Inequality in vaccine distribution across Maine is widening – and explanations are conflicting

A yawning regional disparity in vaccine availability in Maine has worsened this week after state allocations left massive vaccination centers in northern York County and the western suburbs of Portland operating at 50 to 80 percent of their capacity.

Meanwhile, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, two minutes from Tuesday’s media briefing urging Mainers 70 and older to schedule vaccinations at Cross Insurance Center in Bangor, where Northern Light Health has more than 1,000 vaccinated. people per day, repeating the phone number to make a call. The clinic had to scramble to fill appointment blocks that became available after the discovery of a software error.

However, the vaccination site at Scarborough Downs in MaineHealth was running at just 80 percent due to a lack of vaccine, despite serving the most populous part of nearby York County, which has by far the largest number of unvaccinated over 70 Mainers in the state : An estimated 16,500 as of Monday based on census and demographics, compared to 8,900 in Penobscot County, where the Cross Insurance Center is located.

Shah and MaineHealth have strongly conflicting explanations as to why this is happening – and why Northern Light and other Penobscot County providers received 8,720 doses of vaccine this week, while York County providers got 1,600 and Scarborough Downs got it 4,000 to serve both Cumberland and York counties. operate.

Cumberland County, with Scarborough Downs on its southern edge, received 9,120 doses, about the same number as Penobscot, although it has twice the population and is home to the medical and vaccination centers that serve much of Sagadahoc and the northern counties of York.

Shah said the problem is a lack of additional capacity at Scarborough and other mass vaccination centers in the state that received smaller allocations than the number of unvaccinated people over 70 in their catchment areas would imply.

“I’ve been very clear with my priorities: if you run a high-throughput site like the Cross Center or Scarborough Downs or Intermed and you need more vaccine, we’ll find it,” Shah said in an interview on Wednesday. “This isn’t that I’m stingy or have any special love for Penobscot County. If they have people who are willing to get gun shots, I’ll get them vaccinated. “

Shah said he has contacted all mass vaccination site providers and encouraged them to expand capacity rapidly as large sites have the fastest and most efficient methods of achieving effective herd immunity in a population. Northern Light has taken up the challenge, he said, by expanding its capacity from 900 shots a day when it opened on Feb. 2 to about 2,000 currently, and has received large allocations accordingly.

“I’ve offered that to other sites,” said Shah. “If (MaineHealth) needs more vaccine, I’ll get them more. Tell me what you can do and I’ll get it. “

This statement is false for MaineHealth’s chief medical officer, Dr. Joan Boomsma, who said the health system was looking for larger vaccine allocations for Scarborough Downs and its other suppliers. The Scarborough Downs site is set to deliver 5,000 initial vaccinations per week, she said, but has only received enough vaccine from the Maine CDC to do about 4,000 first doses per week.

“MaineHealth has the capacity to vaccinate significantly more qualified Mainers for COVID-19 as more vaccine becomes available,” Boomsma said in a written response to questions.

As a whole, MaineHealth – the state’s largest health care network and the dominant provider in Cumberland, York, Franklin, Oxford, Lincoln and Knox counties – received 8,250 first doses from the Maine CDC this week. “We could easily administer 12,000 first doses next week and even more the following week,” adds Boomsma.

She said MaineHealth notified the Department of Health and Human Services leadership team via email on Feb. 15 that it “had identified the necessary personnel and set up the necessary infrastructure to deliver up to 25,000 total (first and second) vaccine doses per week. “

She also said that the Westbrook vaccination site of MaineHealth is operating at half the weekly capacity of 2,000 first doses, also due to lack of supply, and that the entire network is delivering vaccines at only 35 to 40 percent of capacity.

MaineHealth’s first-dose waiting list stands at approximately 30,000 eligible Mainers over 70, said Boomsma, some of whom have been on the list as of Jan. 26. More than half of them – about 18,000 – live in Cumberland and York counties.

“Obviously, we have a significant chance of vaccinating Maine residents over the age of 70 in the southern part of the state, provided we have the vaccine to do so,” Boomsma’s statement concluded.

In response to MaineHealth’s claims, Shah held out, saying that MaineHealth had not yet reported taking all the doses assigned to it for the week and that the hospital network had not “made a specific request for more doses.”

“We continue to work with MaineHealth and other systems to vaccinate as many Maine residents as quickly and fairly as possible, and we look forward to a day when MaineHealth shows it can get more shots in people’s arms in accordance with Maine’s vaccination plan. ”Shah said in an emailed statement sent Thursday evening.

Shah and Governor Janet Mills sharply criticized MaineHealth after Press Herald columnist Bill Nemitz revealed that the network vaccinated thousands of its remote workers who don’t interact with patients, as well as 10 outside consultants hired to help block a union effort by Nurses from Maine Medical Center. Shah said on Feb. 9 that hospitals that violated vaccination eligibility guidelines are taking vaccines.

Supply restrictions are also at work at MaineGeneral’s new mass vaccination site at the Augusta Civic Center, which opened Feb. 17. It serves Kennebec County, which started the week with an estimated 9,939 eligible residents aged 70 and older who had not yet received their first dose, or 58 percent of that age group, one of the worst numbers in the state.

This week, the Maine CDC assigned the province’s suppliers 2,100 doses, 1,440 of which are used at the Augusta Civic Center site, MaineGeneral spokeswoman Joy McKenna said.

“We are able to increase our weekly vaccinations to the vaccination rate of up to 1000 people per day,” said McKenna via email. “We have increased our vaccine sequence, adjusted our schedule and our workforce to meet this goal.”

The hospital is struggling with a chicken-and-egg problem: It wouldn’t allocate large numbers of staff to expand the site’s capacity unless it knew it would get a big boost in the vaccine. “If we got an additional 1,000 doses tomorrow, it would take us a week to schedule staff and schedule patients to the vaccination clinic,” she said.

As of Wednesday afternoon, she said, there were about 5,000 people 70 or older on the waiting list. “Because we know how many vaccines we will receive in the next week, we will be in touch to schedule them.”

At Central Maine Healthcare, the parent entity of Central Maine Medical Center, Androscoggin County’s main vaccination site, supplies are also the main constraint. “Our capacity is based on the availability of vaccines,” said CMHC chief medical officer, Dr. John Alexander. “As that increases, so does our capacity.”

He said CMHC would also require prior notice to dramatically increase capacity as it would have to divert qualified personnel from other work.

At York Hospital, a 48-bed community hospital in southern York County, capacity appears to be a limiting factor. Hospital spokesman Jean Kolak said the vaccination site at St. Christopher’s Church in York had an effective capacity of 400 to 500 doses per day, but is still working towards being open five days a week and receiving as many doses as it has. can handle. from Maine CDC.

The hospital backlog of eligible vaccine seekers stands at 4,950, she said.

Northern Light announced on Wednesday that the Cross Insurance Center clinic in Bangor will expand from three to four days a week. Spokeswoman Suzanne Spruce said the network is still in high demand and the slots opened this week are due to a scheduling software problem with the system keeping slots in reserve for people needing their second vaccination dose.

“When that was noticed and corrected, a number of appointments for the first doses opened for today and tomorrow,” Spruce said via email. “We saw an increase in the number of people registering online and over the phone later in the day, and we appreciate Dr. Shah’s help in getting the message across.”

Some regions in eastern and northern Maine – including near Bangor – have likely reached the threshold of “early adopters” aged 70 and older who were actively seeking vaccination, Spruce said. “We now have a lot of people eagerly looking forward to their turn – especially those 65 and older,” she said.

The Maine CDC could expand vaccination options to 65 to 69 year olds next week. “If there are open slots, it’s a good signal to us that we can open the categories to fill those spots,” Shah said at Tuesday’s briefing.

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