Although Massachusetts officials are sharply curtailing the supply of coronavirus vaccine to most cities and towns, they are also encouraging municipal governments to band together and create high-capacity regional sites that can deliver more vaccinations than any single community.
On Wednesday, the administration of Governor Charlie Baker approved 11 “regional collaboratives” that would not be quite as massive as the seven state-run mass clinics at locations as cavernous as Gillette Stadium and Fenway Park, but much larger than the smaller clinics so far operated by local governments.
“They are playing an important role to fill geographic gaps in our Commonwealth,” said Lieutenant Governor Karyn Polito on Wednesday. “This approach is designed to ensure vaccines are distributed throughout the Commonwealth in a highly efficient and accessible way.”
Some of the 11 regional collaboratives are already operating, including sites in the Berkshires, in Worcester, in Plymouth County, and on Cape Cod. Others are set to debut soon; in the Pioneer Valley, Northampton and Amherst announced plans to launch a collaboration starting next week.
Governments and hospitals in Randolph, Southbridge, Gardner, Rutland, Lawrence, and Franklin County will also lead regional sites approved by the state on Wednesday.
The regional sites became more central to the vaccine strategy last week, when state officials wrote to local boards of health informing them that most would no longer receive doses to operate small in-town clinics for their own residents.
Instead, Health and Human Services Secretary Marylou Sudders said local governments could receive doses if they teamed up with other organizations to establish larger sites that met several requirements: They must be capable of vaccinating at least 750 people daily, quickly report data, and provide a way to book an appointment through the state’s Vaxfinder website.
The state is also requiring that these sites be open to all Massachusetts residents, rather than limiting use to people in specific communities.
Massachusetts will need an increase in vaccine doses for the regional sites to reach 750 shots per day. On Cape Cod, officials recently said they are still receiving fewer than 1,000 doses weekly for clinics that include the Melody Tent in Hyannis. Meanwhile, the state continues to point to a limited supply of doses from the federal government as the biggest impediment to distribution.
The shift away from smaller community clinics has infuriated many municipalities who had scrambled to help launch the state’s vaccine drive. They now worry that a greater focus on large-scale sites will make it more difficult to help vulnerable populations, especially the very elderly. State officials have countered that they plan to still distribute vaccines to 20 vulnerable communities of color, as well as community health centers, and will rely on cites and towns to get shots to those who cannot leave their homes or are hard to reach.
They stress that most local efforts, however, should be focused on the regional collaboratives, to get many people vaccinated quickly.
This change has also sparked confusion in some communities that were already working together as regional groups but now say they will be unable to continue vaccinating residents.
In the northern Merrimack Valley, Amesbury was leading a group of nine neighboring communities that joined together in the initial push to vaccinate first responders and local health workers. Officials say they planned to run smaller, regional clinics primarily staffed by volunteers on a weekly or twice-weekly basis, and it is unlikely they will be able to scale up to the state’s requirements.
“Essentially what they told the regional clinics is if you can turn into a mass vaccination mega-site, we’ll reopen you,” said John Guilfoil, a spokesman representing the nine communities.
Guilfoil said that the state initially supported letting the nine towns run small vaccination centers “and then in the middle of it said, ‘Actually, no we want you to be big vaccination centers.’”
The Baker administration’s shift over the last month to emphasizing big vaccination sites has brought whiplash to many corners of the state. But in the Berkshires, the regional model was always part of the plan, said Laura Kittross, director of the Berkshire County Boards of Health Association.
The regional model made sense there because distributing the work to the many small towns with populations under 2,500 would have required much more work to likely inject far fewer people, Kittross said. Each Berkshire site will eventually be capable of vaccinating 1,000 people a day, and already the region is leading Massachusetts in the percentage of its population to have received a shot.
Berkshire officials are also developing plans to reach those who are unable to travel to the collaborative sites. But a rural area like the Berkshires may have a built-in advantage in getting people to travel far from home, because residents are so used to driving long distances as part of daily life, Kittross added.
“I do think we’re a little different out here,” she said in a recent interview. “I’m not sure it would work elsewhere.”