CONCORD – New Hampshire health care professionals on Wednesday warned that a dramatic expansion of COVID-19 vaccinations recommended by the Trump administration faces questions about shot availability, scheduling, staffing and guidelines.

Even the initial Phase 1-A — which restricted vaccines to 100,000 long-term care residents and staff, health care workers and first responders — has had its bumps in the road, they told U.S. Sen. Jeanne Shaheen, D-N.H., on a Zoom call.

Dr. William Gessner, of Coos County Family Health Services, said the Berlin-based provider has struggled to get enough vaccines and that fewer than a third of its staff (41 of 140) have received it.

“We have two nurses in full garb giving vaccine that have not gotten their first dose yet,” Gessner said.

Lisa Henderson, executive director of LeadingAge of Maine and New Hampshire, said the scheduling of shot clinics by CVS and Walgreens at long-term care settings “has not been smooth.”

“We have often gone down to the wire to understand who is included in the clinic, all staff or certain staff, nursing facility residents only or assisted living, how many doses exactly are we getting,” Henderson said. “That hasn’t been easy for providers, but when the clinics happen it is pure joy.”

Patricia Tilley, state deputy director of public health, urged those on Wednesday’s call to give state officials time to absorb the latest Trump administration recommendation that states should make vaccines available to all over age 65 as soon as feasible.

“We are asking you to hold tight as we learn how to make these adjustments,” Tilley said.

Henderson said advocates for seniors don’t know whether the pharmacies will be deployed to administer vaccines elsewhere, including at retirement care communities and subsidized housing projects.

“There is a lot of confusion about our independent-living residents being included in the pharmacy rollout. If not, then how are they going to receive the vaccine efficiently?” Henderson said.

Tilley said it’s likely public health networks and larger city health departments will help deliver vaccines to these other senior settings.

Possible complications

Don Caruso, chief executive officer of Cheshire Medical Center and president of the New Hampshire Hospital Association, urged the Sununu administration to “keep it simple” when it comes to spelling out how health care providers should identify new patients to get the vaccine.

The Phase 1-B population, scheduled to start vaccinations at the end of January or start of February, includes anyone over 75 and anyone with two serious medical conditions that put them at “very significant risk.”

“The more complex it is, the slower it will be to give these vaccines,” Caruso said.

Travis Harker, chief medical officer with Appledore Medical Group in Portsmouth, warned that making these assessments difficult would take clinicians away from treating non-COVID-19 patients.

“If it is a bureaucratic process where we have to log into a website for every patient and get them signed up,” Harker said. “That is not what a primary care provider will be able to do.”

Hospital staffing crunch

As more become eligible for the vaccine, hospitals already struggling with staffing shortages will bear the brunt of the new demand, according to Dr. Holly Mintz, chief medical officer with Elliot Health System.

“What we are going to need is patience from the public. What we are trying to avoid is shutting down our clinics and not offering that care. We hope to be able to offer a lot of immunizations in a very short period of time,” said Mintz, a pediatrician.

“We need them to have faith in us. We need them to trust in us that we know who they are and we are going to schedule them for their vaccine.”

James Potter, executive vice president of the New Hampshire Medical Society, said the next federal relief package should contain grants to reimburse medical practices that become sites for mass vaccinations.

“We need increased financial support for every non-hospital partner that wants to distribute vaccine,” Potter said.

Shaheen said she expects President-elect Joe Biden to lead an effort in the coming weeks to increase financial support to roll out more vaccines.

Wednesday, January 27, 2021