Vaccine Requirements Changing, But Distribution Remains An Issue

As the COVID-19 vaccine rollout continues to move forward, questions remain on how best to get residents educated and vaccinated — and several members of the Palm Beach County Commission are not happy with the answers they have been getting.

The commissioners heard an update Tuesday, March 9, including presentations from both Florida Department of Health-Palm Beach County Director Dr. Alina Alonso and Emergency Management Director Mary Blakeney.

Alonso gave not only the newest virus statistics, but also explained the differences between state and federal orders, along with an overview of the virus variants found around the world and here in Florida.

“We continue to be the number one country in the world with the most cases and the most deaths,” Alonso began. “We are finally seeing that downward trend, but there is one thing that concerns me… As the curve starts going down, people are getting complacent. We’ve done this three times now — we’ve got to get it right. I do not want to have a fourth wave.”

Alonso stressed that all existing safety measures should remain in place until the curve is all the way to the bottom. As of March 7, Palm Beach County had a total of 123,520 cases with a current average of 400 cases per day. This decrease allows for better contact tracing.

“Many of the states have actually given up on the contact tracing, which I think is the only thing that we have that can actually control our community. So, we continue to do it as aggressively as we can,” Alonso said.

Her presentation quickly shifted to vaccine issues. “We have to follow the governor’s executive order,” she noted.

Executive Order 21-62 expands COVID-19 vaccinations during Phase 1, where Palm Beach County currently sits. The only individuals currently qualified under this order are long-term care facility residents and staff, persons 60 years of age and older (this is a change from 65 years), healthcare personnel with direct patient contact, K-12 school employees 50 years of age and older, sworn law enforcement officers over age 50 and firefighters over age 50.

“We have moderate vaccine availability; it isn’t flowing robustly yet,” Alonso said. “We will finally be in Phase 3 hopefully by April. We have moved up the idea that by Phase 3 we will be able to do the general public to get the vaccine. The president has moved that to May instead of June — so one month ahead of what we thought we’d be doing.”

Alonso stressed that the vaccine only guarantees individuals who contract COVID-19 will not experience severe complications and death due to the virus. Masks, social distancing and handwashing remain vital.

While all the commissioners had comments and questions, commissioners Mack Bernard, Maria Sachs and Melissa McKinlay stood out with expressions of frustration.

Sachs requested a map outlining the vaccine sites available, both state and federal.

“This is a life and death situation. My office gets approximately 200 e-mails, calls and texts a day,” Sachs said. “I can do this on Google if I need a hair salon. I should be able to access this, and we should be able to share that with our constituents.”

After some discussion with how to get farm workers and others in essential jobs vaccinated, despite the governor’s choice not to allow further vaccinations based on employment, Alonso explained that the Florida Department of Health’s long-term plan is to back off and allow the federal government’s plan to work with pharmacies in vaccinating residents. There is some work being done to organize workers and bring them to health department facilities.

Sachs then requested that County Administrator Verdenia Baker get someone from the federal program to come address the board and explain where the vaccines are going and how the county might be able to have some jurisdiction over the distribution of vaccines.

McKinlay did not mince words when expressing her frustration.

“We are in a more dire spot than the last time we met. Harvest season will end in six weeks. We are running out of time,” McKinlay said. “I don’t know any farm workers over the age of 65, and many are on temporary visas, so I don’t know how they meet the residency requirement.”

She suggested taking a mobile unit to the housing where workers live, since they are qualified under the CDC guidelines.

“That’s a great idea. I can’t do it because we can’t get the federal vaccine, but if we can get the federal vaccine, that’s the exact way to do it. If we go to the feds and get a specific allotment, that would work,” Alonso said. “But it has to be the federal vaccine. We cannot do it under the governor’s order.”

McKinlay asked again for the vaccine information by zip code requested at a previous meeting, to which Alonso responded she had that information now and the department is in the process of making a map outlining where vaccinated county residents live.

“I’m not willing to sit up here and pat anybody on the back for a job well done when I cannot tell where they live. How long have you had that data?” McKinlay asked.

She was not happy when told the data was in hand for more than a week.

“We can’t make decisions about how best to serve our constituents if we don’t have all of the information,” McKinlay said. “You can’t tell if you’re doing a good job.”

She asked that the map be provided before the next workshop scheduled for March 23, and Alonso agreed to provide it.

“Palm Beach County has vaccinated 303,000 [people], and the only one ahead of us is Broward [with 310,000],” Alonso said. “We are staying ahead of other counties even though we started later and don’t really have any of the federal sites doing the big vaccinations. That’s not because we can’t; it’s because we haven’t gotten vaccines.”

Palm Beach leads all metro counties with a total of 66 percent of the population over 65 vaccinated. Because the governor’s goal is 50 percent of seniors in all Florida counties be vaccinated within the next month, some doses are being diverted away to other areas of the state.

Federal vaccine supplies are different. There are 21 national pharmacies working with the federal government to distribute vaccines. As of March 2, those sites have different qualifications to vaccinate. School staff and childcare workers may get vaccinated regardless of age. If these professionals are under 50, they must visit a federally supplied pharmacy in order to be vaccinated.

Alonso then addressed why pharmacies are stepping into the distribution role, explaining that they are trusted sites.

“The personnel are trained healthcare providers who are used to giving vaccines. They have direct access and knowledge to the patient populations in their communities,” she said. “They can provide the education needed and are easily accessible in the communities. All of them are very limited in what [vaccines] they are getting. They could all be doing more.”

The pandemic has been a huge operational burden on state and local health departments.

“We’ve been working now for a year on COVID-19. Our business continues to have to be handled,” Alonso said. “We still have to take care of hepatitis. We still have to take care of tuberculosis. We have not closed a single clinic during this entire year. We have a lot of other things to do — we have to vaccinate our children. We can’t do it all while this is going on. The more help we get from the feds, the better.”

Next, Alonso explained the virus variants. Viruses, by nature, mutate all the time. There are three variants of COVID-19 currently persisting — B.1.1.7 (the U.K. variant), P.1 (the Brazil variant) and B.1.351 (the South African variant). She then shared a map that showed that Florida has the most variant cases in the U.S., nearly double the next closest state (Michigan). Broward has more of these cases than any other in the state with 229. Miami-Dade has 82 cases, and Palm Beach has 64 confirmed variant cases.

Emergency Management Director Mary Blakeney also provided the most recent county data.

“Our overall positivity rate continues to increase, currently at 16 percent. Although there is an overall increasing lab positivity rate, we are seeing a steady decline in our daily lab positivity rate. This is a good sign,” Blakeney said.

The current death rate due to COVID-19 is 2.04 percent, which has amounted to about one death per day.

The Health Care District of Palm Beach County continues to take vaccine appointments at http://vaccine.hcdpbc.org. On March 15, the new categories established by the governor will go into effect, and the site will be updated. Applicants can sit in the virtual waiting room and will be contacted when an appointment becomes available. Residents can also sign up via https://myvaccine.fl.gov.