CORONAVIRUS

Michigan ranks as 7th worst in the nation in administering COVID-19 vaccine

Kristen Jordan Shamus and Dave Boucher — Detroit Free Press
Dr. Chadi Ibrahim receives the Pfizer-BioNTech COVID-19 vaccine from Susan Grand at the Beaumont Service Center, Tuesday, Dec. 15 in Southfield, Mich.

Michigan ranks among the worst in the nation for getting coronavirus vaccines into the arms of health care workers, first responders and others who fall into the top priority for immunizations, according to the U.S. Centers for Disease Control and Prevention.

Only six other states — Arizona, Kansas, North Carolina, Alabama, Mississippi and Georgia — have vaccinated fewer people per capita, CDC data released Monday show.

While Michigan officials argue they are doing what they can to encourage a more rapid administration of vaccinations, the state is facing a problem: Some front-line workers are declining to be vaccinated.

Gov. Gretchen Whitmer and other state leaders have agreed to be publicly vaccinated. Although Whitmer has not received her first dose yet, the idea is many residents will feel more comfortable getting vaccinated if they see her and other leaders receiving the vaccine.

It remains to be seen if state guidelines, regulations or plans will spur more people to agree to the injections.

Michigan has received 379,325 doses of Pfizer's and Moderna's coronavirus vaccines, but only one-third of those vaccine doses have been administered, according to state health department data. That means two-thirds — more than 250,000 doses — remain in freezers, thus far unused in the midst of a coronavirus pandemic that has killed 12,678 Michiganders and infected more than half a million.

State health officials told the Free Press Tuesday that every state is grappling with difficulties in the roll-out of these vaccines, but did not pinpoint specifically why Michigan has fared worse than others.

"Launching mass vaccinations over the December holiday season created delays with some individuals intentionally delaying vaccines for themselves until after the holidays and clinics not being operational due to the holidays," said Bob Wheaton, a spokesperson for the Michigan Department of Health and Human Services. "Although it was appropriate to start vaccinations as soon as the vaccine was available, it has caused roll out to be slower."

Other obstacles have been in distribution, said Bobby Leddy, deputy press secretary for Whitmer.

“The federal government has fallen far short of their goal to vaccinate 20 million Americans by the end of 2020," Leddy said. "When we have the appropriate amount of vaccines, we will be able to quickly expand vaccine administration to additional phases of the general public as we look to reach our goal of at least 70% of the state's adult population — 5.4 million people — within a year.”

But hitting that target could take longer.

At the current pace of 42,796 immunizations a week, just 2.25 million Michiganders — about half the goal — will be vaccinated by the start of 2022.

To speed up the process, the state health officials say they are working with hospitals and local health departments, offering to help with operational challenges and boosting staffing.

Any organization in Michigan that receives COVID-19 vaccines — whether it's a hospital, local health department or pharmacy — has been told it must "aim to administer 90% of it within seven days of receipt," Wheaton said.

“We have also clarified the broad categories of health care workers that should be getting vaccinated, as well as the expectation that hospitals support vaccination of phase 1A workers that may not be their own employees. We will continue to evaluate our overall strategy to increase vaccination numbers in Michigan," Wheaton said.

Still, if a first responder or health care worker doesn't show up for a vaccine appointment or more doses of the vaccine are thawed than initially intended, some have been given to people who don't fall into the phase 1A top priority group, he said.

"We would prefer the vaccine be used instead of wasting it, even if that means someone in another priority group receives the vaccine," Wheaton said, adding that the state health department is not collecting data on how often that has happened.

For Michigan hospitals and health care systems, it's been a struggle, said John Karasinski, a spokesperson for the Michigan Health and Hospital Association, which represents all 133 community hospitals in the state.

Planning and scheduling employee vaccinations while finding enough workers to give the immunizations is a real challenge, as is coming up with storage solutions for the vaccines, which have to be frozen.

But, he said, "the primary barrier to faster vaccination has been the lack of consistent and timely information about how much vaccine hospitals in Michigan will receive from the federal government.

“With little advanced notice on quantity and a specific arrival date, it’s very difficult to plan day-long employee vaccine clinics and to know what other community health care providers the hospitals should try to vaccinate. When doses don’t arrive on the day expected, thousands of appointments can be delayed or cancelled. These vaccination clinics require tremendous planning, staffing, monitoring of vaccine recipients and more.”

Vaccine hesitancy is another concern.

About 600 first responders, emergency medical personnel and other health care workers who were offered vaccines in Wayne County declined to be immunized, said Michael McElrath, a spokesperson for the county health department.

As of Monday, Wayne County had received 1,950 doses of the Pfizer vaccine, and administered 1,391.

Kent County reported a similar problem.

“We could have used a few more arms so far," said Steve Kelso, a spokesperson for the Kent County Health Department. "We are seeing a lower than anticipated uptake.  Perhaps the holidays influenced some people to wait. We have had a number of our staff tell us that they did not want to 'cut in line' by taking the vaccine of someone who they perceived to be more at risk. These are theories based upon what staff has shared with us."

At Spectrum Health, a western Michigan hospital system that employs 31,000 workers across 14 hospitals, about 74% of employees have opted in to get a coronavirus vaccine, said COO Brian Brasser.

But of the roughly 34,000 vaccines Spectrum Health has received so far from Pfizer and Moderna, it had administered about one-third, 11,400, as of Monday. The hope is to complete 4,000 immunizations this week.

"We've also seen an uptick in folks registering after the holidays. We know anecdotally ... that folks were waiting for the holidays to come and go before they schedule their appointments," Brasser said.

At Beaumont Health, 24,125 doses of COVID-19 vaccines have been received, and about 15,000 have been administered, said Mark Geary, a spokesperson for the health system.

The eight-hospital health system has 38,000 employees, and began giving the second booster dose of the Pfizer vaccine to its workers Tuesday, and aims to administer 3,200 shots a day this week.

Henry Ford Health System reported Tuesday that it has administered 13,728 of the 23,400 doses of the Pfizer vaccine it has received. The six-hospital health system based in Detroit aims to have immunized all 33,000 of its employees who would like to be vaccinated by the first week of February.

Once all the workers within hospital systems are immunized, they must then seek out independent health care workers, those in private practice and dentistry, for example, and others in the Phase 1a priority group, and offer them immunizations before the shots can be opened up to the next group on the state's list of priorities.

But Karasinski said that poses yet another challenge that could slow the delivery.

"There's no central database," he said. "Our hospitals do not receive any information about what other health care providers in their local communities are receiving vaccine. So that adds an additional step. ... Our hospitals have to reach out on their own to proactively see which other community members need vaccine.”

County health departments are working to help connect hospitals and health care workers and others in the top priority groups, but they also have heavy lifting of their own to do to deliver vaccines as well as work on contact tracing for new COVID-19 cases along with offering other services.

In Washtenaw County, staffing has limited the health department's ability to fully immunize people in the first priority group.

"The initial shipments right before December holidays made scheduling a bit challenging with holidays and planned time off for some staff," said Susan Ringler Cerniglia, public information officer for the Washtenaw County Health Department. During the weeks of Christmas and New Year, the county was able to immunize 200-300 people a day. The hope is to increase that to 560 vaccinations a day for a least a couple of days this week, she said.

“We have larger/more clinics planned this week and moving forward. We are also hiring temp vaccinators and recruiting volunteers (both those able to vaccinate and general volunteers) to increase volume. Our biggest limiting factor is staffing and many of the same staff still being responsible for all other aspects of the COVID response.

"Our nurses are our vaccinators. We have gradually moved all of our nurses from case investigation and other response roles to vaccination and trained others to fill in case investigation and elsewhere.

"We are recruiting additional temporary staff as well as volunteers. We’re also talking with our hospital partners about their capacity to continue supporting vaccine distribution after their front-line workers are vaccinated, if possible."

Burn out is a concern, Ringler Cerniglia said.

"We’re very conscious of how long we can keep our current vaccinators and staff going at a rapid pace, given the extreme number of hours everyone’s been working for almost a full year now," she said. "So, while we’re prepared to ramp up our numbers with our current staff in the coming weeks, we will definitely need more capacity to keep it going and/or to increase volume much more."

Paula Levesque, left, gives a second dose of the Pfizer COVID-19 vaccination to Giulia Heiden, a Beaumont RN in Grosse Pointe at the Beaumont Service Center in Southfield, on Tuesday, Jan. 5. Beaumont said they can administer up to 3,200 people per day at the facility.