As New Hampshire makes its way through the second COVID-19 vaccination group, the state is trying to keep pace with slowly increasing vaccine shipments and surplus doses from pharmacies while it reschedules appointments for earlier dates and prepares to open more local vaccination sites.
Although supply is still tight after two months, the state is receiving more doses. That means those in the 1B group — people over 65 and those with health conditions that make COVID-19 infection especially dangerous — are having their April and May appointments moved up to February and March.
The state received almost 40,000 doses each of the past two weeks, according to state data, up from fewer than 20,000 doses per week in January. The state still is primarily using drive-through vaccination sites, though officials expect soon to call on hospitals, doctors’ offices and urgent care clinics to vaccinate patients.
“Everybody’s on standby, waiting for those days when we’ll have lots more vaccines,” said Mary Evanofski, vice president of clinical operations at Dartmouth-Hitchcock Medical Center.The appointment shuffle
New Hampshire is one of a few states where people who registered for a vaccine got appointment dates shortly after registration. Some of those appointments were months out, said Perry Plummer, the state official overseeing the vaccination effort.
In most other states, people are having their appointment dates confirmed as doses come into the state, rather than getting one appointment that might be rescheduled for an earlier date.
As New Hampshire receives more vaccine, Plummer said, state workers are calling people to reschedule them for earlier appointments.
Plummer said New Hampshire’s approach gives Granite Staters more certainty that they will get their first shot by that appointment date at the latest.
Another small cache of vaccines may become available in the coming weeks, as the program to vaccinate residents and staff of nursing homes and assisted-living facilities winds down.
Plummer said the state is working on securing several thousand doses that were allocated to CVS, the pharmacy chain that held vaccine clinics for most of the state’s nursing homes and assisted-living facilities.
CVS, under a federal contract, was given enough doses to vaccinate every resident and worker in long-term care facilities, Plummer said. But not everyone decided to be vaccinated.
Walgreens, the other pharmacy contracted by the federal government to vaccinate nursing homes, is using its 6,800 leftover doses to move up the appointments of about 3,400 people in the 1B category, Plummer said.
In other states, health officials have been “clawing back” or “borrowing” doses from the nursing home program for weeks.
In a Feb. 2 congressional hearing, Louisiana’s Secretary of Health Courtney Phillips said she has worked to get doses that pharmacies would not use into the arms of other Louisianans. Ngozi Ezike, director of the Illinois Department of Public Health, said Illinois has been able to “borrow” doses from the pharmacies without affecting nursing home vaccination schedules at all.
More vaccine sites coming
Walgreens will continue to receive a small portion of New Hampshire’s doses, Plummer said, to be distributed to 30 stores around the state. Those stores will help administer vaccines, working from the end of the state’s queue.
Eventually, Plummer said, he wants to see the state’s drive-through clinics wind down, with the vaccination effort taken up by other health-care providers.
In the first weeks of vaccinations, hospitals and doctors’ offices focused on getting shots to their own staff.
Now, said Dartmouth-Hitchcock Medical Center’s Evanofski, hospitals are getting small allotments based on the number of people who live in the area. She said that means Dartmouth, which serves the mostly rural Upper Valley, has the capacity to vaccinate more people if it got more doses.
“I feel like we have the expertise, the knowledge, the skills,” Evanofski said, to give more vaccines. Dartmouth-Hitchcock can’t dedicate itself to vaccine clinics, Evanofski said, but it could handle a large number of appointments.
“I think that’s going to happen,” she said.
Plummer said the state has signed about 100 agreements with hospitals, clinics, urgent care centers and other health care providers to potentially become vaccination sites.
“We’re turning those on, so to speak, activating them as vaccine comes in,” he said.
Plummer said the limiting factor is the speed at which doses reach the state and are sent to the sites — but he said every site in the state has the capacity to vaccinate more people as more doses become available.
Other states’ performance
Of the doses New Hampshire has received since December, just over 72% have been administered, according to state data released Friday.
State data show more than 64,000 undistributed doses, but Plummer said 20,000 of those were being shipped to vaccination sites over the weekend, with the rest soon to follow.
“We’re not really sitting on anything,” Plummer said.
The states leading the nation in vaccinating their populations — Alaska, West Virginia, North Dakota, New Mexico — have administered 90% or more of the doses they’ve received from the federal government, according to data from the Centers for Disease Control and Prevention.
Connecticut, which leads New England in proportion of residents vaccinated, had administered about 85% of its doses as of Thursday.
Benjamin Bechtolsheim, director of Connecticut’s COVID-19 vaccination effort, said during a meeting about vaccine allocation earlier this month that Connecticut is sending doses to places where they will be administered within a week.
“This is partly what will allow us to climb the overall coverage curve as quickly as possible,” he said.
Plummer said Friday that New Hampshire is ordering the maximum number of doses it is eligible to receive from the federal government each week, even if it will not make use of all those doses in a week. Plummer said this strategy could help New Hampshire avoid the weather-related appointment delays other states faced last week.
“Our goal is to make sure the vaccine (supply) is a limiting factor, not our process,” he said.