Teamwork bolsters South Dakota’s efforts to vaccinate residents


When a Sioux Falls vaccinator needed more COVID-19 shots to serve its 80-and-older population last week, it received help from an unlikely source — other parts of South Dakota that are trying to vaccinate their own residents.

Partners in Mobridge, Rapid City and another section of Sioux Falls offered doses they could spare, a bid to maintain fair and even distribution of their weekly batches of vaccines from the federal government.

“They said, ‘Take some of my allocation and send it there so we can be consistent,’” South Dakota Health Secretary Kim Malsam-Rysdon told The Washington Times.

Teamwork within groups of health care providers is keeping South Dakota’s vaccine program on a steady pace, making it a standout as some states struggle to keep their promises or leave doses on the shelf.

Connecticut also got off the blocks quickly. It focused on residents 75 and older and said places could go out of order in a pinch to avoid wasting doses — something New York struggled with early on, forcing it to loosen its rules. Gov. Ned Lamont also made sure state health partners knew how to transfer doses between providers, as needed.

In West Virginia, Gov. Jim Justice used the National Guard to transport vaccines to needy areas and — recognizing that more than half of its pharmacies are not chain-affiliated — used local drugstores to get vaccines to nursing homes instead of waiting on a federal partnership with CVS and Walgreens.

“If we only opted into the federal program, we felt we would be limiting our ability to distribute and administer the vaccine to the population in need,” said state health department spokeswoman Allison C. Adler.

New Mexico, meanwhile, got off to a fast start by offering an easy-to-use website that allows people to register for a vaccine. The system evaluates available doses in a given area and notifies people when a shot is available for them at a location nearby. The system does a check based on state priority — from health and long-term care workers to residents to people over 70 to younger people with serious conditions — and randomizes the selections from within each category to remain fair.

“The site’s really cool, it’s a simple idea,” said state health department spokesman Matt Bieber. “We’ve gotten a lot of interest from other states about this system.”

South Dakota, Connecticut, West Virginia and New Mexico are among seven states that earned kudos from the White House for being the fastest to get at least one dose of vaccine into 10% of their respective populations. The others were Alaska, North Dakota and Oklahoma.

While President Biden is giving the federal government a bigger role in the vaccine push, governors, county health officials and health care providers remain responsible for what happens to weekly vaccine shipments from Pfizer-BioNTech and Moderna. States that were quick on the draw haven’t fit a strict mold, though they tended to have clear rules, built trust with vaccinators, and established a centralized chain of command to direct doses from place to place.

South Dakota Gov. Kristi Noem, who faced criticism for refusing to issue mask mandates and lockdowns last year, told her team to develop a “common-sense” plan to get vaccines into arms. The team speaks daily to the hub system of three major health systems and five independent hospitals responsible for vaccinating the state.

The state is offering the vaccine to people with severe health conditions, such as active cancer treatment or dialysis, but is mainly focused on age, working through people over 80 before moving down in five-year increments until it gets to everyone 65 and older.

“Keep it simple, and keep it consistent — we don’t want anyone left behind across the state,” Ms. Malsam-Rysdon said.

Generally, states with smaller populations seemed to be able to come up quicker with workable plans.

“You don’t have a plethora of large providers and urban centers you have to juggle,” said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation, a health policy nonprofit. “You can kind of streamline the process as the state receives the vaccine and works with a limited amount of providers that are overseeing all the distribution points in that state.”

Larger states have struggled as counties vie for doses or outline their own rules, forcing some course corrections.

Democratic Gov. Gavin Newsom moved to centralize California’s vaccination program in recent weeks after some counties offered shots to those 75 and up while others offered them to those over 65.

Maryland Democrats, meanwhile, are pressing Republican Gov. Larry Hogan to centralize and simplify the system in their state, saying counties are competing with each other and establishing different criteria.

“Due to the lack of a simple and centralized process, local health departments are grappling with an influx of residents trying to receive a vaccine from a county in which they do not reside or work,” Democrats wrote in a Feb. 2 letter.

Hogan spokesman Michael Ricci said the Maryland rollout is becoming more centralized as it adds mass-vaccination sites and appointments at pharmacies.

“There are certainly some local leaders who want to try to micromanage and monopolize the process, but their clinics are just one small facet of a broader distribution network,” he said. “We should be keeping things as simple and accessible as possible for residents.”

The U.S. needs to vaccinate 70%-75% of its population of 330 million to achieve the type of herd immunity that would wrangle the virus.

The nation averaged about 1.3 million shots per day over the past week. The pace should make it easy for the Biden administration to beat its own goal of 100 million shots in its first 100 days, though experts say the benchmark is too modest and they should aim for 3 million shots per day.

States say an influx of doses would help them expand eligibility for the vaccines without overpromising.

Johnson & Johnson last week asked the Food and Drug Administration to grant emergency use of its single-shot vaccine, which was 72% effective against moderate-to-severe disease in U.S. trials and staved off deaths and hospital visits in testing around the world. Regulators are reviewing the data and will decide whether to grant emergency approval after a Feb. 26 meeting with its advisory panel.

Ms. Malsam-Rysdon said the vaccine will help South Dakota reach transient persons, such as the homeless or people who would otherwise receive a first dose in behavioral health treatment and have to be tracked down later on.

“We are really looking for prudent, but fast action on [the J&J] vaccine,” she said “Having a one-dose vaccine will really be an important tool, especially populations where it will be harder to have that second follow-up vaccine.”

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