Why more pharmacies and doctors’ offices aren’t ready to vaccinate against COVID-19

first dose of COVID-19 vaccine in Juneau
Bartlett Regional Hospital pharmacy technician Krischelle Batac draws up the first dose of the first shipment of the COVID-19 vaccine to Juneau on Dec. 15, 2020. (Photo courtesy Bartlett Regional Hospital)

Alaska health officials have been transitioning the state’s COVID-19 vaccine distribution process from deliveries directly to hospitals and clinics to a more decentralized system that relies on pharmacies and individual doctors’ offices. 

The vaccine supply is still very limited. But another bottleneck is the limited number of health care providers opting to offer the vaccine and get through the enrollment process

If you work in the private health care system and want to vaccinate patients against COVID-19, it’s not easy. There’s extra training and tests, complicated logistics so that the vaccines don’t warm up and get ruined, and a lot of data entry. 

“It’s required a lot more than a typical vaccine,” said Tiffany Foss, a certified nurse aide and vaccine coordinator at Family Practice Physicians in Juneau.

Foss thinks she’s already done five exams and multiple trainings for it. And they haven’t even gotten the vaccines delivered yet.

“Every other day it seems like there’s something else that’s also required in order to obtain the vaccine,” she said. “So, definitely overwhelming at some points, but I’m glad they’re being as thorough as they are being with it.”

Foss said she thinks her practice will get some vaccines in February. 

State Immunization Program Manager Matt Bobo said Friday there are 420 providers enrolled as vaccinators. But they’re not all offering appointments right now. A lot of potential COVID-19 vaccinators aren’t ready to do it, are opting not to, or don’t have vaccines yet. 

Alaska’s Chief Medical Officer, Dr. Anne Zink, said there are a lot of disincentives.

Dr. Anne Zink, chief medical officer for the state of Alaska. (Photo by Liz Ruskin/Alaska Public Media)

“If you’re not a regular vaccinator? You know, it’s a complex process. It’s hard to figure out initially how to do VacTrAK.”

That’s a system for ordering vaccines and for tracking the distribution. 

“… It’s not like a flu vaccine that is a one-dose,” Zink said. “It’s very finicky. It has to be stored at the right temperatures. It has to be used in a certain period of time. We have to track what goes in and comes out. There’s a lot of processes to that. And so particularly those that don’t vaccinate regularly, it’s a big lift.”

There’s also an exhaustion factor. 

“These are also people who have been, you know, sprinting since last year,” she said. “To completely changing their entire worlds trying to figure out how to test, how to respond, worrying they were gonna die. Like, this has been stressful for all of us, and health care, too. To say, ‘OK, keep testing, and also do vaccine?’ There are some clinics that say, ‘I can’t. I just can’t. I don’t have the space and capacity to do this anymore.’”

Vaccinators also must agree to administer it to anyone eligible. Right now, that’s mostly people 65 and up and frontline health care workers. 

Nurse practitioner Lauren Hopson said that’s a snag where she works, Glacier Pediatrics in Juneau. Hopson said they only treat kids, so they don’t want to order any vaccine until some of their patients are eligible. They want to limit the traffic in their space.

Zink and other public health officials have said it’s an imperfect system

Economist Kevin Berry said because the federal government failed to plan and support a coordinated vaccination campaign, this may be the best way. For example, Berry said Army medics and National Guard members could have been trained for mass vaccinations.

“And that needed to happen before we got to this point, not now,” he said. “And so, I think you’re thinking about the largest body of people who can administer vaccines quickly and safely, and know how to handle things that, you know, need to be delivered and kept at negative 80 degrees Fahrenheit, and administered safely following all these medical procedures — you’re talking about pharmacists, and you’re talking about these people at Walgreens.”

Berry is an assistant professor of economics at the University of Alaska Anchorage. Since about 2012, he’s studied the economics of social distancing and pandemics. So when COVID-19 swept the globe, he had mixed feelings. 

“And it was super-predictable how it happened, too. The whole thing was quite disappointing. It was like, ‘Finally, I’m relevant!’ Basically, because nobody read any of my work about how to stop it.”

Right now, Berry’s concerned that if vaccinations go too slowly, the risk goes up that the entire effort will fail. Especially with faster spreading coronavirus variants emerging, like the one out of the United Kingdom. When preventable spread isn’t prevented, he said it’s like taking extra rolls of the dice. 

“As far as mutations that can make the disease worse. And so this movement to the private sector that gets the vaccines in people’s arms faster is good, because it reduces the risk that we’re gonna wind up in trouble with a new variant of the disease that is even worse than what we’ve seen so far.”

There’s a lot of good reasons for providers to step up, too. They want to help their patients and communities. And individual health care workers who volunteer in an upcoming mass vaccination event would become eligible themselves for the vaccine.