COVID-19 vaccination efforts in counties across the state are shifting from health care workers to community members. Limited supply has been a problem, but some counties say it's the unpredictability of that supply that’s the real barrier to carrying out plans to vaccinate the public.
With a smirk on his face, 68-year-old EMS worker Sherwin Smith is razzing one of the Teton County public health nurses vaccinating health care workers at an indoor park pavilion in Choteau.
“I’m tickled we’re getting it," Smith said.
Teton County Health Department Director Melissa Moyer says her six staff are handling the county's entire vaccine rollout. Her team has moved onto phase 1b, which includes those 70 or older as well as others with certain underlying health conditions.
More than 4,800 people are now eligible to be vaccinated in the county.
“We don’t have any public transportation throughout the county at all, so it puts some pressure on us to be out and move around and offer these vaccination clinics in different locations," Moyer said.
However Moyer said the health department’s plans to put on vaccination clinics in various communities across Teton County have been stymied by an unpredictable vaccine supply.
“If we schedule a clinic out a week from now or two weeks from now, we’re keeping our fingers crossed that that vaccine shows up in time," she said.
It’s not just rural counties facing this issue according to Yellowstone County Health Officer John Felton.
“The past several weeks, we received about 2,000 doses of vaccine for first doses," he said. "This last week, we only received only 1,100.”
Felton said the county finds out the number of doses it is getting just a couple of days ahead of time. That means vaccine clinics are planned out somewhat on the fly.
In a video last week, Missoula County Incident Commander Cindy Farr said her county is in the same boat.
“And we do not know when our allocation may be increased, but we will keep you posted as we continue to move forward," she said.
Missoula, Yellowstone and other counties have been asking the state for more long-term projections on vaccine supplies.
But the Montana Department of Public Health and Human Services says that is something it can not do. Every Tuesday, state officials find out from the federal government how many vaccines are coming in the following week.
“So this week, I think similar to last week, was another 13,500 first doses," said Maj. Gen. Matt Quinn, head of the state’s COVID-19 task force.
DPHHS says supplies coming into the state the first week of February will increase, and expects 15,625 doses. To help provide more predictability at the local level, President Joe Biden’s administration has promised states three-week projections for vaccine supplies. But state officials say they have no information on those plans.
Biden has also announced that the Federal Emergency Management Agency, or FEMA, will establish 100 vaccination centers around the country by mid-February. It will also deploy mobile vaccination teams to rural communities.
Quinn said those announcements have raised more questions than answers.
“If the feds want to come in and do a mass vaccination clinic, where are they going to get the vaccines from?" he asked. "Does it come out of our already-limited supply? Is it some supply that they're going to bring into the state? We haven’t heard anything more on that.”
MTPR reached out to FEMA to ask these and other questions about how Biden’s plans could take shape in the state but did not receive a response by deadline.
In a press release, FEMA officials said the agency will fully reimburse states using national guard troops for vaccine deployment. The release only said FEMA will coordinate with other federal agencies to stand up vaccination centers and mobile vaccine efforts.
While details about federally-supported vaccine clinics and mobile teams in Montana are uncertain, public health experts like Laurie Freeman with the National Association of County and City Health Officials say they are a step in the right direction.
“Bottom line is we have not done a good job throughout the pandemic - let alone right now at this critical juncture of vaccination - with ensuring that resources are flowing down to the community, where that last mile of response has to occur," she said.
Back in Teton County, Moyer said any additional resources or predictability about vaccine supply would be a big help at the local level. She wants people to remember that delivering COVID vaccines is not the health department's only job right now.
“We still are contact tracing, we’re still doing case management with our COVID cases, we still have other regular health department programs, we’re still doing routine childhood vaccines: We’re not able to drop everything to just do COVID-19 vaccination," Moyer said.
Despite those challenges, the six-person Teton County Health Department is still finding a way to deliver the vaccines that do come in.