PROVINCETOWN — Massachusetts had a plan for rolling out the Covid vaccine. First up would be the entire health-care industry, police and fire depts., and congregate living facilities where large numbers of people sleep under the same roof, including not only nursing homes and assisted-living facilities but also homeless shelters, jails, rehab facilities, and even residential schools for the disabled — places where pathogens could spread with deadly speed.
This early focus served several purposes. Getting home health-care workers vaccinated in Phase One, for example, made sense: besides working in elderly people’s homes, they often live in multi-generational housing themselves, and the intimate nature of their work makes them particularly vulnerable.
Another purpose in keeping Phase One limited to certain groups was that it allowed time to prepare for the much larger Phase Two population. Health officials expected Phase Two to begin in mid-February. As of mid-January, the state’s own graphics showed the last groups in Phase One becoming eligible in the first week of February, with Phase Two beginning sometime after that.
But on Jan. 25, Gov. Charlie Baker threw his own plan into chaos by starting Phase Two weeks earlier than he had originally signaled.
The statewide population of the first subgroup of Phase Two that became eligible — people 75 and older — is half a million. In Barnstable County, there are around 29,000 people in that bracket — almost 14 percent of the county’s total population.
There was neither the organization nor sufficient vaccine doses to support that expansion. Telling hundreds of thousands of people that they are eligible for a lifesaving vaccine without being able to deliver it caused anguish and confusion.
Available Appointments: Zero
The first vaccine appointments for those 75 and older became available at midnight on Jan. 27. Senior citizens and their families and friends huddled around computer screens across the state, trying to secure a slot.
Vaccination clinics can be found on a map at mass.gov/covid-19-vaccine, which then links to more than a dozen websites, including those run by Stop & Shop, Walgreens, CVS, the state, hospital groups, and a handful of other pharmacy chains. Having so many websites is a hurdle, but the real problem is not having sufficient vaccines.
On Cape Cod, a county-run vaccination clinic was posted on the state’s scheduling site, mavaccinations.org, before it was posted on the map. By the time that Falmouth clinic made it onto the map, the Cape Cod Times reported, its 600 appointments were already taken.
Two days later, another county-run clinic, in Hyannis, went live with 600 more appointments. There was a frenzy of phone calls and emails, and all the spots were taken in about an hour. (Barnstable County has now announced that an email alert will go out 24 hours before registration at its vaccine clinics is possible. To sign up for those alerts, go to barnstablecountyhealth.org/vaccine-registration.)
The cycle of heartburn and heartache will persist, however, until vaccine deliveries are more in line with eligible populations. Having 29,000 people age 75 and up on Cape Cod competing for 1,000 vaccines a week is going to mean dashed hopes and frustration for as long as that ratio continues.
“I want to be clear — no one is sitting on doses on Cape Cod or the Islands,” said state Sen. Julian Cyr, who also serves on the Cape Cod Recovery Task Force. “The inventory and distribution of this vaccine is beyond my control, beyond the control of this task force, our partners at the county, at Cape Cod Healthcare, or in municipal government. Inventory depends on availability from the federal government and on the state for distribution to us.
“We have a readiness to be able to administer this vaccine,” Cyr continued, “but unless we have the vaccine, we can’t administer it. They should have held back on Phase Two until the supply was there. When we’re not able to come anywhere near close to meeting the demand, that’s when you have this frenzied situation. It was a big breakdown this week.”
Phase One Is Incomplete
Besides the Phase Two shortfall, there still are people eligible in Phase One — such as home health-care workers — who haven’t been vaccinated. And now that Phase two has begun, it’s not clear that it would even be legal under current guidelines to host a clinic specifically for Phase One workers.
According to state guidance, congregate living facilities can still make special arrangements with the state for vaccination. Small private medical practices whose staffs may not be fully vaccinated can reach out to certain designated hospitals to try to procure vaccine. But for individual health-care workers — such as chiropractors, psychiatrists, physical therapists, and home health-care workers — the only option is to book a vaccination along with the half million others in Phase Two who are now scrambling for scarce appointments. Those health-care workers were essentially robbed of their spot in the vaccine line.
“We have all been receiving hundreds and hundreds of calls,” said Cyr. “I have a real concern about folks who were in Phase One who might not have gotten a vaccine. There’s such a crush of people in Phase Two … it resembles something Ticketmaster would use for a Beyoncé concert.”
Where to Go Locally
Planning is in progress for vaccination sites in Provincetown and Wellfleet, according to Morgan Clark, Provincetown’s health director. Provincetown’s site may be the Veterans Memorial Community Center, which also houses the council on aging, but other locations have been considered as well.
No one at the local or county level appears to know if Stop & Shop or CVS locations in Provincetown will ever become vaccination sites. The state’s contracts with those companies were only recently revealed and came as a surprise. At the moment, there doesn’t appear to be a large amount of vaccine moving through those companies, though that could change.
Outer Cape Health Services (OCHS) attempted to order 300 doses of vaccine specifically for some private practices, home health-care agencies, and congregate housing facilities that had reached out to them, said CEO Pat Nadle. This was after OCHS had first secured doses for its own staff and the staffs of several private practices in the area earlier in January.
That request for 300 doses was denied by the state on Jan. 26, heightening concern about vaccine access for those in Phase One. OCHS has since gotten authorization for those 300 vaccines, however, raising hope that medical organizations can remain an alternate pathway to the vaccine for vulnerable Phase One frontline workers.