Wait listed for COVID vaccine? First come, first served? It depends where you live.

In Wake County, 68% of those who are dying of COVID-19 are 75 years and older.

They’re part of the second group of people eligible to receive the COVID-19 vaccine, after health care workers and long-term-care staff and residents.

After finishing up the first group of vaccinations, the Wake County Health Department decided not to take residents on a first-come, first-served basis, said Stacy Beard, the county’s vaccine communication specialist. Instead, they focused on those 75-and-up in the 10 ZIP codes with the highest community spread.

Wake’s strategy is just one of several that Triangle area counties are adopting as the number of people seeking vaccines far outstrips the state’s supply. In many cases, counties’ allotments have shifted week to week, and in some cases not arrived at all.

More than 80,000 people have signed up for the vaccine in Wake County, Beard said last week. The county had never received fewer than 975 vaccines per week from the state and twice received 1,850 per week.

And that was more than some.

Orange County reported last week that the N.C. Department of Health and Human Services had failed to send it any first-dose vaccines for three weeks in a row, with 17,000 people on a waiting list there.

Health directors around the state have complained to DHHS after promised vaccines went undelivered and appointments had to be canceled.

Some speculated that larger events in Charlotte and planned for Durham have taken vaccines from other counties.

Beard said she didn’t think the events had affected Wake since the county has consistently been given 975 doses.

Other counties referred questions about their vaccine allotments back to DHHS, declining to answer.

In response to the health directors, DHHS Secretary Dr. Mandy Cohen announced Friday that each county will receive weekly a baseline allotment of vaccines based on population. DHHS pledged to divide 99,000 vaccines among the 100 counties.

As of Saturday, there had been 752,627 cases of COVID-19 and 9,287 deaths since the the case of coronavirus hit the state, according to the DHHS website.

As of Thursday, 699,885 first doses of the vaccine have been administered around the state, along with 122,158 second doses.

For the Wake County Health Department, Beard said, the state has now allocated 3,900 vaccines per week for three weeks.

Durham County, which stopped scheduling new vaccine appointments Thursday, will get 600 per week, Health Director Rod Jenkins said. The county is continuing to add people to a wait list, he said in a news release.

Orange County spokeswoman Kristin Prelipp said her county has been allotted 200 vaccines per week.

Demand outstrips vaccine supply

Cohen’s announcement may come as a relief for some counties who feel their needs haven’t been met.

“Demand at each of our mass drive-through clinics has been more than the vaccine we have available,” said Paulette Williams, Johnston County’s spokeswoman.

Williams said Johnston has received 100 to 1,500 vaccines doses each week. Sometimes the supplies were lower to give CVS and Walgreens what they needed to vaccinate those at long-term residential facilities, she said.

Without a consistent supply, Williams said her county isn’t operating with a waiting list. Instead, Johnston County health officials have hosted drive-through clinics that are first-come, first-served.

As of Thursday, just over 6,000 vaccines had been administered with 19 people receiving a second dose in Johnston County.

None of the counties with waiting lists contacted for this story could say how long people would have to wait for shots.

Chatham County has 17,000 people on a waiting list, but Chatham County Public Health Director Mike Zelek said the list includes all the names the county has collected. Some of those people have already been vaccinated either in Chatham or elsewhere.

“We are working through this list to schedule appointments based on allocations from the state,” Zelek said. “We will continue to schedule appointments with those who are on our list, but given our limited supply relative to this demand, we encourage residents to explore other options for the vaccine like our partners at UNC Health.”

As of Wednesday, 8,575 residents had received a first dose of the vaccine, according to DHHS. Zelek said second doses began last week in Chatham County, with 1,201 residents receiving the booster.

“We are capable of distributing more vaccines than we have received, like many other providers in the state, but we understand that demand exceeds supply right now,” Zelek said. “We remain ready to administer each dose we receive within a week, and additional doses as allocations allow.”

Reaching underserved communities

DHHS is also letting counties compete for additional vaccines to help marginalized populations, said Ryan Jury, mass vaccination branch director for Wake County.

A DHHS news release Friday said another 55,000 doses are available for counties with higher numbers of people over 65 with low incomes, that have historically marginalized populations over 65, and that received fewer doses per population in previous weeks.

The “set-aside” vaccines will also go to new providers with greater access to rural and underserved communities and those who can provide vaccines to long-term care facilities not participating in a federal program.

Those doses will also go to community vaccination events spread throughout the state based on equity, readiness, speed and partnership, DHHS said in a news release.

Jury said WakeMed will be getting some of the extra vaccines after submitting a successful proposal.

This story was originally published February 1, 2021 at 5:50 AM.