‘Technical glitch’ left Pierce County under-ordering COVID-19 vaccines, state says
Pierce County has been previously under-ordering COVID-19 vaccines, and the state blames a “technical glitch,” after initially faulting the county.
A text from Gov. Jay Inslee’s staff to Pierce County staff said that “all that we offered has not been accepted,” according to Pierce County Executive Bruce Dammeier.
When The News Tribune asked the Washington State Department of Health for details, the state said a malfunction led to Pierce County unknowingly under-ordering vaccines.
“They’ve been under-ordering compared to what was available for their county both last week and this week, and this situation is a result of both a misunderstanding and a technical glitch with the ordering form,” spokesperson Shelby Anderson said Thursday. “We have been working together to resolve the issue since the glitch was discovered.”
Despite the miscommunications, the fact remains that Pierce County’s vaccination rate remains lower than the state average, as well as many surrounding counties, including King County.
As of April 5, the latest data on the state Department of Health’s dashboard, Pierce County remained lower than its neighbors and the state average, with 25.44 percent initiating vaccination in the county and 16.63 percent fully vaccinated.
That contrasts with the state’s percentages: 31.39 percent initiating vaccination, and 19.98 percent fully vaccinated.
King County was listed at 34.43 percent initiating and 20.59 percent fully vaccinated.
The City of Seattle this week announced it and its vaccine partners had received their largest weekly allocation yet of more than 30,000 doses, with Lumen Field Event Center offering 8,000 vaccinations on Wednesday, its largest single day of operations to date.
When Pierce County began slipping further behind other counties in vaccination rates, Dammeier grew concerned. He and Council Chairman Derek Young penned a letter March 29 to the state asking for more vaccines.
“I think we are not getting sufficient vaccines to Pierce County, and it’s not getting better,” Dammeier told The News Tribune. “So I’m going to do everything I can to correct that so we can get as many people vaccinated as quickly as possible.”
He read aloud in a Wednesday Tacoma-Pierce County Health Department Board of Health meeting a text from Gov. Jay Inslee’s staff contending that Pierce County wasn’t accepting all vaccine doses the state had offered.
Tara Lee, Inslee’s executive director of communications, told The News Tribune that information was communicated from the governor’s office, and was provided by the state health department. Lee referred further questions to the agency.
Local health department officials including its director, Dr. Anthony Chen, flatly rejected the assertion that Pierce County had “not approved” all offered vaccines at Wednesday’s meeting.
On Thursday, in an emailed statement to The News Tribune, the Washington State Department of Health said a “technical glitch contributed to under-ordering compared to what was available to the county as we sought to catch them up on pro-rata. This has been identified and fixed.”
Dammeier said he doesn’t want to get caught up in the details of what happened, but he does want to ensure that Pierce County is getting as many COVID-19 vaccine doses as possible.
“My question to the state is how are you going to get us caught up to the state average?” he said. “We are the second most populous county in the state of Washington. It’s not OK to be five percent behind the state average. So technical glitch or whatever, that’s not important. What is important is, what are you going to do to get us caught up?”
The county was 5 percent lower than the state in initiating vaccines before the latest figures were released, which put the county at 5.95 percent lower.
VACCINE ADMINISTRATION
To date, Pierce County has been allocated a total of 448,045 vaccine doses. The county has received approximately 92 percent of its expected doses based on its pro-rata share, Anderson said.
Vaccine allocations are determined by the Washington State Department of Health. Anderson said in an email the vaccine ordering process has been adjusted to a spreadsheet order. Each week, local health jurisdictions send their vaccine orders to the state. The state health department said staff do their best to fill counties’ orders.
To give counties a proportional share of the vaccine, the state calculates a “pro rata” amount, which is determined by the county’s population of eligible groups, equity, distribution channels and available vaccine from the federal government.
“If there are additional doses allocated to the state from the federal government, we send those doses to counties that requested additional vaccine or counties in pro-rata,” Anderson said.
A few weeks ago, there was a “system-wide error” that impacted ordering.
“We recognized the error and reached out to providers right away to let them know,” Anderson said. “This did delay orders for one day and the issue has since been resolved.”
The state did not respond before publication on whether other counties had been impacted.
Stephanie Dunkel, TPCHD’s Assistant Division Director for Communicable Disease, said she was not aware of other counties struggling with under-allocated COVID-19 vaccines.
To make up the difference from the under-ordering, Pierce County has been receiving more vaccines, the state health department said.
For the week of March 29, Pierce County received over 100 percent of its expected weekly allocation of first doses and all its requested second doses. For the week April 5, Pierce County received 1,400 more doses than requested by providers.
“We will continue to work closely with our partners in Pierce County to ensure they get the vaccine they need and more in line with their pro-rata; however, allocations ultimately depend on the number of doses we receive each week from the federal government,” Anderson said.
Dunkel confirmed that Pierce County was receiving more vaccines than requested in recent weeks.
She did not know how many vaccines Pierce County was under due to the technical glitch, but said the state is quickly closing the gap.
Dunkel continued to defend the department’s vaccine distribution work.
“We’re going to continue to expect that vaccine and we’re also building the infrastructure so that when they roll out more of the vaccine we’ll be ready for it,” she said.
As more vaccines are given to Pierce County than the “pro rata,” she and Dammeier said getting shots into arms will not be an issue.
“There’s no question, we’ve got the plans in place, we’ve got the resources committed to double what we’re currently getting,” Dammeier said.
The local and state health departments will improve communications to ensure the issue does not occur again, Dunkel said.
PHASE 2 AND IMPACT ON BUSINESSES
On Thursday, other officials were gearing up for a fight with the governor’s office over any fallback to Phase 2, particularly in light of the disputed vaccine allocations for Pierce County.
The state’s “Roadmap to Recovery” puts counties in reopening phases based on their COVID-19 case rates and hospitalizations. Pierce County’s rates are higher than the current Phase 3 standards.
Dammeier wondered whether the vaccines his county was shortened by impacted the metrics.
“Would that be enough people vaccinated to slack our case rates enough that we don’t go back to Phase 2?,” he said. “I don’t know that it would, I got to think it would help. I got to think it would be beneficial.”
Dunkel said the disparity of COVID-19 vaccines is not the reason Pierce County is teetering on its return to Phase 2.
“We’re not talking 10s of 1,000s of vaccines right now, which may have made a difference,” she told The News Tribune. “So mask mandates and isolation and quarantine and investigations work that we’re doing are still effective tools, and tools we need to continue going. With the balance of the vaccine and those tools, we’re still definitely in that phase where we need to be doing all of the above.”
Others felt the vaccine glitches had cost the county progress.
“The governor … through the state, has shorted us,” said Tacoma-Pierce County Chamber President Tom Pierson, in a phone interview Thursday morning.
He contended that moving back to Phase 2 would be devastating to local businesses and said he was preparing a memo to send to Inslee outlining various concerns.
Pierson stated: “The fact the State has erred for weeks getting the proper vaccine allocation to Pierce County … has caused the continuation in disparity of equitable distribution in our region. Therefore, we are calling on the Governor and Leadership in our state to right the wrong and not to penalize individuals, businesses and our community for the state’s error — do not roll us back into Phase 2 until we get all our vaccine allocations.
“I think this is going to be a real issue for the governor,” Pierson told The News Tribune. “And I think it’s a fact that they had an error, and now are penalizing us. That’s a big problem.”
Additional feedback was also expected from the State Hospitality Association.
“We are closely monitoring the numbers and will release a statement when we see what happens Monday,” Niki Reading, media representative for the group, told The News Tribune on Thursday in response to questions.
Inslee on Thursday addressed potential backlash from counties and businesses over the risk of moving to Phase 2 next week after evaluation April 12. He noted the affected counties would revert to the same rules as the previous Phase 2 earlier this year.
“This is not judgment day, Monday, I will not be making a judgment, Monday. We are just going to count numbers Monday in public that you will be able to look at the dashboard, and you will see the numbers just as well as I do. So that’s all that’s going to happen. I’m like the scorer at the referee’s table.
“You know what I hear a lot from people on the sidewalk, they come up to me and say, ‘thank you for saving lives in the state of Washington.’ That’s the feedback I get.
“Please do not discount the importance of saving lives in this endeavor, at this critical moment,” Inslee added.
HOSPITALIZATIONS AND ROADMAP METRICS
Pierson also questioned the rate of hospitalizations, another metric the state uses in its Roadmap to Recovery phase determination, noting that reports of hospitalizations at Virginia Mason Franciscan Health’s St. Anthony Hospital in Gig Harbor could be more reflective of growth in Kitsap cases, but also could unfairly add to Pierce County’s total.
“How are their numbers being reported? Is it by where they live? Or just cases coming into our hospitals?” he asked.
On Wednesday, the Kitsap Sun reported that South Kitsap had become a Covid “hot spot” for cases. The report quoted Kitsap district’s health officer Dr. Gib Morrow, who said he’d heard from the emergency department at St. Anthony’s in regard to their intake rates: “about 80% of their COVID emergency department patients are coming from South Kitsap and about half of their current COVID in-patients are as well.”
Dr. Michael Myint, physician executive of population health, quality & risk adjustment at MultiCare, told The News Tribune on Thursday it was his understanding that while case counts report back to individual counties, hospital counts are assigned to where they are hospitalized.
“The hospital data only shows it by hospital,” he said. “So whether the patient came in from a different county, you know, we don’t track that. The state may track that, but for us, what we report out is just the number of patients within our hospital, because that’s where we partner with groups like the Northwest Healthcare Response Network, as well as Pierce County and King County, and then the state, and then look at load leveling.
“Early on in the pandemic, early 2020, we had actually several patients from King County, transfer down to us, and then we would just report those patients that we were seeing. The statistics would say that the case was reported in King County, but the hospitalization would have reflected in Pierce County, I suspect it’s the same now.”
Both Myint and Dr. Michael Anderson, senior vice president and chief medical officer for Virginia Mason Franciscan Health, in separate interviews, noted that while hospital capacity was still good, the level of hospitalizations remained concerning, regardless of where the patients were coming from.
“We have done a couple of looks at this, and with great hopes that we would see start to see a shift in the demographics, away from those that are hospitalized, you know, to other groups, but unfortunately, I’m gonna have to say, consistent with the state’s report of demographics in regard to who’s hospitalized, we’re still seeing that over age 50, or over the age of 60, those are the individuals that are being hospitalized.”
He said the older hospitalized COVID patients had not been vaccinated.
“These are the individuals with what we call the comorbidities, that make them more susceptible to be sicker and need hospitalization.
“When you look at the overall state’s demographics on who’s actually getting COVID-19, there has been a clear shift down,” in age, he added.
“Unfortunately, again, when you switch over and say, ‘OK, but who’s being hospitalized?’ Sixty percent of those infected with COVID-19 that are hospitalized are in the age group over 60,” Anderson said.
There was a bright spot.
“We are not seeing the same number of patients hospitalized as we did two months ago,” Anderson added, which he credited to vaccine efforts.
In Pierce County, 62.9 percent of those 65 and older have received vaccines.
To address the numbers of those still not vaccinated showing up in hospitals, both Anderson and Myint noted that their health systems were offering shots to qualifying patients hospitalized with other non-COVID issues, similar to offering flu vaccines in other seasons.
“We say, ‘We notice that you’re not vaccinated for COVID-19. Here are the advantages of what we can provide to you by offering the COVID-19 vaccine, and certainly the biggest advantages, we can reduce the occurrence of hospitalization, and practically eliminate the risk of death from COVID-19, if we’re able to vaccinate you today,’ ” Anderson said.
“We basically educate folks on their risks so that they can make an informed decision.”
For inpatient vaccines, “We were one of the first organizations in the state to start up a program,” Myint said of MultiCare. “We still have some vaccine hesitancy, even in patients just by being in the hospital for a different condition, they certainly are at higher risk, because of that other condition that brought them in, whether it be heart disease, or, or something else. So we’ve been working with our patients to help with that.”
Both systems favored Johnson & Johnson single-dose vaccine for the inpatient vaccine drive, and Pfizer and Moderna used for nonhospital patients.
Myint added: “The challenge is that we could always use more vaccine. So we’ve been requesting more than we’ve been getting, partially because our capacity to deliver those vaccines … we’re well over 150,000 doses of vaccines given, and we have a lot of capacity to be able to give vaccines.
“We still have waiting lists trying to get into our clinics as these phases move on. We’ve been requesting more than we’ve been getting, but … we understand why … . There’s not enough for every organization in the state to get as much as they would like.”
This story was originally published April 8, 2021 at 6:02 PM with the headline "‘Technical glitch’ left Pierce County under-ordering COVID-19 vaccines, state says."
