Texas Shifts Covid Vaccination Plan in Face of Criticism

With Texas setting new records in the number of people hospitalized with Covid-19, the state is trying to increase access to the vaccine.

Pat Austin takes Covid-19 swabs in for testing at the state drive-thru testing location UTEP on Oct. 26, 2020 in El Paso, Texas. (Briana Sanchez/The El Paso Times via AP)

(CN) — Amid widespread criticism its Covid-19 vaccine program is leaving those who qualify in the lurch, Texas is shifting to a more centralized approach where it will send most of its supply to large hubs with the goal of each site inoculating more than 100,000 people. 

The Texas Department of State Health Services tried to make it easy for those in the initial two phases of the state’s vaccination plan — frontline health care workers, nursing home residents, senior citizens and people 16 or older with underlying health conditions — to connect with vaccine providers.

It posted a map where Texans can type in their addresses and find clinics, hospitals, pharmacies and even eye doctors’ offices that have received doses within 15 miles of their homes.

But getting an appointment to receive the shot has been difficult.

Susan Larmore, 70, of Houston, the seat of Harris County, said she and her husband had called all the sites listed around her home.

“It’s extremely hard to get through to any of them, most of them have recordings, most are not taking any type of registration or reservation system or assigning appointments,” Larmore told the Harris County Commissioners Court, the county’s elected executive board, last week.

A month into its Covid vaccine rollout, Texas had distributed 1.48 million doses across the state, with about 589,000 Texans receiving at least one dose, as of Friday.

Madelyn Braden, 74, lives in a nursing home in Sealy, a small town 60 miles west of Houston.

Braden got her first shot Thursday. 

“I really didn’t want to take it because I never get sick,” she said.

She had no choice. “Everybody here talked me into it, you know everybody insisted that I had to take it. And I think that I probably would have gotten kicked out of here if I didn’t take the shot.”

One might assume the first round of vaccines would be cause for celebration at the home, the first step toward reuniting its residents with family and friends they have not seen in the flesh since last spring when the state first barred non staff from entering nursing homes, sites of some of the worst outbreaks in Texas and across the country.

Braden has only been out of the building once since March. She was taken to a polling place to vote on Election Day.

But she said the staff told her nothing about the shot, not which of the two vaccines approved for use in the U.S. she received, or when she would be getting the second dose — the vaccines require two doses about a month apart. They just pushed her in her wheelchair back to her room, where she spends her days watching TV.

“They tell us as little as possible,” she said.

Lack of info about the rollout is a common complaint across Texas.

Local officials say because the state is giving their cities and counties sporadic deliveries of doses — as Harris County’s chief executive Lina Hidalgo recently said “We don’t know how many we are going to get, or when, we just get them,” — they have not been able to create a predictable process for administering the vaccines.

Houston’s leaders are used to dealing with disasters, be it hurricanes or chemical plant fires, and they are adapting on the fly as the vaccines trickle in.

In a test run of the hub strategy, the city on Saturday set up an inoculation center at the Houston Astros’ stadium Minute Maid Park for people who had registered for shots.

The city initially planned to administer 1,000 doses at the park, but received an unexpected delivery of 2,600 more on Friday, so it reopened the registration and 1,000 people applied within 20 minutes, Houston Mayor Sylvester Turner told the Houston Chronicle.

The city plans to operate two mega vaccination sites.

These sites will be key in the state reaching herd immunity, where the risk of infection for the unimmunized is nil because so many others have been vaccinated, but it will be a steep climb.

Dr. James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine Houston, said for the Greater Houston area to achieve herd immunity about 5 million have to be vaccinated.

“And if we are going to do that between now and the fall…that’s roughly 50,000 people a day, seven days a week,” he said.

Despite the state’s pivot to sending most of its supply to hubs, McDeavitt believes it will ultimately settle on a blended approach, where hospital and health system operators like Baylor, which he said has 53,000 patients that qualify for the state’s opening phase, vaccinate their patients in their doctor’s offices, rather than sending them to hubs, and pharmacies continue giving shots.

McDeavitt, who has led Baylor’s covid response since February, said he thinks city and county health departments will be crucial to reaching different ethnic enclaves in the Houston area, where 145 different languages are spoken, to get shots into people who may not be reachable by health systems or drug stores.

Such outreach is already in the works for the city of Houston, which said as supply increases it will deploy mobile vaccine units.

Even with all the state’s challenges, McDeavitt has faith it will soon work out the kinks in its distribution protocol. 

“The state will offer something that is the right answer. They are working hard to get it right,” he said.

The effort is unfolding as a record 13,935 Texans are hospitalized with the respiratory illness, and the majority of the state’s 22 hospital regions have crossed thresholds set by the governor requiring hospitals to stop performing elective surgeries, for bars to close and for nonessential businesses and restaurants operating at 75% capacity to cut it to 50%. 

Though some counties are refusing to enforce the stricter measures because they say they don’t have enough law enforcement to do so.

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