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Hawaii COVID-19 vaccine distribution uneven because of limited supplies

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                                Wearing large blue stickers, the recently vaccinated made their way Tuesday from the Pier 2 COVID-19 vaccination site operated by Hawaii Pacific Health.


    Wearing large blue stickers, the recently vaccinated made their way Tuesday from the Pier 2 COVID-19 vaccination site operated by Hawaii Pacific Health.

The state Department of Health is well into its COVID-19 vaccination rollout across the islands, but there still appears to be confusion and frustration about apparent inconsistencies in the pecking order within designated priority groups.

Health officials tried to reassure state lawmakers at an informational briefing Tuesday that although the DOH established a distribution system based on federal guidelines, it allows flexibility for communities to tailor their vaccination schedules based on their circumstances and capabilities.

An estimated 109,808 vaccinations had been administered statewide as of Monday, according to preliminary data from the DOH Disease Outbreak Control Division. These include shots given at large long-term care facilities through a program with Walgreens and CVS; small care facilities via independent pharmacies; federally qualified health centers that serve rural and higher-risk populations; and through so-called points of dispensing, or PODs, operated by health care providers and the DOH.

The latter group includes mass vaccination centers operated at Pier 2 by Hawaii Pacific Health and at Blaisdell Concert Hall by The Queen’s Health Systems.

Appearing via videoconferencing before members of the Senate Committee on Health and the House Committee on Pandemic and Disaster Preparedness, DOH Director Dr. Libby Char said Phase 1-A of the vaccination program has been successful in immunizing 80% of the state’s health care workers so far, while Phase 1-B continues to vaccinate adults age 75 or older as well as first responders and “frontline essential workers” whose duties must be performed on-site and require being in close proximity to the public or co-workers, and are essential to the functioning of society.

The Phase 1-B group includes the approximately 500 employees at the Legislature, who will have the opportunity to get immunized at an exclusive vaccination clinic Thursday at the state Capitol coordinated by the DOH. The legislative employees are deemed essential for state government operations.

Phase 1-C opens vaccinations to adults age 65 to 74; people age 16 to 64 with high-risk medical conditions or underlying conditions that increase the risk for severe COVID-19; and essential workers not recommended for vaccination in Phase 1-B.

DOH estimates vaccinations for those in Phase 1-C will be available in the spring, and for Phase 2 — everyone else age 16 or older not covered in the Phase 1 groups — in the summer.

“These are not really, really hard categories, and it’s something of a continuum,” Char said, with vaccination providers moving through the various groups based on vaccine availability and community circumstances.

Several lawmakers said they have gotten reports that some individuals who fall within the 1-B priority group have been able to get the vaccine while others in the same occupations have been rejected, causing uncertainty and concerns about favoritism.

Sen. Joy San Buenaventura (D, Puna-Kau) said she had received calls from Hawaii island charter school teachers who were being told it wasn’t their turn, even though educators at others schools had received vaccinations, resulting in “mixed messaging” from health officials.

On Oahu, Rep. Ty Cullen (D, Waipahu-Royal Kunia-­Makakilo) said he had heard from farmers in his district wondering why their counterparts on Kauai and Molokai had been able to get the vaccine and they hadn’t when all are considered to be front-line essential workers.

“Each county seems to be doing something different as far as allocation,” Cullen said.

The Hawaii Vaccination Plan estimates there are nearly 230,000 people statewide in the Phase 1-B group, and Char said that so far there haven’t been enough doses allocated on a weekly basis to cover everyone. So providers in different communities are working their way through the priority lists as circumstances and supplies allow. For example, one community may have had success in reaching its kupuna and was able move on to essential workers, while other areas may still be focusing on kupuna and limiting the vaccine to others.

“There are a lot of people in 1-B, and on Oahu we are prioritizing catching the 75 and older and also doing some of the other front-line workers that actually are in contact a little bit more with the virus,” Char said. “Once we get through them, we will start adding other groups. And so, yes, agricultural workers are listed in 1-B, and we will add them in as we get more vaccine.”

DOH officials said vaccine availability remains their biggest challenge. Until now the federal government has announced state allotments on Thursdays, leaving local officials unsure from week to week how many doses they will receive.

The Biden administration pledged in a call Tuesday with the nation’s governors to provide states with firm vaccine allocations three weeks ahead of delivery.

Although the latest confirmed DOH data from Jan. 20 shows only 45% of vaccine received in Hawaii had been administered, Char said the figure is now actually closer to 76% due to a lag in processing and reporting. The vaccine is delivered directly to vaccination providers, she said, and it might take several days from when shipments are received and processed to when they are used.

“When we compare ourselves to the rest of the nation, we are actually doing quite well. I’m happy with where we are now.”

The state currently has a capacity to administer 60,000 to 70,000 COVID vaccinations weekly and will be able to gear up when federal allocations increase.

“We have a lot of capacity to get more shots in arms. We’re just waiting to receive more vaccine,” Char told lawmakers.

Rep. Gene Ward (R, Kalama Valley-Hawaii Kai) asked the health director when officials might expect to see the “light at the end of the tunnel,” when a large percentage of the population has been vaccinated and current COVID restrictions can be relaxed.

“We feel like if we can get a little bit more vaccine, we can probably get just about everybody who wants the vaccine vaccinated probably into August or September, if we’re able to really ramp up and get the vaccine out there,” Char said. “If it (the vaccine allotment from the federal government) continues at the current pace, it will take longer.”

Ward also asked health officials to take into account the urgent need to revive Hawaii’s economy and pay attention to both “lives versus livelihood” when devising public health strategies. When asked by Ward whether she had been in contact with tourism and business interests, the health director replied she had more pressing priorities.

“Honestly, at this point we’re really, really focused on getting the vaccine out to try and vaccinate to protect the community. We’re having conversations about what does it mean now that you’re vaccinated. Is there some point in the near future we could possibly change things, like the requirements for travel program or something along those lines? So it will obviously have implications for the economic sector. …

“We’re trying to create a really healthy population and mitigate the disease and illness in the community, and we know that when we have a healthy, robust, thriving public health aspect in our community, that will lend itself well to economic recovery as well.”

Ward emphasized Hawaii’s economic health goes hand in hand with the public’s well-being.

“Look, 75% of all of our budget is coming in through employees or GET taxes. If we don’t open the economy, there won’t even be money to pay for the DOH to do what you do, so we’ve got to have a little bit of balance.”

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