Where we stand on vaccinations

Most businesses dream of the situation in which Greene County Public Health finds itself: demand that far outstrips supply.

In the private sector, that condition often drives up price. But not so in the public sector. For Public Health, it means trying to distribute a relatively few available doses of COVID-19 vaccine in the fairest and most appropriate way.

It’s definitely not an easy job. Becky Wolf, Greene County Public Health director, stands in the eye of the storm. 

State and federal guidelines stipulate priorities for who gets vaccinated in what sequence. The guidelines help, but the county’s allotment of vaccine falls woefully short of what’s needed and wanted.

Greene County gets a shipment of about 100 doses of vaccine each week, Wolf said. The county gets a few days’ advance notice when a shipment is coming. That batch is followed in a few days later by an identical number of doses so that anyone who gets the first dose can get the second dose four weeks later. 

(Greene County has been receiving the Moderna vaccine rather than the Pfizer, because the Pfizer variety requires ultra-cold freezer capability which Greene County health providers don’t possess. The second dose of the Pfizer vaccine is injected three weeks after the first. Moderna’s vaccine requires a four-week wait.)

First in line for vaccinations under the guidelines have been nursing home residents and medical personnel. Most who fall into those categories in the county have received their first round of vaccinations, Wolf said. 

Next on the list (tier one) are first responders and the staffs of the county’s schools, early childhood education staffs and child care providers. Due to limited vaccine, priority within that grouping is given to staffs of pre-kindergarten through fourth grade, special education and their bus drivers. Wolf expects that vaccinations in those latter categories will be completed by the end of this week.

Public Health has been able to work in a few residents age 65 and older, while simultaneously trying to complete vaccinations in tier one. But as of a week ago, the waiting list for Greene County folks in that age category had grown to 1,200. People over 65 represent about a third of Greene County’s population. The state pegs the county’s population at 8,888 for distribution purposes.

Wolf said Public Health has been vaccinating the older residents in the order in which they called in to add their names to the waiting list. As more vaccine doses become available, each tier’s priority populations will be weighted into the lists.

Health factors and occupations are factored into the mix for each tier, Wolf said, according to risk and potential frequency of virus exposure.

In Iowa, each county’s vaccine allocation, based on its population, goes to its public health department. In counties with larger populations, some of the precious fluid then goes to pharmacies, hospitals and other locations that participate in vaccinations. 

Greene County’s allocation is small enough that it doesn’t permit any redistribution to pharmacies yet, Wolf said. A total of 130 doses went to Greene County Medical Center for its staff, and to fire and law enforcement personnel. No mass vaccination clinics can be scheduled under the present conditions, she added; those clinics are probably weeks down the road.

As the manufacture of vaccines increases, the amount of vaccine distributed to counties, hospitals, pharmacies and mass clinics on a regular basis will also rise, of course. That will ease the heavy backlog on the county’s waiting list. It’s uncertain at this point how fast and to what extent the vaccine supply will grow.

Iowa’s allocation of vaccines ranks near the bottom among the nation’s states. Reasons for that fact are unknown to the state’s leaders, who have been trying to sleuth out why. Answers have been hard to come by.

Wolf strongly urges anyone whose name is on the county’s waiting list, but who then gets vaccinated in another county, to let Public Health know about it right away so others on the list can move up in priority.

And, of course, Public Health urges everyone to get vaccinated when it becomes possible to do so.