Why the older members of the 65-plus age range aren’t always first in line for vaccines; plus, a look at other counties’ COVID-19 vaccine distribution processes

photo by: Ashley Golledge

A sign points to LMH Health's drive-thru COVID-19 vaccination center on Tuesday, Dec. 15, 2020.

“How can a 65-year-old be as vulnerable as a 90-year-old?”

That’s the question Cheryl Fruetel asked Wednesday morning in a phone interview with the Journal-World. Her parents, who are 89 and 86 years old, had not yet received COVID-19 vaccines in Douglas County. And they’d been waiting for over a month.

Fruetel, who lives in Richmond, Va., is 65 years old herself. People ages 65 and older qualify to receive a vaccine as part of Phase 2 of Kansas’ vaccine distribution process. But Fruetel wondered why the older members of that population had not been given priority over the younger ones.

“If Unified Command’s mission is to protect citizens, why aren’t they protecting the most vulnerable?” Fruetel asked.

But members of Unified Command say it’s not as simple as just moving the oldest residents to the front of the line. The county already has a method for allocating vaccines to the different groups in Phase 2 of its rollout — older residents, education workers, food service workers and several other groups. And local health leaders say that splitting those groups into more and more tiers would bog down the vaccination process, which is also heavily dictated by how many vaccines are available.

“Our goal is to do the most good for the most people,” Dr. Jennifer Schrimsher, a LMH Health infectious disease physician, said in an email update from the hospital on Wednesday. “Unified Command aims to vaccinate people quickly and achieve herd immunity as fast as possible. Overall, we need to not focus on one small segment of the population, but distribute the vaccine more diffusely, proportionally, equitably, and most importantly, rapidly.”

As the Journal-World has reported, the county’s Phase 2 vaccine distribution plan allocates doses in the following manner: 40% go to residents ages 65 and older, 25% go to the education sector, 15% go to workers in the food service industry, 10% go to essential workers in the local government and 10% go to workers critical to the functioning of the community. Additionally, between 50 and 150 doses are distributed to people in congregate care settings each week.

What’s being done for seniors?

About 30 minutes after Fruetel spoke to the Journal-World about her concerns Wednesday morning, she heard from her parents — Sigler Pharmacy had just called them, and they had a vaccine appointment scheduled for Friday.

“Crying tears of joy!” Fruetel wrote in an email.

But though Fruetel’s parents got the lucky phone call this past week, other members of the 65-plus group are still waiting, and Fruetel said it was important that the older members of that population be prioritized. Fruetel wondered: Who is advocating for older residents?

Dan Partridge, director of Lawrence-Douglas County Public Health, said the county was acknowledging that older residents were at higher risk, even if it wasn’t giving different priorities to different ages within the 65-plus range.

“We took a balanced approach as the best way to say to this community that everyone matters,” Partridge wrote in an email to the Journal-World. “We tried to in a limited way acknowledge that some older people are more at risk by both working to front load that congregate care piece and also allocating the 65+ as the largest percentage of doses per week.”

As certain groups in Phase 2 reach completion — K-12 is nearly finished — Partridge said the county would look at trying to move more doses into the 65 and older category, because that was the largest group needing vaccines.

“As we work through this, we are doing what we can to make that be an even larger percentage without reducing another sector’s share,” he said.

Limited supplies

One big problem has plagued the vaccination rollout in Douglas County and elsewhere: Demand for vaccines outpaces supply.

Partridge said that Douglas County has been receiving 2,340 doses of vaccine each week. The county has been having weekly vaccination clinics for people in the 65-plus age range, and there are an estimated 16,000 people in that age range in the county. George Diepenbrock, spokesperson for the health department, said on Friday that there were about 7,000 people in the 65-plus age range who had completed the vaccine interest form and had not yet received their first dose.

When people are selected for vaccinations, 90% of the people are chosen randomly from the pool of people who have filled out the county’s vaccine interest form and are eligible as part of Phase 2. The remaining 10% of people are chosen from names provided by various community and social services organizations that serve people who are in hard-to-reach groups.

Partridge said Douglas County’s vaccine distribution process was not perfect, but that the county was doing the best it could.

“What would make it more perfect is more doses,” he said. “It bothers me that we are leaving people behind and that people continue to be vulnerable.”

By “leaving people behind,” Partridge said he was referring to those who had not yet been able to get an appointment because of the limited supply. But Partridge said the things the county was doing to protect people went beyond vaccinations. The county’s response started a little less than a year ago, with public health orders, a mask mandate and “our broad work with Unified Command and (organizations) in our community.”

“In the big picture as far as our rates of cases and deaths when compared with other communities in the region, we as a community in Douglas County have been trying to protect one another and doing a pretty good job during the pandemic,” he said. “I hope that we can continue to acknowledge that as we work to vaccinate more people even given the current challenges of vaccine supply.”

What other counties are doing

Here’s how Douglas County’s Phase 2 vaccine distribution compares to surrounding counties. Spokespersons from the health departments in Miami and Jefferson counties were not reached.

Johnson County:

In Johnson County, Phase 2 has been divided into three tiers, and the county is currently working on Phase 2, Tier 1. Tier 1 includes people 65 and older; K-12 workers; licensed child care workers; emergency services, fire and police; agriculture workers; grocery store workers; food processing; and restaurants and bars.

Lori Sand, a spokesperson for the Johnson County Department of Health and Environment, said that JCDHE was vaccinating health care workers and people over 80, and that JCDHE had partnered with hospitals to vaccinate people 65 and older and Children’s Mercy to vaccinate K-12 and child care staff.

Sand said the health department prioritized older members of the 65-plus age group by first vaccinating those 80 and older. However, she said that appointments for those 65 and older would be available in the coming week.

Leavenworth County:

In Leavenworth County, vaccines are being distributed equally among those 65 and older, essential workers in local government, workers in the K-12 education sector and congregate care facilities. A spokesperson from Leavenworth County Public Health said that there was no further prioritization being done in the 65 and older group. The spokesperson said that the county holds weekly vaccine clinics for approximately 1,100 to 1,400 people in the 65-plus age range.

Shawnee County:

Shawnee County has also split Phase 2 into different tiers. Phase 2a includes people 65 and older, law enforcement officers, first responders, K-12 faculty and staff and some congregate settings. Craig Barnes, spokesperson for the Shawnee County Health Department, said the county was working to finish Phase 2a in the coming weeks and then would move on to Phase 2b, which also includes people 65 and older as well as other high-contact critical workers and other congregate settings.

Barnes said the health department and the University of Kansas Health System St. Francis campus had been scheduling vaccinations for the 65-plus population by working through interest surveys in the order they were received. Stormont Vail and the Topeka VA Medical Center “have been working via a risk stratification” method by targeting the higher age groups within the 65-plus population. As of Wednesday, Barnes said Stormont Vail was vaccinating people ages 70 and above.

Osage County:

In Osage County, those who qualify for Phase 2 are being vaccinated in the order their call is received by the health department. Jackie Patterson, the county health officer and director of the Osage County Health Department, said the county was not prioritizing anyone in Phase 2, but that it did schedule teachers in blocks because that made it easier for the schools.

Patterson said the health department got a lot of calls, and that many were from “angry and frustrated” people who wanted to know when they would get their vaccine. Patterson said it was difficult to answer that question because the list was often in flux, with individuals calling to say they had already received their vaccine or that they decided they didn’t want it. She also said Osage County’s weekly vaccine supply was not set in stone, and that there were some weeks when no vaccines arrived at all.

Franklin County:

Franklin County prioritized the 65 and older population. Kaci Brady, spokesperson for the county, said that vaccines were administered to the 65-plus age group by date of birth, starting with the oldest. Brady said the county expected to finish first-dose vaccinations for that population in the first week of March. Brady also said that if an individual in the 65 or older age group had a younger spouse or companion who lived with them and who still fit into the 65-plus age range, those people would be vaccinated at the same time in order to keep them on the same schedule. After Franklin County has finished distributing first doses to the 65-plus population, it will move onto firefighters and first responders, K-12 teachers, licensed child care providers, district court personnel, grocery store workers and food service workers, Brady said.


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