You might not get your COVID shot as soon as you hopedTo come anywhere near meeting the widespread expectation that most people would be vaccinated by midyear, Illinois needs to get a lot more vaccines and administer them a lot faster.
Friday, January 08, 2021
Crain's Chicago Business
by Stephanie Goldberg
Illinois Gov. J.B. Pritzker blames skimpy supplies for the slow pace of COVID-19 vaccinations in Illinois.
So far, Illinois has received 737,125 doses of vaccine, which is coming in at a rate of about 175,000 per week. At that pace, it would take about two years to vaccinate the 10 million residents needed to achieve herd immunity and neutralize a virus that has killed 17,000 and sickened 1 million in Illinois.
"We're waiting for more vaccine to arrive," Pritzker said during a Jan. 6 briefing. "That's really the biggest holdup to getting through the entire thing."
But getting vaccines is only a start. To confer immunity, they have to be injected into people's arms. That's up to the states under the federal government's immunization program. According to the Centers for Disease Control, Illinois has administered only 213,045 shots, or 29 percent of the vaccines it has received. Nationally, about 27 percent of the 21 million doses distributed have been administered.
"Everyone hoped for a faster distribution," says Katherine Baicker, dean of the University of Chicago Harris School of Public Policy. "What remains to be seen is whether it's just a slow first couple weeks but we're on an accelerating trajectory and soon we'll be up and running, or whether this is the steady pace and then we're in real trouble."
To come anywhere near meeting the widespread expectation that most people would be vaccinated by midyear, Illinois needs to get a lot more vaccines and administer them a lot faster. For example, Illinois would need to give nearly 800,000 shots per week starting now to achieve herd immunity by June 30.
Pritzker said Jan. 6 that the state is getting about 120,000 doses per week. On Jan. 5, Chicago Department of Public Health Commissioner Dr. Allison Arwady said the current weekly total received by the city was about 32,000 first doses and 23,400 second doses. Those figures add up to a statewide weekly pace of roughly 175,000 doses received.
Supply is expected to increase substantially under the Biden administration, which has pledged to invoke the Defense Production Act to boost manufacturing. The number of available doses will further increase as additional vaccines get federal authorization.
Meanwhile, Pritzker recently called on the federal government to immediately distribute vaccines that he and seven other governors say are being erroneously reserved.
"We'd like to see half a million per week, and we're hopeful we can get to that point," Pritzker said. "It's hard for me to predict exactly when we would get there, or exactly how many will be delivered, but my expectation is it will be a lot more delivered to the state of Illinois once the Defense Production Act is invoked."
To make sure the state is ready when the time comes, Pritzker said the Illinois National Guard will open mass vaccination sites using arenas and other large locations. He also expanded the next phase of Illinois' vaccine rollout to include people age 65 and older, down from seniors 75 and older.
Like much of the U.S. pandemic response, the federal government has left immunization efforts to the states, which have relied heavily on public health departments and private hospitals to push out vaccines.
Too much reliance was placed on the capacity of local health care providers and local governments to manage an incredibly complex distribution chain, and that's why we're seeing such patchwork success," Baicker says. "We're asking more of (hospitals) than they have the resources to accomplish."
With 73 percent of the 21 million total vaccines distributed nationwide yet to be administered, there's a concern that some doses could expire before long. Thawed Moderna vaccines may be stored in a refrigerator for up to 30 days, and Pfizer vaccines can last for up to six months in an ultracold freezer, stored for 30 days in the shipping container if dry ice is routinely replaced, or five days in a refrigerator.
Advocate Aurora Health recently had to discard roughly 570 vaccines in Wisconsin after a pharmacy employee allegedly intentionally left the doses unrefrigerated. In Ohio, Walgreens had about 35 doses expire when a long-term care facility ordered too many vaccines. Walgreens is among retail pharmacies administering shots in long-term care facilities under the federal government's pharmacy program.
And while adverse reactions to the shots are uncommon, facilities are hesitant to inoculate too many workers at once as a precaution.
"Up until now, the vaccine has only been offered to specific locations in staggered proportions because hospitals and nursing homes have been concerned about too many of their staff receiving the vaccine on any given shift," Pritzker said, noting that only about one-third of health care workers outside Chicago have received the vaccine.
More than 43,000 doses had been administered to Chicago residents as of Jan. 6, but that doesn't include shots given to Chicago health care workers that reside in other areas. Arwady recently said 42 percent of doses distributed to Chicago institutions are going to people who don't live in the city.
Illinois and local health departments are working to enlist more providers to administer the shots, including federally funded clinics and retail pharmacies, to improve capacity and ensure an equitable distribution.
The Cook County Department of Public Health is partnering with Jewel-Osco to inoculate health care workers in suburban Cook County. That partnership and others, including a new deal with Sam's Club and Walmart, will expand in coming weeks.
Hospitals are also working to expand their capacity.
NorthShore University HealthSystem has inoculated more than 10,000 health care workers, including its staff and other local providers. With vaccination clinics at two of its hospitals, Evanston and Glenbrook, the health system can give about 1,500 shots a day, which is on par with the number of vaccines it gets from the state, says Jeff Thiel, assistant vice president of pharmacy services at the six-hospital chain.
"We're actively having conversations now internally about, how do we continue to grow and support the broader community and different phases," Thiel says.
For example, hospital-operated drive-thru testing sites could become vaccination drive-thrus. That's something Thiel says NorthShore is considering.
A lack of funding has presented another roadblock for states, but a new pot of $3 billion in federal funds, announced by the U.S. Department of Health & Human Services on Jan. 6, should help. Illinois is getting $90 million, and the city of Chicago, which is responsible for its own rollout, is getting $24 million.
Pritzker said it will be several weeks before Illinois moves into the next phase of the rollout, which includes essential workers like first responders and teachers, as well as individuals 65 and older.