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State's New Mandate To Push Out Vaccine Might Be 'Really, Really, Really Hard To Hit'

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Hilltop Pharmacy has been administering doses of the Moderna COVID-19 vaccine since last month

Meeting the demands of a new mandate meant to accelerate the pace of COVID-19 vaccinations in Pennsylvania might prove difficult for some providers.

Earlier this month, the state's Department of Health issued an order mandating that, among other things, 80% of first-dose allotments must be in the arms of eligible Pennsylvanians within seven days of receiving that vaccine. The directive comes after criticism of the state’s slow vaccination rate.

Because providers get little advance notice as to how much vaccine they will receive in a given week, Alexandria Lavella of Hilltop Pharmacy said compliance with the new directive will be “really, really, really hard to hit.”

For example, Lavella said she could plan a Sunday clinic to administer 1,000 doses, knowing it is possible that her order might not be completely filled and that she could end up with only enough vaccine for 200 slots.

“Did you want me to schedule 1,000 people or schedule 200 people, and then play judge and juror, and drop 800 people? Or did you want me to not schedule?” she said.

The Biden administration says it is working to give more notice on how much vaccine is coming down the pike. Meanwhile the state is encouraging providers to not schedule vaccination appointments until they have received shipments -- a directive that might exacerbate the logistical hurdles of setting up clinics.

“It's not like you can call somebody and just say, 'Hey, I need your space, I need 20 volunteers and I need you to shut down your facility for a day,'” Lavella said. “It takes us at least a week just to find volunteers, to train everybody … to make sure people can spend the full day there.”

The health department’s order states that providers who are not in compliance may have future vaccine allocations reduced or suspended. However, there is a provision in the order that allows the department to access whether this action is warranted on a case-by-case basis.

Other providers have voiced similar frustrations about the lack of predictability of weekly vaccine supply, though larger institutions might be better positioned to handle the variability. Giant Eagle said it has "no trouble" meeting the seven-day mandate, and UPMC said it will “fully comply with the state’s most recent vaccine requirements.”

When announcing the new mandate, Acting Health Secretary Alison Beam said the state was also going to cull the number of vaccine providers to concentrate allotments to those that have “demonstrated their ability” to administer doses quickly. Some 1,700 providers have reportedly registered to administer the vaccine, but Beam said only 200 or 300 will be receiving it. 

Along with independent pharmacies and county health departments, Beam cited hospitals as a type of provider that has been able to quickly vaccinate Pennsylvanians. But even these facilities are feeling the pressure.  

“There is a daily tension of managing these processes between getting the matching and scheduling just right, and getting [vaccine] in arms as quickly as possible," said Dr. John Sullivan, the chief medical officer of St. Clair Hospital.

Because emotions around the vaccine are so high, Sullivan said it would almost be better to get a consistent amount of vaccine doses, even if that meant receiving fewer doses on a given week. When people come to St. Clair for vaccination appointments, Sullivan said, “People are taking pictures … they’re crying with joy. You can imagine the anguish that would occur if you’re canceled.”

While logistics will be messy and complicated for at least a few more months, many providers are working hard to persevere.

“We have yet to waste a single vaccine since we started the process. We’ve been driving around at like 11:00 at night to [vaccinate homebound patients,]” said Hilltop's Lavella. “If [a clinic] starts at 8:00 a.m., we’re getting up at about 4 a.m. to start drawing syringes.”

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