County COVID-19 vaccine distribution hinges on supply

With COVID-19 vaccine still in comparatively short supply in Montana, it's unclear when mobile vaccine clinics may be dispatched to Lincoln or other outlying communities in Lewis and Clark County.*

(Editors note: The county receives vaccine allocation information Tuesday morning. On the morning of Feb. 2 they had received enough to conduct a mobile vaccine clinic in Lincoln at the Lincoln Fire Hall Feb. 5 for Lewis and Clark County residents. The information wasn't available when the print edition of the BVD went to press.)

Lewis and Clark Public Health is currently in Phase 1b, Tier 1 of Gov. Greg Gianforte's vaccine distribution program. Gianforte re-aligned vaccine distribution to give priority to elderly residents and residents with medical conditions that put them at higher risk from COVID-19.

Phase 1a, which began under the Bullock administration, included front line personnel like medical providers and support staff as well as long term care facility staff and residents.

Phase 1b is broken down into five phases, with Tier 1 including all persons over the age of 70. Tier 2 will include people 60 and older with high-risk medical conditions, while Tier 3 covers people 50 and older with high-risk conditions. Tier 4 adds people 30 and older with high-risk conditions and Tier 5 includes individuals 16 and older with high-risk conditions. The tiers include Native Americans and other people of color at elevated risk for COVID complications.

Lewis and Clark County is currently in Phase 1b, Tier 1, and the timing for moving from one tier to the next isn't clear.

"In terms of time frames, we are at the mercy of the vaccine supply," Emergency Preparedness Coordinator Brett Lloyd said during the Jan 29 online community briefing. "When we're going to be able to get to those tiers is a question we cannot answer. It's going to depend on when we get enough vaccine to move onto those next tiers.

Dispatching mobile clinic to outlying areas like Lincoln or Augusta is also dependent on the vaccine supply. Eric Merchant, the disease control administrator, explained that the limited supply of vaccines has prevented them from making a concentrated effort to focus on folks in in the outlying communities who are eligible for vaccinations under Phase 1b, Tier 1.

"That's really important right now because they haven't had the same opportunity," he said. "We understand with wintertime and that age category, there are barriers to travel, so we a want to make sure that is a focus."

Merchant said it may look like all the focus is on Helena, but that stems in part from the fact it's the county seat and the site of their resources. He also pointed out that Helena and East Helena are home to several senior residential facilities that need to be served.

"We are doing what we can. We're trying to exercise as many points of distribution, or PODS, as we can; stand up as many as we can. But it's all contingent on having that vaccine," he said. Making distribution more complex is the need for the second dose of both the Pfizer and Moderna vaccines. The two aren't cross compatible and have slightly different time frames for the second dose. The two vaccines therefore require separate, brand-specific second dose clinics. Those clinics began recently. Individuals who received their initial vaccination Jan 5 or 6 under Phase 1a were eligible to get their second dose at the fairgrounds Feb. 4 and 5. LCPH also announced Monday that Carroll College will serve as a second-dose, drive-through site beginning Feb. 11, when they will begin providing second doses to individuals who received their first shots at the fairgrounds Jan. 19 or 20.

Merchant said they are trying to expand the drive through clinic at the fairgrounds, expand the Mobile POD program and ramp up other distribution methods like appointments through care providers.

"There are basically three issues here: we have vaccine supply, staffing – not just vaccinators, but other related activities like traffic control, medical monitoring, things like that – and the third prong is infrastructure to provide those shots'" he said. "We feel like we are building, and have built, a staffing and infrastructure for those PODs. We're waiting for vaccine."

Until more vaccine supplies are available, the focus is likely to remain largely on the drive through clinics at the Lewis and Clark County fairgrounds and require an online pre-registration system.

Currently, Public Health is relying primarily on social media and online resources such as the COVID-19 hub at http://www.helenamontanamaps.org/LCPHCovid19HUB/ to get the word out on updates and upcoming clinics. The Rocky Mountain Development Council Area IV Agency on Aging has volunteered to help older folks without internet access register for vaccinations clinics. Their number is 406-447-1680, but they ask people not to call if they have another way to register online.