But he is not sure if he will get the chance to use it, as health officials have so far not said when private doctors’ offices get vaccinated.
“I’m really angry,” Carroll said.
Not only are doctors struggling to get vaccinated for patients, but many of the community-based doctors and medical staff who are not employed at hospitals or health systems also report mixed results to be vaccinated. Some have had their shots, and others are still waiting, even though health care workers caring for patients directly are located in the U.S. Centers for Disease Control and Prevention.
Many of these doctors say they do not know when – or if – they will get doses for their patients, which will soon become a bigger problem as states want to vaccinate more people.
“The reason it’s important is that patients trust their doctors when it comes to the vaccine,” said Carroll, who complained on social media that his country had not yet announced plans for how doctors in primary care in the walk will not come.
Collectively, doctors in the country can vaccinate thousands of patients a day, he says, and can attract those who would otherwise hesitate if they went to a large hospital, a fair or another central site.
His concern comes as a result of the introduction of the vaccine in a slower way than expected, and it is far behind the initial goal of giving 20 million doses before the new year.
But dr. Jen Brull, a GP in Plainville, Kansas, said her rural area had made good progress with the first phase of vaccinations, recognizing close working relationships formed long before the pandemic.
This fall, before any doses were available, the local hospital, health department and doctor’s offices coordinated an enrollment list for medical workers who wanted the vaccine. When their province, with a population of 5,000 inhabitants, received its first 70 doses, they were ready to start. Another 80 doses came a week later.
“We will be able to vaccinate almost all the people who want it in the country,” Brull said recently.
Gaps in the deployment
But this is not the case everywhere.
Dr. Jason Goldman, a family doctor in Coral Gables, Florida, said he could be vaccinated at a local hospital that received and distributed most of the vaccines in his country.
In the weeks that followed, however, he said several of his top staff members still “did not have access to the vaccine.”
In addition, a “huge number” of patients are calling his office because Florida is loosening the distribution guidelines to include everyone over the age of 65, Goldman said, asking when they can get the vaccine. He appealed to officials about the distribution of the vaccines through his practice, but he heard nothing about it.
Patients “are frustrated because they do not have clear answers and that I do not get clear answers to give it,” he said. “We have no choice but to send them to the health department and some of the hospital systems.”
Another worrying point for Goldman, who acted as a liaison between the American Academy of General Practitioners and the panel of experts to draft the CDC distribution guidelines, is the tremendous variation in the implementation of the recommendations in the states.
The CDC recommends several phases, with leading health care workers and nursing home residents and staff in the initial group. Then, in the second part of the phase, come people over 75 and non-health care front workers, which may include the first responders, teachers and other essential workers.
States have the flexibility to design their own deployment schedule and priority groups. Florida, for example, offers doses for those 65 and older. In some provinces, older people have been told that vaccines are available on a first-come, first-served basis, a move that has resulted in long queues.
“To say 65-plus now, if you have not even vaccinated all the health workers well, denies the phasing,” Goldman said. “There has to be a national standard. We have the guidelines. We have to oversee.”
The American Hospital Association on Thursday expressed concern in a letter to Alex Azar, secretary of health and human services. Hospitals – along with health departments and large pharmacy chains – do most of the vaccinations.
The letter calls for additional coordination by federal officials, which is set out to achieve the goal of vaccinating 75% of Americans by May: 1.8 million vaccinations each day. Noting that there are 64 different deployment plans of states, cities and other jurisdictions, the letter asked whether HHS ‘assessed whether these plans, taken as a whole, are capable of achieving this level of vaccination?’
To make it work
Lack of direct national support or strategy means that each country is essentially alone, with success or failure influenced by available resources and the experience of local officials. Most state and local health departments are underfunded and are under intense pressure due to the rising pandemic.
The success of vaccination efforts still depends on planning, preparation and clear communication.
In Lorain County, Ohio, 310,000 residents began practicing local officials in October, said Mark Adams, deputy health commissioner. They have set up mass vaccination clinics for flu to investigate what is needed for a Covid-19 vaccination effort. How many staff? What would the traffic flow be like? Can patients be kept 6 feet apart?
“It gave us an idea of what is good, what is bad and what needs to change,” said Adams, who has had previous experience coordinating mass vaccination efforts at the provincial level.
When the county received its first shipment of 500 doses on Dec. 21, Adams had his plan ready. He called the fire chiefs to invite all medical emergency technicians and affiliated staff to an ad hoc vaccination center housed in a large reception hall staffed by his health department. Upon arrival, people were greeted at the door and separated to lanes at a distance, after which they fired, and then to a monitoring area where they could wait 15 minutes to make sure they were not responding.
Just after Christmas, another 400 doses arrived – and the temporary clinic reopened. This time, doses went to community physicians, dentists, and other practical medical practitioners, 600 of whom had previously enrolled. (Hospital workers and nursing home staff and residents receive their vaccinations through their own institutions.)
As they move into the next phase – recipients include residents over 80, people with developmental disabilities and school staff – the challenges will grow, he said. The province plans a multiple approach to notifying people when it’s their turn, including the use of a website, the local media, churches, other organizations and word-of-mouth.
Adams shares the concerns of medical providers nationwide: he only gets two days’ notice of how many doses he will receive, and at the current rate of 400 or 500 doses per week, it will take a while before most residents in the country have a chance to get a chance, including the estimated 33,000 people aged 65 and older.
With ten nurses, his clinic can inject about 1,200 people a day. But many other health workers voluntarily administered the shots as he received more doses.
“If I were to run three clinics, five days a week, I could do 15,000 vaccinations a week,” Adams said. “With all the volunteers, I was able to do almost six clinics, or 30,000 a week.”
For those in the last public group, 18 years and older without underlying medical conditions, it could be ‘summer,’ Adams said.
KHN (Kaiser Health News) is a non-profit news service that covers health issues. This is an editorial independent program of KFF (Kaiser Family Foundation) that is not affiliated with Kaiser Permanente.