Vaccines are available to all in parts of NC. Here’s why you’re still waiting in Wake.
Steven Greene started trying to make a COVID-19 vaccine appointment for his son on March 17, quickly growing frustrated with a process that he said would be easier if he were willing to drive an hour or more to find a shot.
“It would drive me crazy,” Greene told The News & Observer, “because it was like you could walk into Rocky Mount right now or walk into Dunn or walk into Fayetteville — and there was nothing or one appointment in North Raleigh.”
Greene’s 18-year-old son, Alex, has been diagnosed with tuberous sclerosis, a condition that causes moderate intellectual disabilities and leads to the growth of benign brain tumors. To keep the tumors at bay, Alex takes medication that suppresses his immune system, leaving him at higher risk from COVID-19.
“We worry for him,” Greene said.
Greene and others have questioned how some providers in rural parts of North Carolina are able to open vaccine eligibility to everyone who lives there while many in larger counties still need to register on a waiting list or hope that they log onto a web page at the right time.
The answer comes down to demand. Several providers who moved forward into new vaccination groups told The News & Observer that they did so once they saw people in open vaccination groups start to make fewer appointments. In the Triangle, both Wake County and UNC Health officials said their appointments are still booked, even as supply has increased.
As of March 31, anyone who is an essential worker or has a health condition that leaves them at higher risk from COVID-19 will be eligible for a vaccine in North Carolina. Anyone who is 16 or older will be eligible on April 7.
During the week of March 22, the N.C. Department of Health and Human Services shifted the formula it uses to decide where to send the bulk of available vaccine doses.
For about two months, the state largely used county populations to decide how much vaccine to send to each place. Now, 97% of doses will be based on the number of unvaccinated adults who live in a county, an effort state health officials hope will help it better account for people who cross county lines and those who are vaccinated in some federal programs.
Wake County in Group 4B
Wake County saw its baseline vaccine allocation — the number of doses it is guaranteed to receive each week until April 10 — jump from 13,500 doses of the Pfizer-BioNTech vaccine during the week of March 15 to 19,280 doses the week of March 22.
Much of that increase went to Wake County Public Health, which saw its baseline supply jump from 4,680 first doses of the Pfizer-BioNTech vaccine to 9,360 first doses. The county health department also received an additional 1,500 doses of the Moderna vaccine and 100 doses of Johnson & Johnson last week.
“Our mass vaccination sites are regional vaccine programs. And we do know that we vaccinate other counties or we vaccinate residents from other counties,” Ryan Jury, who oversees vaccine operations for Wake County, told The News & Observer.
About 10% of the people who are vaccinated at a Wake County Public Health vaccination site come from outside the county, Jury said.
Demand for a COVID-19 vaccine is still outpacing the health department’s supply.
“We have seen strong, filled schedules for the last couple weeks,” Jury said, “and we predict that into the coming weeks.”
Late Tuesday, after the Wake County health department opened up to the second portion of Group 4, there were 40,750 people on its waiting list, according to Stacy Beard, a county spokeswoman. That included 21,146 people in Group 4, 20,000 from Group 3 and about 300 apiece in Groups 1 and 2.
DHHS has sent more doses to Wake County than anywhere else in the state — 266,285 as of this week, a number that includes not only the health department but also hospitals and pharmacies. Still, Wake remains in the bottom third of the state in doses per capita, with one first dose received for every 4.18 people, worse than the state average of one dose for every 3.7 people.
Counties in Group 5
In Greene County, near Kinston, the county health department noticed that demand fell off dramatically once it reached Group 4; that was the main factor in its decision to make the shots available to anyone who wanted one.
The health department took about two extra weeks to move through Group 2, which included people at least 65 years old, wrapping up on March 12. It opened up vaccinations to all people in Group 4 on March 15, two days before most of North Carolina made shots available to some people in the group.
On March 17, the county opened appointments to anyone who wanted one.
“We had vaccine here,” said Joy Brock, Greene County’s health director. “We didn’t have the appointments filled and we decided, ‘Let’s open it up to Group 5 and let’s get the appointments filled,’ because if we have vaccine, we don’t want it here sitting on the shelves.”
Allowing anyone to get a vaccine has helped Greene County fill its slots, with the county quickly filling up its capacity until the week of April 5.
As of Monday, 5,094 people, or 24% of Greene County’s population, has received at least one dose of a COVID-19 vaccine.
“We still have a long ways to go,” Brock said.
Other providers who opened appointments early to anyone who is interested include health departments in Craven, Jones, Moore and Randolph counties. Cape Fear Valley Health, in Fayetteville, also opened eligibility to anyone who is interested.
Chris Tart, Cape Fear Valley Health’s vice president of professional services, said the system was one of the first in the state to receive the vaccine on Dec. 14, 2020, and has consistently been two or three weeks ahead of most of the state’s providers. Once demand dipped below 50% in a given group, the system moved on to the next set of eligible people.
Tart said he is hopeful that now that the system is in the largest group, Group 5, demand will stay strong for the next two months even as the supply of vaccine continues to grow.
“We need to get to herd immunity,” Tart said.
UNC Health receiving extra doses
UNC Health Care, which operates vaccination sites affiliated with a dozen hospitals across the state, has not seen that decline in demand, UNC Health officials told The N&O.
“We never have trouble filling appointments,” Ian Buchanan, UNC Health’s president of ambulatory and post-acute care, said.
The system has benefited, though, when other providers can’t fill their appointments. Each week, DHHS asks providers how much vaccine they can distribute in the following week. In some instances, providers will tell DHHS to hold the vaccine, meaning they cannot take more. The state then sends those doses elsewhere.
“We’re already starting to see some of the smaller communities throughout the state start to become a little saturated because a lot of UNC’s extra supply that we’ve been getting has been coming in the form of hold reallocations,” said John Prieur, who as manager of UNC Health’s Center for Pharmacy Excellence has helped support the logistics of the system’s vaccination effort.
Typically, the people who receive shots at UNC Health sites come from nearby. At the system’s Rocky Mount site, for instance, about 82% of shots have gone to people who live within 10 miles.
The biggest exception to that is the Friday Center site, on UNC Chapel Hill’s campus. There, only about 37% of those who have received a shot so far are from Orange County, with many others coming from Durham or Wake County.
UNC Health has created a system where most appointments are made over the phone, with slots posted on the internet only as a last resort. Officials have also conducted outreach to churches and community organizations to find people who are interested in the shot.
That effort, the N&O has reported, has helped ensure that people living near a given vaccine site make up the largest portion of those who are vaccinated there.
“We try to balance that online scheduling versus that more intentional scheduling for folks who are close to home, making sure that vaccine stays in the community where it was intended,” said Matt Gitzinger, UNC Health’s director of population sciences.
Alex Greene will end up being one of those people who is vaccinated in the community where he lives. His family signed him up for Wake County’s vaccination list on March 17, the first day he was eligible. They also put him on Duke Health’s list. Steven Greene continuously checked UNC’s Your Shot vaccination scheduling tool, but was dismayed to discover that the only available appointments were hours away.
“They never tell you anything,” Steven Greene said about the wait lists. “It’s just, you hope you hear something all of a sudden.”
Greene finally did find an appointment for his son — at Wake Tech’s southern campus later this week. That, he said, left him “super excited.”
This story was originally published March 31, 2021 at 10:07 AM.