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It’s been more than a month since Minnesota began administering coronavirus vaccines and while the state has been promised more than 828,000 doses, it’s a complex and time-consuming process.
That’s left many Minnesotans who are eager to be vaccinated against COVID-19 wondering why what many hoped would be a flood of doses instead feels more like a trickle.
Efforts have been complicated by inconsistent plans at the federal level. State health officials say they were shocked when Alex Azar, former Health and Human Services secretary, announced Jan. 12 that all seniors were now eligible for vaccine. Previously, plans were to focus on the oldest and most vulnerable residents.
“That was not because we had more vaccine and not because we had finished vaccinating our most vulnerable elders,” said Kris Ehresmann, director of the infectious disease division for the state Department of Health. “I think it gave the mistaken notion we should have enough vaccine. Our vaccine supply did not go up.”
State leaders, health officials and other experts say Minnesota continues to work to improve vaccine administration in four areas to speed up the process. They may seem like common-sense solutions but are challenging nonetheless as the state undertakes its largest mass-inoculation effort in recent history.
OBTAIN MORE VACCINE
Since the Pfizer and Moderna vaccines were approved in December, the U.S. has allocated about 48 million doses, according to the Centers for Disease Control and Prevention. In a nation of 328 million people, with 255 million adults, that’s only enough to provide one dose to less than 20 percent of the population.
Both vaccines that have received emergency approval require two doses.
Minnesota’s share of the nation’s allocation was roughly 828,000 doses with more than 650,000 shipped to providers. It’s unclear how many of those doses have actually made it to the state, but more than 444,000 had been administered as of Friday.
Minnesota could administer 40,000 doses a day if there were enough vaccine, Ehresmann said.
“All of this is about not having enough vaccine,” she said. “We have providers who are ready and waiting to vaccinate.”
So far, there are 345,636 Minnesotans who’ve gotten at least one dose and 96,842 who’ve gotten both doses required for maximum effectiveness. State officials say they’re close to finishing the state’s top-priority group of medical workers and people living and working in long-term care.
One hurdle the state has faced is the CDC only informs health officials once a week of the doses they will receive the following week. This makes it nearly impossible to plan longer term, and the challenges are exacerbated by the need to transport the Pfizer vaccine at subzero temperatures.
Last week, President Joe Biden’s administration told states that they could expect their weekly allocation of new doses to increase by about 16 percent in February. State health officials want more, but they say the advanced notice should help planning.
“That’s wonderful,” Ehresmann said, “now we have three weeks we can plan for.”
Federal officials have contracts in place for 600 million doses of vaccine, but much of it won’t be available for months. Vaccine isn’t expected to be widely available to the general public until spring at the earliest.
INVOLVE MORE PROVIDERS IN VACCINATING
Minnesota is close to finishing vaccinating its top-priority group, which includes medical workers as well as residents and workers in long-term care. Much of that vaccine distribution was done by hospitals and medical clinics with pharmacy chains taking the lead at long-term care facilities under a federally overseen program.
State officials opened a nine-site pilot program Jan. 21 to start vaccinating seniors, educators and child care providers. The community sites are intended to be a model for a larger-scale rollout to come.
Yet, health officials say when vaccine becomes more widely available, most people will get their shots at their doctors’ offices or local pharmacies. Adding them in would dramatically increase the number of providers able to administer vaccine, which now stands at about 440 sites.
MOVE VACCINE MORE EFFICIENTLY
One issue that has plagued state officials is why it takes so long for vaccine to reach the state, get to providers and be administered. Vaccine promised to the state on Tuesday typically doesn’t get here until the following week.
Why is that? Health officials offer a stark reminder — this is not like ordering a book or flowers online.
Vaccines must be stored at particular temperatures, have a limited shelf life once thawed and must be used within a few hours after they are prepared for administration.
Those restrictions, along with the very limited supply, mean health officials have to be very specific when calculating how much vaccine each provider should receive.
Pfizer is overseeing its own shipping while Moderna has enlisted pharmaceutical distributor McKesson. Both types of vaccine get to their initial destinations via UPS and FedEx.
John Parker, spokesman for the Healthcare Distribution Alliance, said the effort to distribute the coronavirus vaccine is unprecedented in its scope and just getting started. The U.S. has committed to purchasing more than 600 million doses of vaccine by summer and shipping them across the nation.
“These companies move product every day,” Parker said. “Whenever you go to a pharmacy and your medicine is there, it is a tribute to the complex and incredibly efficient supply chain that is working around the clock.”
In Minnesota, national distributors send a specified number of vaccine doses to 24 hubs around the state, which can take anywhere from one to five days. Once they arrive, providers have a limited capacity of how many shots they can provide in a day — especially at smaller hospitals and clinics in rural areas.
As more vaccine becomes available and more providers are involved in administering doses, health officials say Minnesota will be able to inoculate more people each day.
USE DOSES MORE QUICKLY
Gov. Tim Walz announced a new goal Jan. 25 for vaccine providers to use 90 percent of their doses within three days of receiving them and all doses within a week. The objective was announced after health officials noticed Minnesota pharmacies in the federal program vaccinating residents long-term care facilities were slow to use their doses.
Health officials say this was happening because it can take several days to arrange visits to long-term care facilities to vaccinate residents and workers. As a result, pharmacies were holding more doses than they needed each week.
Minnesota leaders are working to redistribute vaccine doses to meet the new goals set by the Walz administration. As of Friday, 74 percent were meeting the three-day goal and 90 percent the weekly goal.
MOST WILL HAVE TO WAIT
State health officials say they continue to fine-tune the state’s vaccine distribution plans, but considerably more doses are needed before most Minnesotans will notice a change. While their are two more vaccines — from Johnson & Johnson and AstraZeneca — working toward the emergency-approval process, production takes time.
For Ehresmann, who’s worked much of her career on vaccination efforts, the supply shortages are frustrating.
“We just don’t have the vaccine necessary to meet expectations,” Ehresmann said. “To be in this position where there’s all these people who want to be vaccinated and we can’t give them the vaccine they want — that’s a tough position to be in.”
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