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Half of COVID-19 vaccines haven't been administered in Delaware. Here's why.

Brandon Holveck Sarah Gamard
Delaware News Journal

Editor's note: This story has been updated with new vaccine dose numbers.

Delaware has administered less than half of the coronavirus vaccine doses it has received, a slow start that has frustrated residents who feel officials are not acting with enough urgency.

Public health officials and health policy experts say the pace should accelerate in the next few weeks.

Delaware received its first vaccine doses three weeks ago. Since then, the state has administered 23,851 of the 53,650 doses it has received, according to its vaccine tracker, which launched last week. 

Dr. Karyl Rattay, director of the Division of Public Health, said on Tuesday at the state’s weekly COVID-19 press briefing those totals don’t reflect what’s actually occurred due to reporting issues. She said there was a plan for all of the doses that hadn't been administered, including more than 10,000 that were being held for second doses.

"They are going into arms as soon as possible," she said.

Director of Education Angeline Dewey prepares a dose of the Pfizer BioNTech COVID-19 vaccine at Bayhealth's Kent County Campus COVID-19 vaccination clinic Tuesday, Dec. 15, 2020, in Dover. The hospital began giving vaccinations to frontline employees early Tuesday morning.

Residents in the first phases of Delaware’s rollout are concerned about the lack of clear answers they’ve received as they attempt to plan for when and where they’ll be vaccinated.

Health workers included in the first group to be given access to the vaccine but who aren’t employed by major health care systems have had difficulty receiving the vaccine.

Q&A: When can you get the COVID-19 vaccine in Delaware? What you need to know

A home health nurse at Bayada Home Health Care in Dover said she was one of the first of her office to get the shot on Tuesday night after receiving little to no information about when her employer would receive the vaccine.

"Even though we’re at high risk and we’re classified 1A, there’s been no information about when we’re going to be scheduled until yesterday," the nurse, who asked to remain anonymous because her superior asked that she not publicize her vaccination, told Delaware Online/The News Journal on Tuesday.

Senior Cpl. Katie Watts, left, receives the Moderna COVID-19 vaccine from Lt. David Aber Tuesday, Dec. 29, 2020.

Delawareans who fall under the later stages of Phase 1 also feel left in the dark.

Several said they called the state's COVID-19 vaccine hotline with questions about their place in the order and where they should plan to get vaccinated, and were told to contact their primary care provider.

Their providers didn't have any specific information to share with them. Some providers suggested calling pharmacies, which then referred them back to the hotline.

"There's a whole bunch of unanswered questions," said Carl Eissner, a 63-year-old lifelong Delaware resident from Newark. "This is January now; we've known these things are coming for months and months and months."

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Roger, a Dover resident who worked in Delaware hospitals for 30 years, said the state needs a greater sense of urgency as it distributes the vaccine.

"You can't give group 1A forever," he said. "If there's not a deadline, people will take their time getting their project done."

Roger, who declined to provide his last name, has two conditions that amplify his risk: cardiomyopathy and asthma.

"Being stuck at home for 11 months now, not being able to see your family, is just getting old very quick," he said. "Knowing there is a vaccine available but it's not being distributed is just very frustrating."

Division of Public Health Medical Director Dr. Rick Hong (left) and Division of Public Health Director Dr. Karyl Rattay (right) look at a shipment of Pfizer COVID-19 vaccines at the agency's Kent County warehouse on Dec. 16, 2020.

Rattay said she was confident the pace of vaccinations would soon increase and noted that while Delaware has a strong vaccination infrastructure to build on, the process in terms of scale and speed is “different than anything we've ever done before."

She said the holiday season presented logistical issues and led to some hesitancy among health care employees who feared suffering from side effects during the holidays.

According to the vaccine tracker, no one was vaccinated on Christmas Day, and 28 people were vaccinated on New Year’s Day. The state doesn’t appear to be administering the vaccine on Sundays, with fewer than 20 doses reported every Sunday since the first vaccines arrived.

Rattay said more than 10,000 doses were sitting in the Division of Public Health’s warehouse to be used at mass vaccination events, 5,000 of which would be put into people’s arms in the next week. Another 15,000 doses were with health providers to give to their employees.

As of Tuesday, 12 long-term care facilities had completed their first round of vaccinations through a federal pharmacy program to vaccinate residents, while 171 other facilities were scheduled for their first vaccinations. Long-term care facilities started being vaccinated on Dec. 28.

"We have a plan and we are executing that plan, and we are very confident we are going to get the vaccine out into the arms of people very quickly," Rattay said.

In neighboring Philadelphia, the city’s top health official this week had a more grim outlook on the slow pace of vaccinations when warning that it could take a year to get a vaccine to all residents if the process didn’t speed up, according to the Philadelphia Inquirer.

Across the country, vaccine distribution is lagging as a new, more contagious variant of the virus has made its way into the U.S., further threatening hospital capacity amid an already straining winter surge. Officials already expected the situation to worsen in the weeks following the holiday season after many people traveled and exposed themselves to non-household members. Before Christmas, Gov. John Carney warned that the state could not afford another surge in cases following a skyrocketing of hospitalizations after Thanksgiving.

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The repercussions of the holiday season won’t be fully known in Delaware for another few weeks. Delaware on Saturday reported a record 464 hospitalizations, which falls within the estimated 400 to 500 total beds available for patients before hospitals are considered overrun.

The state reported 975 new cases and a daily case average of 804.9.

The seven-day average for the percent of tests that are positive was 10.2% as of Friday, which is the highest it’s been during the fall and winter.

LPN Jennifer Hroncich, left administers the Pfizer BioNTech COVID-19 vaccine to Silver Lake Center nurse Kolubah Goniah Thursday, Dec. 17, 2020.

The state estimates there are 70,000 health care workers and long-term care staff and residents who fall under the current group that has access to the vaccine. 

But demand will skyrocket as more than 200,000 more people become eligible this month for the next phase of the vaccine. The next group will be people 65 and older, and front-line essential workers such as firefighters, police officers, teachers, U.S. Postal Service workers, grocery store workers, correctional officers, public transit employees, child care providers and food processing workers. 

State officials estimate this group, which it is calling "Phase 1B," will start receiving the vaccine in mid- to late January.

COVID-19 TRACKER: Tracking coronavirus cases in Delaware

Essential workers will likely receive the vaccine through their employer. Employers who believe they fit the qualifications for 1B or the remainder of the first phase have been asked to fill out an online survey. John Rutkowski, who runs a small IT support business called Boulder Designs, said he hadn’t received any information beyond that.

The Division of Public Health has sent resources to help employers plan on how to vaccinate their workers, according to a spokesman for the agency. 

People 65 and older will receive the vaccine from their health care provider if they have one and the provider is enrolled in the state’s vaccine program. They may also be able to get vaccinated at pharmacies or a public health clinic. Those who are 65 and older and still working may also be able to receive the vaccine through their employer.

Marc Pevar, a 76-year-old from Fairfax who will be included in the 1B group, said he understood why health care workers and long-term care residents were receiving the vaccine before him, but was frustrated to learn the state had unused doses as he anxiously waits.

He said it’s been difficult to find simple information through the state’s hotline and website.

"Just tell me when and where," Pevar said.

Vaccine distribution and communication around the process has largely been left to states, which health policy experts say are ill equipped to handle entirely on their own.

States have had several months to consider how to distribute the vaccine equitably and efficiently, but during that time they were already saddled with handling the pandemic itself, taking on the burden of acquiring personal protective equipment, organizing testing sites and standing up contact tracing programs. 

The federal government invested heavily in vaccine development, but provided little guidance and support to states for distribution.

"The tragedy is there was a missed opportunity," said Dr. Jeffrey Levi, a professor of Health Policy and Management at the Milken Institute School of Public Health at George Washington University. "We know how to respond to emergencies like these. There was a conscious decision not to do that."

The result is a number of varying systems across state and county lines where groups are prioritized differently.

You can now pre-register for the COVID-19 vaccine by enrolling in New Jersey's vaccination registration portal.

Some states including New Jersey, New York and Tennessee, as well as Washington, D.C., have launched online portals that promise to notify residents when it’s their turn to receive the vaccine based on the information they input.

Katie Greene, a visiting policy associate at the Duke-Margolis Center for Health Policy, said these pre-registration systems seem like a promising way to get people answers as soon as possible.

"It remains to be seen how that will work in practice, but theoretically that’s a good strategy," Greene said.

Delaware has no sign-up system, but rather refers residents to its vaccine hotline.

Greene said "constant communication" from state officials will be key as the rollout ramps up.

"The sort of angst that this is a disaster is a little bit premature," Greene said.

Contact Brandon Holveck at bholveck@delawareonline.com. Follow him on Twitter @holveck_brandon. Contact Sarah Gamard at sgamard@delawareonline.com. Follow her on Twitter @SarahGamard.