The city and county health departments already have a shortage and will continue to struggle to get vaccines out of people, the National Association of County and City Health Officials said.
“The concerns outweigh the benefits here,” NACCHO CEO Lori Tremmel Freeman told CNN.
“The money and funding support that makes it possible for this to happen successfully comes after the vaccine has already been distributed – so our local health departments are in short supply,” she added.
HHS Secretary Alex Azar has compiled the changes, which are in line with the approach previously announced by the incoming Biden government, as something that has been part of the plan throughout. A senior administration official told CNN on Tuesday that the move follows two Operations Warp Speed meetings that Azar has held over the past 48 hours on how to advance the delayed deployment process.
Opening up vaccinations for those 65 and older can help in areas where there have been more doses than people who are eligible or willing to receive – in some cases, extra doses can be disused, expired and discarded. And the release of reserved second doses could benefit areas where there was not enough vaccine for everyone eligible.
Local health officials are getting health workers in place for a flood of additional doses of Covid-19 vaccine – but many of the departments are understaffed and do not have enough resources, Freeman of NACCHO said.
“The release of all the second doses and the removal of the resistance are not necessarily seen as a solution to get the vaccine out faster. We still have problems – logistical problems – about how to plan this mass vaccination effort and to man, “she said.
“A balance is needed”
At both state and county level, supply and demand are not always in line for the Covid-19 vaccine.
The two vaccines approved for emergency use in the United States – Pfizer / BioNTech and Moderna – are administered as two-dose shots, 21 and 28 days, respectively.
With the Trump administration’s new implementation guidelines, Freeman said, there are concerns about mixed messages to the public about how important it is to receive a second dose of Covid-19 vaccine and when.
“What message will send the original guideline we were given where you have 21 to 28 days to get your second dose? What if that does not happen?” Freeman said. “There is a balance needed between wanting to get as many people immunized as possible and making sure we can do the second doses of vaccine successfully and have enough stock.”
Another concern at the local level is the detection of who received their first and second Covid-19 vaccine.
During Tuesday’s newsletter, Azar said that the second doses will still be available to those who need them.
‘We are still in the midst of the pandemic’
At the local level, some health departments may decide not to change their plans.
The city and county of Denver, for example, administered Covid-19 vaccines under the Phase 1a and 1b priority in Colorado, meaning that health care workers, first responders, and people 70 years and older are the only groups currently eligible for the vaccine.
To make any changes to the phased approach, such as lowering the age to 65, ‘I think it would be a decision at state level,’ said Dr. Judith Shlay, co-director of Denver Public Health, told CNN on Tuesday.
“Our governor will have to make the decision. I’m not sure we will do that at the moment because we really have a lot to do with what we are trying to do at the moment,” Shlay said.
Some states have decided to vaccinate more people.
Idaho will open Covid-19 vaccinations for all residents aged 65 and older from Feb. 1, Governor Brad Little announced Tuesday afternoon. “We do not want to create a bubble or backlog,” Little said. “Once we manage capacity, we will be able to reach the 65-year-old population.”
Meanwhile, Governor Tate Reeves in Mississippi has announced that Mississippians 65 and older, or those with pre-existing medical conditions, can make appointments for Covid-19 vaccinations.
But Shlay said the business is big.
“What we need to build is the infrastructure that can then be consistently available for months at a time. It will probably take nine months or a year to execute it all,” she said.
The American Hospital Association said the simplification of the process and the release of more vaccines could help speed up vaccination.
But, “to succeed in this initiative with the speed at which we need it, there must be a robust infrastructure in every state and jurisdiction capable of accommodating a large number of people who receive both their first and second shots. way, ” Rick Pollack, president and CEO of AHA, told CNN in a statement on Tuesday.
‘Our local health departments have not always been at the forefront’
While Freeman spoke to CNN on Tuesday morning, she said she was on her way to a meeting with the chosen team, President Joe Biden, to discuss the Covid-19 vaccine.
She said local health departments were left out of the federal decision-making process.
“During this pandemic, our local health departments were not always at the forefront,” she said.
“It is disappointing to us that this kind of decision will be taken without fully integrating the public health system’s response to such a decision, especially as our health departments are so needy and understaffed and yet do an excellent job,” she added. .
“With every layer of complexity that comes, the weight on the shoulders of our health departments just becomes unbearable. They want to do a good job – they want to protect and immunize their communities and do it efficiently, effectively – but that does not necessarily help them. to do. ‘
CNN’s Maggie Fox, Andy Rose, Jamiel Lynch and Nick Neville contributed to this report.