Mich. health systems adjust for vaccine increase, ask state to give them more


Michigan health systems have asked the state of Michigan to reallocate hundreds of thousands of COVID-19 vaccine doses sitting idly in deep freezers to hospitals and local health departments.

Once unused vaccine doses are reallocated, health system executives say their nurses and medical assistants can quickly expand the number of vaccinations for people over age 65 and essential workers, including teachers and first responders.


On Monday, COO Carolyn Wilson of eight-hospital Beaumont Health in Southfield said health system executives in a conference call with the Michigan Department of Health and Human Services asked the state to supply them with more vaccines and free up any unused doses.

“The health systems were pretty quick and fast in ramping up. It’s a puzzle and challenge. Vaccines are in freezers (at different locations around the state and being unused),” Wilson said. “We suggested the state reallocate it to health systems for distribution.”

Besides health systems, local health departments and other organizations “are begging for more vaccines” to administer to thousands of people wanting them, Wilson said.

“I think the state is working hard,” she said. “It’s a logistical challenge to figure out how to get this distributed. And so we are all giving feedback and input as to how we think we can get more vaccines faster.”

At eight-hospital Trinity Health Michigan, Dr. Rosalie Tocco-Bradley, the system’s chief clinical officer, said she doesn’t want to take vaccines away from long-term care facilities or rural hospitals if they can use them on a timely basis within a week or two.

“I just don’t want them sitting in freezers for two to three weeks,” she said. “If we could get the state to keep pace to those of us who have stood up with very active vaccine clinics, we can continue to get vaccines in the arms of patients.”

So far, according to a Crain’s analysis of state data, Michigan has received or been promised by federal officials 829,200 Pfizer and Moderna doses and has recorded 245,191 vaccine shots, a 30 percent vaccine administration rate.

State officials acknowledge those vaccination numbers may be low due to reporting delays or other delivery problems.

Crain’s reported earlier Tuesday that at the current rate, some 61,300 vaccine shots per week, Michigan would take at least two years to reach the 80 percent threshold at which most of a population is immune to the infectious disease.

Health systems contacted by Crain’s say they can vaccinate many more people if the state allocates more doses to them.

On Monday, Michigan received 60,000 total vaccine doses from the federal government, the smallest weekly number to date, health system executives told Crain’s they learned Monday in a state briefing. Hospitals had been receiving 100,000 to 200,000 doses per week since mid-December.

Wilson said Beaumont asked the state for 34,000 doses last Thursday and received 7,000 on Monday.

“We can dose up to 10,000 people per day if we had the vaccines. We will run out of vaccine next Tuesday unless we get another shipment,” said Wilson, adding that Beaumont vaccinates about 3,000 people per day now.


Dr. Adnan Munkarah, Henry Ford Health System’s chief clinical officer, said the six-hospital health system plans to ramp up the number of vaccine doses between 4,000 to 5,000, up from about 1,100 to 1,300 per day, but only if the Detroit-based system receives more Pfizer doses from the state.

“We received a very small allocation this week. We are identifying people in our medical records over age 65 who fit the criteria for vaccination,” Munkarah said. “We are working with the state on vaccine availability. The state’s doses are based on what they receive from the federal government and the numbers are not enough.”

Munkarah said Henry Ford would also run out of vaccines by Tuesday or Wednesday if it doesn’t receive another large shipment. He said the system asked the state for 20,000 doses last week and only got about 6,000.

“We need to have more consistency” and advance notice of the vaccine shipments so Henry Ford can schedule ahead appointments more than a week in advance, Munkarah said. “We can do 30,000 shots per week if we know we have it. We can make sure we accelerate the number of new sites. We need to know what size they can be (to avoid) regulatory hurdles.”

Tuesday afternoon, U.S. Health and Human Services announced the federal government will no longer hold back required second doses of the Pfizer-BioNTech and Moderna vaccines, practically doubling supply.

In a reversal from CDC policy, the federal government said states should immediately start vaccinating other groups lower down the priority scale, including people 65 and older, and younger people with certain health problems.

Michigan was one of the first states on Monday to authorize vaccinations of those 65 or older.

Wilson said Beaumont also is working with local health departments in the counties where they have hospitals to assist with vaccinations of teachers and first responders. The Michigan National Guard also has been helpful in assisting with clinical and administrative support staff.

“(Local health departments) aren’t standing up clinics fast enough for their first responders, so we are helping and taking people over age 65,” Wilson said. “We had the opportunity to have National Guard in the clinic for us. It is helpful to have them staffing with us and intermixed with nurses and pharmacists.”

Wilson said with more vaccines, Beaumont could open clinics in Troy and Dearborn.

“We want to vaccinate as many people in the community as possible. We believe the vaccine is safe and effective,” said Wilson, adding the system will not accept walk-ins because of limited supplies and social distancing needs.

Trinity is working with local health departments, including Washtenaw County, to help with staffing on vaccine administration. She said Trinity will help staff a clinic at the Eastern Michigan University Convocation Center when more vaccine is available.

So far, the Washtenaw County Health Department’s EMU’s vaccination center has eight to 14 vaccination stations operating and can inoculate up to 1,000 people a day, said Susan Ringler Cerniglia, the department’s spokeswoman.

“We’re working toward that as soon as we have sufficient vaccine to do 5,000 a week,” Ringler Cerniglia said.

Tocco-Bradley said other Trinity hospitals are partnering with county health departments to help vaccinate teachers and frontline health care workers.

“Right now, because we don’t have enough vaccines, we may have to pause on vaccines to teachers and others,” Tocco-Bradley said. “Some health departments have zero vaccines and are sending (age 65 and other people) to us.”

beginning Friday, Trinity’s call center started getting thousands more calls than normal. Usually, the call centers gets 2,200 calls per week, but Friday got more than 6,000 calls about the vaccines and the system continues to receive record numbers of calls this week.

“At two of our hospitals, we had hundreds of people just show up ” wanting a vaccine, Tocco-Bradley said. “We are having them fill out a form, taking their names. And if we don’t have appointments, we’re putting them into an organized database so that we can reach back out to them to schedule. … The public is incredibly frustrated.”

As of Monday night, Trinity had vaccinated 24,300 health care workers at between 1,400 to 2,000 per day.

“We could do 4,250 doses each day if we had the vaccines,” she said.

Last Thursday, Trinity asked for 14,000 doses for its eight hospitals. It received 5,000 but 4,800 went to Trinity’s Mercy Health St. Mary’s Hospital in Grand Rapids and St. Joseph Oakland Hospital in Pontiac received 975 doses.

“Six of our eight hospitals didn’t receive any,” she said. Those hospitals are located in Ann Arbor, Muskegon, Livonia and Chelsea. “It’s a lack of transparency. We don’t understand.”

On Monday, Tocco-Bradley said Trinity will run out of doses unless it is resupplied by the state.

“They (federal government) told us that they would send separately the second doses and we would have a separate line of requests, and those would be guaranteed,” Tocco-Bradley said. ” And we are not receiving those second doses that were promised.”


Tocco-Bradley and Munkarah said they haven’t heard how or when the state will disperse the approximately $150 million in state and federal dollars to be used for vaccine administration.

Michigan and the federal government have appropriated about $148 million for vaccine distribution, according to an email Crain’s received from the state Department of Health and Human Services.

Through Senate Bill 748, $51.3 million in general funds will support local health providers to increase capacity for direct vaccine administration. Facilities include nursing homes, hospitals, federally qualified health centers and health departments.

An additional $1.2 million in state funds will be used to extend the National Guard’s mission through March for testing and vaccinations.

Another $5.9 million from the federal CARES Act can be used for clinic infrastructure development tied to COVID-19 vaccine efforts.

However, another $90 million in federal funds from Congress’ CARES Act 2 funding awaits state legislative action to be released. The funding will go to help distribute, administer and monitor the vaccine program, state officials said.

“We were made aware by the state of Michigan of their designated funds to assist health care providers with vaccination distribution efforts,” said Trinity Health in a email statement. “We are evaluating and may choose to access these funds. Currently, we’re in the process of finalizing our use of the federal monies that were provided to us as part of the CARES Act.”

On Monday, Gov. Gretchen Whitmer asked the federal government for permission to make a one-time purchase of up to 100,000 doses of COVID-19 vaccine directly from Pfizer.

Whitmer also asked the Trump administration to release millions of vaccine doses that she said had been “held back” to give people the necessary second and final dose to complete the vaccination process.

Most experts believe the main problem for the vaccine distribution problem lies with the federal government. They cite three reasons: policy to hold back Pfizer second doses; lack of state funding to ramp up vaccine administration sites; and underestimation of how long CVS and Walgreens would take to vaccinate nursing home residents and staff.

“We need the federal government to speed up delivery of vaccines to the state,” Wilson said.

As of last week, state data shows the retail pharmacies had vaccinated about 40,000 people at nursing homes, or nearly 3,000 people per day at nursing homes since Dec. 28. The first week, when ramping up, Walgreens and CVS were only doing about 1,000 per day.

Whitmer has asked the federal government for permission to hire Kroger and Meijer pharmacies to assist with nursing home vaccinations. COVID-19 has hit nursing homes hard with 3,700 residents and 34 staff dying of the disease with 29,000 positive cases.


Spectrum Health in Grand Rapids and Munson Medical Center in Traverse City also receive far fewer vaccine shipments than they expected, officials said.

Dianne Michalek, Munson’s vice president of marketing and corporate communications, said because of limited supplies Munson will start vaccinating its patients age 80 or older and higher risk patients and then work down to age 65 or older.

“Don’t call (Munson) clinics to get on list” or request an appointment with your doctor, said Michalek, adding that Munson will reach out to eligible patients for appointment scheduling. “There will be vaccinations at independent locations affiliated with our hosptials.”

At Spectrum, the 14-hospital system opened a vaccination center in Grand Rapids on Monday and scheduled 1,800 patients for its first day. If vaccine supplies last, Spectrum has staff to inoculate 1,800 and 2,400 patients per day, said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan.

“We are not making appointments when we know we won’t have vaccine,” Elmouchi said. “We’re only scheduling appointments for the vaccine we currently have on hand.”


Wayne County is advising seniors to contact their local hospital or affiliated doctor to be scheduled for COVID-19 vaccinations. County officials said local health departments don’t have enough for the larger group of residents aged 65 or older.

“We know many people are frustrated about the slow distribution of vaccine from the state of Michigan,” said Wayne County Executive Warren Evans in a statement. “We are working with our local hospitals to ensure we can effectively and efficiently prioritize our seniors for vaccinations.”

Health systems have asked residents to contact them online or through a patient portal rather than calling over the telephone.

Wayne County Chief Health Strategist Dr. Mouhanad Hammami asked seniors to contact hospitals for COVID-19 vaccinations.

Hammami said demand for the vaccine is outpacing the state’s ability to supply it to regional health departments. The county has an estimated 500,000 people eligible for the vaccine but anticipates it will only receive 2,900 doses this week.

William Mullan, a spokesman for Oakland County Executive David Coulter, said the county also needs more vaccines and has ended appointment scheduling this week. So far, Oakland has received 5,850 doses and administered 2,373.

“Our shipment this week, we’ve been told, will only be 1,950 doses,” Mullan said. “We asked for 5,000. And even with the additional doses, we can’t schedule additional appointments because current scheduled appointments account for this shipment.”

Detroit also will start vaccinating residents older than age 75 at the TCF Center starting Wednesday in a slow rollout that will ramp up to about 1,000 per day, officials said. More than 100,000 requests for appointments have been received by the city, but Detroit will only book up to 20,000 appointments through Feb. 5.


Source: modernhealthcare.com

Tags: covid-19, pandemic

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