Massachusetts officials Monday outlined plans to ramp up COVID-19 vaccinations after what Governor Charlie Baker described as a state and national vaccine rollout burdened by “bumps.”
Shots for more than 45,000 first responders, such as police, firefighters, and emergency medical technicians, will start next Monday at sites across the state, including four regional vaccination hubs that later could be used to vaccinate others, Baker said.
And in a change from priorities outlined last month, the governor said he’ll adopt a proposal from his COVID-19 advisory panel to move state residents age 75 and over — a population deemed to be at higher risk for coronavirus — to the front of the vaccine line, along with residents with two or more chronic health conditions, in the second phase of inoculations slated to begin in February.
“It’s a ticket back to what we might call regular routines and everything that comes with that,” Baker said at a press briefing.
But the governor was clearly frustrated by the three-week-old vaccine rollout. Responding to a question on Republican lawmakers challenging the presidential election results, Baker lashed out at what he suggested was a lack of focus in Washington on vaccinations.
There have been “bumps associated with the [vaccine] rollout, which we all expected,” he said. “That, in my view, is where our colleagues at the federal level should be focusing their time and their attention . . . doing everything they possibly can to make sure every vulnerable American, every health care worker, every long-term care resident, every long-term care staff member, and everybody else gets access to those two doses as soon as is practically possible.”
The vaccination rollout in Massachusetts was temporarily slowed by a federal cutback in December allotments initially committed. But the state program has made up ground in the past week.
As of Sunday, the governor said, Massachusetts providers and pharmacy contractors had vaccinated 116,071 front-line hospital workers and nursing home residents and staff with first doses of their two-dose regimens — using 40.4 percent of the 287,000 doses that had been shipped to the state by the end of the year.
That was up from the 31 percent rate Massachusetts had administered at the end of last week, the lowest rate of any New England state, according to the Centers for Disease Control and Prevention. State officials said the earlier rate was lower partly because some shipments didn’t arrive until Dec. 30, just before the New Year’s holiday. They also called vaccination reporting a “rolling” process, noting there can be a lag of two days or more in health providers logging injections into a state computer system.
The national vaccination rollout has been far slower than Trump administration officials had promised, with only about 4 million Americans vaccinated compared to a year-end goal of 20 million. It has also encountered obstacles ranging from pockets of vaccine resistance nationwide to wasted or spoiled doses in Wisconsin to long lines in states like Florida that already have made injections available to high-risk members of the general public.
Massachusetts has been playing catchup to a dozen states, including Connecticut, Maine, and Vermont, where vaccinations at long-term care sites began a week earlier. Other states, like West Virginia, were able to accelerate injections at senior sites by setting up their own immunization programs rather than joining the federal effort to contract with CVS and Walgreen’s to run on-site clinics.
Some hospitals in Massachusetts initially experienced technical scheduling glitches and complaints of employees jumping the line ahead of front-line workers who treat COVID-19 patients.
But state and health care leaders said the process is now going smoother, with first doses given to workers at 74 of the state’s 76 hospitals and residents and staff at many long-term care facilities — the top priority groups for the rollout. First doses have also been given at the two state-run soldiers’ homes in Chelsea and Holyoke.
Mass General Brigham, the state’s largest hospital system, already has vaccinated about 24,000 “Covid-facing” health workers and expects to immunize all 40,000 within three to four weeks, said Dr. Paul Biddinger‚ the system’s medical director for emergency preparedness. Biddinger, who chairs Baker’s advisory committee, said other hospitals in the state are “on schedule or ahead of schedule” for vaccinating their front-line workers.
“It’s been a challenging time to ramp up,” Biddinger said. “But most of the acute care hospitals have been mobilizing their resources.”
Some in the long-term care sector also said vaccinations were off to a good start, though not everyone has embraced the shots.
“With vaccines being rolled out, there’s finally light at the end of the tunnel,” said Kevin Morris, president of Bane Care Management in Braintree, which runs a chain of Massachusetts nursing homes.
Morris said seven of his company’s 11 homes have completed their first vaccination clinics, while the other four are scheduled by Jan. 17. So far, an average of 76 percent of residents but only 40 percent of staffers have been vaccinated in Bane nursing homes. Morris said he expects that share will climb in the next rounds of vaccinations as people see the side effects were minor in those getting shots.
“It’s been better than I could have hoped for, and I think we’re going to see an uptick,” Morris said. “We’re fighting the misinformation people are reading on the Internet and giving them the facts.”
Even though Massachusetts is a national health care leader, it’s been grappling with many of the same problems seen elsewhere.
“This is the most ambitious vaccination effort in the history of the country,” said Dr. Howard Koh, professor at the Harvard T. H. Chan School of Public Health who was a former Massachusetts public health commissioner and assistant US health secretary during the Obama administration. “But there have been major challenges, and I don’t think our state has been spared any of them.”
Koh said the challenges have included launching during the Christmas holidays, scattered snow storms across the country, two-dose vaccine regimens that have forced states to hold back second doses, and the need for ultracold storage capacity for the vaccines made by Pfizer and BioNTech. All of this has taken place, he said, against a backdrop of poor federal coordination and a lack of guidance and funding for states organizing vaccinations.
“You need the highest level of coordination between federal, state, and local officials,” Koh said. “Unfortunately, on opening day, the [federal] message seemed to be the states are on their own . . . The state and local public health infrastructure in our country have been underfunded and overstretched for far too long. Now they’re exhausted and being asked to do even more during this rollout, and they will rise to the challenge because that’s what they do.”
Nearly four weeks after state officials released their vaccination timetable and priority list, some details have changed and others remain to be worked out. Among questions yet to be determined is how many vaccine doses will be shipped in January and February.
One hopeful sign came Monday when Cambridge-based Moderna, maker of one of the US-authorized vaccines, said it’s boosting its 2021 vaccine production by 20 percent to 600 million doses, though it’s too soon to say how that will affect Massachusetts.
Other unresolved questions include how Massachusetts residents in the second and third vaccination phases will be notified when shots are ready for them and where they’ll be injected.
But some questions were answered Monday by Baker administration officials who said vaccine injections of first responders, the priority group next in line, will start Jan. 11. Police and fire departments and ambulance sites will be able to receive shipments if they can agree to vaccinate 200 people and have vaccine storage capacity.
Others will be vaccinated at schools, community centers, or other designated sites or at one of four mass vaccination sites that will be created around the state in the coming weeks.
The governor didn’t identify the mass vaccination sites but said he would release more information in the coming days. He also said it was likely the regional sites could eventually be used for other groups and for the general public in later vaccination phases.
Massachusetts officials are also considering making vaccine shots available for the general public at doctors offices and at retail pharmacy stores but are still working out details.
Robert Weisman can be reached at firstname.lastname@example.org.