Equitable distribution, rural community outreach and shifting federal vaccine allocations continue to pose challenges to the vaccine rollout in Texas, Department of State Health Services officials said Thursday.
As of Thursday, 2,057,000 doses of the COVID-19 vaccine have been administered in Texas. Of those, 370,000 have received both vaccines and 1.7 million people have received at least one dose.
Hubs will be the continued choice for distribution across Texas. So far, there’s about 80 in Texas, with four in Hidalgo County and one in Cameron County.
“For the providers, having a dependable supply of vaccine each and every week is exceptionally helpful,” Imelda Garcia, DSHS expert vaccine allocation panel chair, said during a virtual news conference. The constant supply helps providers plan the administration of the COVID-19 vaccine, she added.
Equitable distribution remains a challenge for the state, though it’s a constant topic of conversation for the Expert Vaccine Allocation Panel.
Hubs began receiving vaccines during the fifth week of the rollout in Texas as public health officials shifted their focus from 1B tier groups, which mainly included healthcare workers, to 1B tier groups that included a broader section of the population — people either 65 years and older or those 16 years of age or older but with a chronic condition.
“We wanted to afford a way to be able to do big numbers at strategic locations all across the state,” Garcia said. So far, one of every six people in Texas who is 65 years of age and older has received a vaccine, according to state data cited.
The plan to distribute through hubs started with 28 sites, but the list kept growing.
Garcia said the panel began by asking “who could do 2,000 a day during a week for the urban centers and 200-400 a day for the rural centers.”
Hubs approved must adhere to certain requirements including vaccinating all who qualify under the 1A and 1B tiers, even if they’re residents of other Texas counties. Hub providers must also have equitable distribution that considers demographics and “hardest-hit zip codes.”
“This is the really important one,” Garcia said, referring to the hub requirements. “They have to use every single dose within that week that they received it. They need to burn through within those five to seven days.”
Efforts to strike a balance between advantaged and disadvantaged populations were likely adversely affected by the lack of race and ethnicity data, an error Garcia said they will soon be rectifying.
“We’re going to be moving to make the race and ethnicity fields required in order for the vaccine to be coming through as well as we’re also going to be redoing the user module, what they see when they’re doing data entry, to make it easier to facilitate completing that information,” Garcia said.
The fields are part of the provider’s reporting process. Data of each person who receives a vaccine is entered into the DSHS vaccination database, ImmTrac2, and a Texas Division of Emergency Management vaccine registration portal.
Next week, the state will be receiving a greater allocation of vaccines from the federal government. Instead of receiving 333,000 doses, Texas will be receiving 385,000 vaccines.
A one-time bonus shipment is also expected.
“We will also see a one-time boost in the doses that we can push out next week as the federal government returns about 126,000 first doses that we were required to set aside for the federal long-term care program,” Garcia said. Those extra doses will be used to help fill in some of the disparity in areas that haven’t received vaccines proportional to their population.
Federal officials said to expect the future allocations to remain at the newly increased rate of 385,000 vaccines a week, but state officials will be playing it safe.
“Ultimately it’s never certain until we actually get the allocation numbers from our federal partners,” Garcia said.
They will continue using the old weekly vaccination rate as they plan allocation estimates for the next week until the new rate is confirmed.
The additional vaccines could also help shift their strategy to include smaller distribution sites.
“As supply increases, and you’ll notice in Week Eight allocations that we have started increasing vaccines going to pharmacies and other providers as well,” Garcia said.
It may be awhile before the new tier group, 1C, is defined and added. The allocation panel is still actively working to find the “trigger points” that would signal the need to move into a new phase of vaccination.
During the 1A phase, “We were looking at vaccine uptick, and hesitancy, and seeing how quickly vaccines were flying off the shelves.”
Under the current broad tiers, the panel is looking to increase the vaccine availability to older adults, though underserved areas away from hubs, like Starr and Willacy counties, have posed a problem.
They’re hoping the newly announced State Mobile Vaccine Pilot Program operated by the Texas Division of Emergency Management may help them bridge that gap before moving into the next tier group.
