Patients Count on ‘Connections’ in Georgia’s Mess of a Vaccine Rollout

If you’re a health-care worker in Georgia, you may have already received your vaccine.

If you’re anyone else, chances are you’ve gone searching for a shortcut.

“Our hospital has done an excellent job of getting physicians and staff vaccinated,” said Dr. Adam Friedlander, an Atlanta-based emergency physician at a suburban hospital, who received his second dose on Jan. 6. “It’s been very smooth and easy for really every doctor I know. But what’s crazy is that every single non-physician I know who has been vaccinated did it through a back door.”

“They’re all stories of connections, like ‘my neighbor is a nurse’ or ‘I took my grandmother, and they gave her one too’ or ‘I just showed up at the pharmacy every day for a week, and they gave us one,’” said Friedlander. “But I don’t know a single person who has been able to get it through official channels. Appointments are completely filled.”

Friedlander’s experience reflects a grim reality for his state: This week’s official launch of COVID-19 vaccine doses for seniors and first responders in Georgia—it was previously available to nursing home residents and frontline health workers—hit myriad hurdles, causing frustration among civilians and finger-pointing at the county, state, and federal level.

While that echoes an error-plagued, haphazard rollout nationally, conversations with residents, doctors, and health officials suggested the state somehow underestimated appetite for doses—and is still playing catch-up.

“I don’t think we were prepared for the number of folks that really wanted the vaccine. It’s a better problem than we imagined,” said Dr. Theresa Jacobs, a clinical lead for the Georgia Primary Care Association. “Originally we were thinking with vaccine hesitancy that we weren’t going to have anybody who wanted the vaccines, but we have people calling all over the state of Georgia and even driving to Florida to get vaccines. It’s a good problem to have, and I think we’re going to overcome it.”

“We have more than enough patients who want it,” said Jacobs. “But we just do not have enough providers to give the vaccine yet. There were some misunderstandings about how providers could issue vaccines.”

The website for the Centers for Disease Control and Prevention on Wednesday showed that Georgia ranked second-lowest in the entire nation of residents per 100,000 who had received a first dose, a one-step improvement from its last-place spot two days earlier, amid notoriously poor COVID vaccination rates all over the country.

Gov. Brian Kemp has claimed that there’s a “significant” problem of “underreporting’’ of how many vaccinations have actually been carried out among the public. But the federal chart estimated the state had provided first doses to 1,872 people per 100,000 residents. Only Alabama had a lower rate as of Wednesday evening.

Duane Kavka, executive director of the Georgia Primary Care Association, said the nitty-gritty shows about 50 percent of the state’s 35 total Federally Qualified Health Centers—a reimbursement designation for community-based clinics—have received the COVID-19 vaccine and have started the process of vaccinating their staffs and then the state’s population of elderly citizens over the age of 65.

Kavka called the response “overwhelming,” saying it overran county systems. Still, at present, the sites receiving the vaccine are often not receiving the amount they ordered, he added—in some cases coming in one-third or lower than what they ordered.

Of course, there are many that have not yet received the vaccine at all.

For some of those, said Kavka, they “have received their approval emails from the state [public health department] but still do not have the PIN that is required on the COVID-19 vaccine order form.”

“No PIN—no order,” said Kavka. “Those will hopefully have vaccines within the next 7-10 days.”

Nancy Nydam, director of communications for the state’s department of public health, said the PIN issue had been resolved by the end of the day on Wednesday.

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“Some health districts have scheduled appointments well into February, others into March,” added Nydam. “To ensure there is adequate vaccine supply, including second doses, some districts have temporarily paused appointment scheduling.”

Mallory Blount, press secretary for Gov. Brian Kemp, said that her boss has “been clear that he wants every Georgian to have the opportunity to receive a COVID-19 vaccine as soon as possible.” She added that, even in the context of Jacobs’ assertion about the overwhelming response from the population, the state did not “have a role in deciding how many vaccines we received,” math that was done by the federal government based on population.

“Unfortunately, there has been severe underreporting by some providers regarding the amount of vaccines they are administering,” Blount added in her statement to The Daily Beast. “As of yesterday, the number of vaccines administered in Georgia had increased by 102,183 since last week—a 97 percent increase, indicating significant progress in working through that backlog.”

“Over the past week, we have reached or exceeded that daily goal,” continued Blount, claiming that puts “Georgia on-par with surrounding states,” like the Carolinas.

But even if the state’s numbers were underreported and its true numbers were “on par” with its neighbors, that information was cold comfort for residents who’ve tried and failed to get appointments.

Though Whitesburg, Georgia, resident Janice Morris, 66, was able to get a spot through her hospital network because she was recently a patient, her 70-year-old husband Joe appears to have no such options in any surrounding counties.

“I think on my last shift, three-fourths of the people I saw were COVID cases.”

— Dr. Adam Friedlander

Morris told The Daily Beast she tried online, then over the phone, and has been unable to get her husband an appointment quick enough before the slots fill up.

“I’m concerned because he’s 70,” said Morris. “Help desk never answers, can’t ever get through other public vaccination sites.”

“It’s extremely frustrating,” she added.

It’s a complicated, multifactorial problem that starts at the very top, said Dr. Jennifer Horney, founding director and professor in the University of Delaware’s epidemiology program.

“The main challenge is one of logistics, and these are exacerbated by the cold chain necessary to preserve the vaccine and the timing of the two-dose regimen,” Horney told The Daily Beast. “Public health and health-care workforces are overwhelmed responding to a record number of new cases, hospitalizations, and deaths each day in the midst of the vaccine rollout.”

Much has been made of the debate over who gets protection first—by age, risk factor, and other measures—and despite federal guidelines, states have the ability to make their own decisions about which Americans must continue running major risk of catching the virus.

“While it is important to prioritize groups at highest risk, limiting the vaccine initially to the very same groups that are charged with responding to the surge has also made the rollout slow,” she added.

Friedlander, who serves on the Committee to Protect Medicare—a self-described public advocacy and grassroots lobbying group that works “to persuade elected officials to support health care for all Americans”—perhaps unsurprisingly believes the blame lies more pointedly with the Trump administration.

“This is a very simple case of the Trump administration doing what it does best—being unprepared and pushing the problem off to someone else,” he said. “They pushed it off to under-resourced and under-funded state and local departments of health. This wasn’t a calculated error that fewer people would want the vaccine, it’s that the federal government failed to put any meaningful planning or resources behind making mass vaccination a reality.”

Dr. Anurag Sahu, a cardiologist at Emory University Hospital in Atlanta, agreed that the rollout in the state has been “haphazard,” telling The Daily Beast he got his first shot last Friday.

“But I don’t think any state is doing it well,” he added. “That falls upon federal leadership, when every state is doing poorly.”

Still, Jacobs was optimistic that things will turn around quickly in the coming weeks.

“With more providers, there will be more avenues as opposed to just the public health websites, they’ll be able to go to pharmacy websites and private doctors,” said Jacobs. “Georgia will get millions more dollars to help with the rollout, meaning there’ll be more resources.”

For Friedlander, the need is more dire than ever.

“I think on my last shift, three-fourths of the people I saw were COVID cases, where a month before I would have said it was half that,” he said. “There are some days where I feel like I don’t see anything else.”

To that point, Sahu agreed, noting that the state’s cases had recently increased by 50 percent in just two weeks.

“One out of every 1,000 residents of Georgia have died from COVID,” he said. “It’s absolutely horrible.”