March 12, 2021
Dear Neighbor,
Last night, President Biden made a bold announcement. It has me very excited! Sure, I had to scrap most of my weekly email and start over. But it’s worth it!
President Biden announced that all adults will be eligible for a vaccine by May 1st. He hopes to have everyone in this group vaccinated with at least their first shot by the end of May. In order to make this dream a reality, the federal government is increasing vaccine allocations immediately. We had previously received guidance that the allocation would be relatively flat for the next two weeks so vaccinators are scrambling to ramp up for next week.
The President is also doubling federal support for mass vaccination sites, doubling the number of pharmacy locations in the Federal Pharmacy Partnership, and directing pharmacies to expand mobile vaccination operations. By May 1, the federal government will also launch a nationwide vaccine search website, and a phone line to help people find vaccines near them through federal outlets. In addition, they are providing technical support to states for their websites. More details are here.
This bold leadership, expedited timeline, and genuine investment in states' ability to get doses into arms is very exciting. But it will take some time for the state and counties to update their plans based on these new resources. My regular update is included below, but please know plans and opportunities for vaccines will likely be changing over the next few weeks.
This Week’s Big Picture Vaccination Numbers
54% of eligible 1A, 1B, and 1C have been vaccinated across Maryland. Officials will spend the next few weeks working hard to get this number up above 70% in every region of the state across all vulnerable populations. Maryland is building out infrastructure, with an average of 37,000 first and second-dose vaccines administered each day across the state. On a really good day, we can administer 50,000 a day - and that number is increasing.
Maryland now ranks 24th in the nation for first doses administered and 22nd in the nation for people fully vaccinated. Montgomery County is also towards the middle of the pack in Maryland. The County is 14th of 24 Counties for people with one shot and 19th of 24 for people fully vaccinated. Prince Georges and Baltimore City are behind us, and Howard, Baltimore, and Frederick Counties (plus many of the smaller counties) are ahead of us.
The state is making a shift in how it tracks the percentage of the population vaccinated. Last week the percentage of population that has received a first vaccine dose (we’re at about 18.6% in Maryland now) was tracked. With the Johnson & Johnson one-dose shot rollout, that has gotten too confusing. So now the state will track the percentage of the population that is fully vaccinated, either through two doses of Moderna or Pfizer, or one dose of Pfizer. Using that new metric, we are 10.2% fully vaccinated.
Maryland received 65,100 of the Johnson & Johnson single shot vaccine. We have already administered 45,025 of these doses. Montgomery County Health Department has administered all of their doses! In fact, at least one ranking has found Maryland first in the nation for getting the J&J doses into people's arms. We have used J&J at mass vaccination sites in Waldorf and Baltimore, in hospitals, and at Montgomery County Health clinics for educators, childcare providers, people experiencing homelessness, and for the County pilot project vaccinating homebound individuals.
SPRING AND SUMMER VACCINE INFORMATION
What's the timeline?
With federal, state, and local governments working together with the private sector on this rollout, there’s no single authority completely in control of timing, so leaders at different levels of government are understandably reluctant to make firm commitments on timelines for vaccination availability by phase. However, President Biden’s announcement last night establishes a clear goal for states to move through the eligibility phases quickly.
In April, allocations will increase significantly, and throughout May those allocations will continue to remain high. President Biden has set a goal of having a vaccine for every adult on its way to the states by the end of May.
For this reason, the states (including Maryland) plan to spend March readying their infrastructure for administering a much higher volume of vaccinations in April and May. Maryland is also developing plans and reporting systems to ensure that as vaccine availability expands, we do so in an equitable way.
When we enter Phase 2 (Late March/Early April?) and later Phase 3 (May 1), inevitable “high demand” periods create stress for the community, and the potential to exacerbate the disparities in vaccine administration we have seen since the very beginning of the public vaccine rollout - when more affluent populations and rural areas were being vaccinated at much higher rates than less affluent and more urban populations.
State and County planning efforts are both focused on how to mitigate the potential for disparities during these high-demand periods. As new phases open up, prepare yourself that appointments may initially be very difficult to secure. As with Phase 1A, 1B, and 1C, patience is key. It takes time to move through these phases. Not everyone can have an appointment in the first week of the new Phase, but we are working hard to make sure nobody is left behind. President Biden has set a goal of every American who wants a vaccine having access to at least a first dose by the end of May.
March
The week of March 15 should be pretty steady in terms of vaccination priorities. Towards the end of the week, we should know more about our next J&J vaccine shipment, and the increased federal allocation. The week of March 22 there should be extra doses to distribute from that shipment. These two weeks will hopefully get us from 54% vaccinated to above 70% vaccinated in group 1A, 1B, and 1C.
The mass vaccination sites will open in Salisbury (3/18) and Hagerstown (3/25). The County will also be working on building out the Montgomery College Germantown Campus potential mass vaccination site in partnership with Holy Cross. In addition, Giant and Safeway will expand their on-site clinic offerings, focusing on high-density senior housing.
The state mass vaccination pre-registration site will likely be rolled out sometime next week (mid-March). According to the Acting Health Secretary, the counties will have the option to coordinate and roll their pre-registration information into the state mass vaccination list. Montgomery County has not yet confirmed if they will share their list with the state or if County residents will have to register for both.
In addition to vaccinating all seniors (65 and over) who want a vaccine, we will also be focusing on essential workers including public transportation, food production, critical manufacturing, grocery store employees, clergy, and childcare. There will also be a focus on highly vulnerable populations, including people experiencing homelessness, incarcerated individuals, and people with disabilities. See below for more details on vulnerable populations.
April
By the last week of March or the first week of April, we should see vaccine allocation from the federal government increasing significantly. The State and the County will likely open up to people with co-morbidities and pre-existing conditions (Phase 2 for the State, 1C Tier 2 for the County). State estimates show there are 1.1 million people eligible in Phase 2. I’m hopeful that a state-run Montgomery County mass vaccination site in Germantown supported by FEMA will be opened during this period. In addition, I expect Montgomery County community organizations to have vaccination clinics running in partnership with the State Equity Task Force that focus on high-risk communities (see more on Holy Cross pop-up clinics below).
May, June, July, August
By this time, we will be open to State Phase 3 - which includes the whole population aged 16 and older. The first few weeks of Phase 3 will likely have intense competition - but hopefully, we also will have expanded our vaccinators to include physicians' offices and urgent care clinics by then. The state projects that there are around 1.2 million individuals in this phase.
September, October, November
Into the fall, we will continue to vaccinate hard-to-reach populations and begin vaccinating (hopefully) newly eligible children, by age group. While Montgomery County and Maryland officials haven’t yet released public goals, Prince George's County Executive Angela Alsobrooks has set a County goal of vaccinating 65% of the eligible population in her County by summer and 80% by the fall.
Vaccines For Those Under 65
Many residents have asked if the age tiers could continue to ensure people in their fifties or early sixties are vaccinated prior to people in their twenties, thirties, and forties in Phase 2 and Phase 3. Montgomery County’s Health Officer has indicated this is unlikely. Maryland's Acting Health Secretary has indicated he will follow federal recommendations. Although age does correlate with an increased likelihood of serious COVID, this is a much less significant factor for people under age 65. For the population under age 65, other variables, such as the presence of a pre-existing condition, access to health care and health insurance, and exposure risk as influenced by profession and household conditions are more likely to increase the rate of severe COVID.
Vaccines for Children
Safety trials are underway for children under age 18 (and under 16 in the case of Pfizer). Pfizer and Moderna are currently conducting trials for individuals 12 and older with data expected from those trials by mid-summer. Johnson & Johnson also launched a study of younger teens this week. In a recent White House briefing, Dr. Fauci recently said that he expects teens will have access to the vaccine by fall and younger children by the first quarter of 2022. Keep in mind that while the CDC has said it’s unnecessary for children to be vaccinated before returning to school, it is important that we vaccinate some of the 73 million Americans aged birth - 18 in order to return to complete normalcy.
Preparing for Phase 2 and Phase 3
If you feel based on your age or your own health and exposure risks you need an early appointment within Phase 2 or Phase 3 there are a few things you can do. Make sure you are pre-registered with the state mass vaccination sites (once that link becomes available) and the County Pre-registration list and reach out to your primary care provider to see if they are keeping a list of eligible patients. Sign up for MD TEXT ALERTS by texting "MDReady" to 898-211. Just before appointments open up at different mass vaccination sites, a text alert is sent to everyone on the list. You may also want to join the Vaccine Hunters Facebook Group for tips on how to get vaccine appointments at different pharmacies.
NEW VACCINATORS
Target and CVS
This week Target announced a partnership with CVS Pharmacy to bring vaccines to more than 600 stores nationwide, including stores in Maryland and Virginia. Vaccines will be available to eligible groups as well as Target employees. Target already administers in-store vaccinations annually for the flu, shingles, and pneumonia with CVS. Fitting rooms will be turned into appointment rooms at select stores, and this partnership is expected to get underway in the next few weeks. To learn more, click here.
CVS also announced that an additional 15 locations across Maryland will begin offering COVID vaccinations. Appointments will go live on Saturday and can be scheduled through cvs.com or 800.746.7287.
Changes to Mass Vax Sites
The Governor is quadrupling the number of appointments reserved each week for Prince George’s County residents at Six Flags, so fewer appointments will be available for Montgomery County residents at this location. Six Flags does about 14,000 a week, and 2100 will now be reserved for Prince George’s residents.
The new mass vaccination site opening on 3/25 at Hagerstown Premium Outlets is equally close to some parts of Montgomery County as Six Flags. Another new mass vax site will be opening in Salisbury around 3/18.
Here’s a handy resource list you can use with all the websites of vaccinators in the area.
When Can I Get A Vaccine From My Doctor’s Office or Urgent Care Clinic?
The State hopes to open up this program as soon as possible, but the Administration can’t make any commitments until there is a sense of what the increased allocation from the federal government will look like. Many doctors and urgent care clinics have already pre-registered with the state to become vaccinators when the vaccine supply is increased. You can check with your primary care provider. If they need information on how to sign up as a vaccinator when vaccines are available, I can help them. There is a process for training and authorizing certain medical staff to administer vaccines once providers are registered with Immunet.
VULNERABLE POPULATIONS
Friendship Heights & Low-Income Senior Housing
The Friendship Heights Community is largely senior citizens and has a population density greater than Manhattan. Many of these seniors are dependent on public transportation and have had difficulty getting to mass vaccination sites and County clinics. In my Week 10 update, I mentioned the D16 Delegation was working in conjunction with Councilmember Andrew Friedson to get an on-site vaccination clinic for this community under the state’s “High-Density Senior Housing Program.” Here’s the letter sent by the District 16 Delegation on this topic. I’m happy to report our request was granted, and Friendship Heights Village Center will be scheduling an on-site clinic in partnership with Giant within the next few weeks.
We are also working with the Housing Opportunities Commission towards getting on-site clinics at their low-income senior housing buildings across the County. Montgomery County has six HOC properties with an average age over 65, including one in Bethesda.
Homebound Seniors
The County began vaccinating this population this week in a pilot program that will be expanded in the coming weeks.
Essential Workers
Grocery store workers, child care providers, and transportation workers are all currently eligible. In addition, Montgomery County has opened up pre-registration for Food Service Workers. These individuals are in MoCo Phase 1C, Tier 3. However, the state has them eligible only in Phase 2. If you or a loved one are a food service worker who wants a vaccine as soon as possible, please pre-register with the County. This will potentially allow you earlier access to a vaccine.
I have been hearing reports of healthy high school students from D16 seeking vaccine appointments at the mass vaccination sites under the “tutor” category. Any system we set up will have people trying to scam it, but please know the essential worker's category is designed to protect the lives of the heroes who have risked their lives to keep our community functioning during this difficult time. The risk of death increases significantly with age and comorbidity, and the risk of exposure increases significantly in low-income zip codes.
People with Pre-Existing Medical Conditions
It’s almost time for your group! I’m sure you are getting antsy and eager. We expect Montgomery County (1C) and the State (Phase 2) to open up to this group around the same time. The County may be able to vaccinate you a little bit sooner than the state if you live or work in a targeted zip code (make sure you are pre-registered)
. The timeline for this group changed dramatically with President Biden’s announcement yesterday. I will share more specific information when it is available.
People with Disabilities & Caregivers
Some advocates are concerned that we may be falling behind in vaccinating this important group. According to the Department of Disabilities, there are 17,764 Marylanders who rely on state services and of that population 1853 have tested positive for COVID, and 92 have died from COVID. There are thousands more who may not receive state services but are eligible in Phase 1b to be vaccinated, and are having difficulty finding vaccines.
A recent study found that those with intellectual disabilities are 2.5 times more likely to contract COVID-19, 2.7 times more likely to be admitted to the hospital, and 5.9 times more likely to die from COVID than the general population. Unfortunately, earlier this week five localities in Maryland did not list individuals with intellectual and developmental disabilities as eligible on their websites.
Children under 16 with disabilities are not yet eligible for vaccination and in many cases, neither are their parents and caregivers. Efforts are underway by advocacy organizations and legislators to ensure these families are protected, particularly in light of the newly expedited timeline for vaccine access for the general population announced by President Biden.
Immigrants
Maryland’s vaccine program guidelines make very clear that vaccine appointments may not be refused on the basis of citizenship or immigration status. Nevertheless, there have been reports of immigrants facing racial profiling and harassment when seeking vaccines. The Maryland Legislative Latino Caucus is working to ensure the state makes our policy clear to all vaccinators.
Maryland’s work to vaccinate immigrants through churches and community groups has also been highlighted in national news. We need to do a lot more of this type of work in the coming months.
REMOVING BARRIERS
Thoughts on “Demand” and “Hesitancy”
In the coming months, we will open to Phase 2 and Phase 3. If this goes anything like Phase 1 did, I expect to hear from many constituents who are extremely eager to get a vaccine as soon as possible. Montgomery County, and District 16 especially, has a highly educated population, many with backgrounds in medicine, science, and public health. We are also a low poverty jurisdiction that has seen less of an economic impact from COVID than other areas. I would describe us as a “high demand for vaccine” jurisdiction.
It is important to remember that not all people are as eager to get a vaccine as soon as humanly possible as you or I might be. That doesn’t necessarily mean they are “vaccine hesitant.” Some people have logistical limitations that make it less feasible for them to drive over an hour each way in order to hustle to get a vaccine, and are waiting until less burdensome options are available. Still others have fears that their workplace documentation will be challenged, or they will be asked for proof of citizenship (which is not allowed but has
happened). Many face technological barriers with sign-ups. Some people are waiting a bit until friends or family can tell them about their experience, both with the process of getting a vaccine and with any side effects. There are all sorts of reasons people who want to be vaccinated aren’t rushing to be first in line in this confusing process.
I’m making this point because as we move rapidly through the phases, it will be difficult for us to remain patient. We have to keep in mind that some people need more help than others in making vaccine appointments happen. For example, vaccination rates today for seniors in Prince George’s and Baltimore City are significantly lower than state averages and MoCo rates. While 54% of seniors are vaccinated statewide, almost 68% of people over 85 in Prince George’s County remain unvaccinated. 62% of people 75-84 in that County are still unvaccinated. In fact, more than twice as many Montgomery County residents have been vaccinated (105,234) as Prince George’s County residents (51,452). The key to herd immunity, and leaving this pandemic behind, is making sure that enough people get vaccinated all across the region.
To illustrate this point, let’s look at the differences between the Prince Georges County waitlist and the Montgomery County waitlist. Prince George’s has 144,000 on its pre-registration list and a population over 900,000. Meanwhile, slightly larger Montgomery County (population just over one million) has more than 400,000 on their waitlist. Both of these waitlists have plenty of people on them to ensure the County Health Departments make good use of their weekly vaccine allotments for the foreseeable future. There’s no shortage of people seeking appointments in Prince George’s County (or in MoCo!) right now. That said, clearly some areas have incredibly high demand, and others have less overwhelming demand at this time.
We see this playing out when looking at the pre-registration numbers by race. In Baltimore County and Montgomery County, the Black and Latino population are severely underrepresented on their pre-registration lists. Baltimore County, which has been leading the large jurisdictions in percent of population vaccinated announced this week a new plan to address equity in vaccine access. Baltimore County has found that their Black and Latino populations are being vaccinated at rates well below their percentage of the population as well- in part because they are underrepresented on the waitlist.
Programs are launching in Montgomery County and across the state to help people who are interested and eligible get better access to the vaccine. Holy Cross Hospital held a
pop-up clinic at Lakeforest Mall in partnership with a local church that serves the Latino community. More than 100 seniors and childcare providers were vaccinated. Holy Cross has at least five more “pop-up” clinics planned in targeted communities in the coming weeks.
Removing barriers and improving access for the Latino Community is a Montgomery County responsibility. State data shows that nearly ½ of Maryland’s Latino seniors eligible for the vaccine (65 and older) live in Montgomery County. In fact, 15,184 of Maryland’s 33,934 Hispanic seniors live in Montgomery County. 19% of the non-Hispanic population in Montgomery County is vaccinated, but only 7% of the Hispanic population is vaccinated.
Despite these very real challenges, overall, things are really looking up. The weather may be cold again this weekend, but spring is definitely coming!
Best,
