaccines were administered in Wisconsin on Dec. 14. Moderna’s vaccine was approved on Dec. 18.

The vaccine subcommittee then got to work on the eligibility list for “Phase 1B.” It completed a preliminary list ready for public comment last Tuesday. It includes everyone over the age of 70, as well as teachers, police and prisoners. That same day, the federal government told states to open up vaccinations to everyone over the age of 65.

“New York Gov. Cuomo accepted that guidance a few hours later, and those residents were able to schedule their vaccinations for as soon as this week. That same day in Wisconsin, by contrast, the state committee tasked with making priority recommendations was discussing a draft proposal for future priority guidance based on national recommendations that were already outdated,” Sanfelippo wrote in a press release.

“What do we do to speed up the decision-making process?” Sanfelippo asked.

“We definitely want to be moving faster,” Olson said, but she was unable to explain precisely how. 

The vaccine subcommittee will next have to develop an eligibility list for “Phase 1C.” After “Phase 1C” comes “Phase 2,” when everyone will be able to get the vaccine. That isn’t expected to happen until July.

Olson insists DHS’ biggest problem is supply. It’s waiting on the federal government.

“There will be mass vaccination clinics. Our question is when,” Olson said. “We have the facilities. We have the infrastructure in place. We’re ready to go.”

DHS already has a contract in place with a provider who will be able to administer mass vaccinations. However, it will not be able to operate at full capacity if DHS hasn’t completed its eligibility list. 

Meanwhile, elderly Wisconsin residents are calling legislative offices wondering why their peers in other states are receiving vaccinations before they are, multiple sources told Empower Wisconsin. 

Read more at The MacIver Institute. 

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