State vaccine plan trashes years of municipal planning
(EDITOR’S NOTE: This is Abington News’ first-ever editorial. )
The Baker Administration and state Department of Public Health owes Abington an apology and an explanation. Actually it owes many communities across the Commonwealth an apology and explanation.
For years, Massachusetts cities and towns – including Abington – spent time, money, and energy preparing an Emergency Dispensing Site plan. This plan outlined how municipalities would handle the logistics involved with quickly vaccinating residents, if there was ever a pandemic.
Every year local emergency preparedness teams would physically walk state health officials through their plans – where the clinics would happen, who would administer the shots, and so on – and the state would give a sign off. This is good public policy. It’s always better for public agencies to plan ahead, and then not need those documents, than have to scramble in the middle of an emergency.
Turns out those emergency plans were needed after all. COVID-19, the worst global pandemic in a century, has killed more than 480,000 Ameircans, laid waste to parts of the economy, and forced friends and families apart for nearly a year. Thankfully there are now multiple vaccines ready for emergency distribution.
Good thing Massachusetts has all those Emergency Dispensing Site plans ready, right?
Except the Baker Administration and state DPH has inexplicably pivoted in recent weeks, shelving all those plans they had endorsed as recently as six months ago. Instead it has embraced a strategy that favors distributing vaccinations at sports stadiums and for-profit businesses.
“The [local] plans were immediately set aside and not used,” said Abington Fire Chief John Nuttall, who has met with state health officials about Abington’s Emergency Dispensing Site plan annually since becoming chief in 2010.
“That’s a 100 percent accurate statement,” agreed Abington Health Agent Marty Golightly in a separate interview.
Instead of being on the front lines of the greatest mass inoculation effort since the polio vaccine, municipal officials are left twiddling their thumbs, canceling their planned clinics, and wondering what happened. For the second week in a row, Abington has been notified it will receive 0 (zero, zip, zilch) doses for the coming week.
“We have no idea why [the state is] doing this,” Nuttall said. “I am absolutely mystified by what they’re doing.”
Abington isn’t the only community simmering in a combination of outrage and frustration. Days after vaccinating 200 residents in three hours during a drive-through clinic, the Norwell Fire Department confirmed it also will receive no doses this week.
“We challenge anyone that says a small town can’t vaccinate its residents efficiently!,” the department said in a Twitter post.
Plympton Fire Chief Steve Silva was frank in a recent statement posted on his department’s Facebook page.
“DPH will no longer provide us with the medication, despite very successful programs already underway or that had been previously approved and slated to begin this week. According to the Governor, vaccines will be distributed through private concerns, such as CVS, Walgreens, etc., or State-run sites such as Gillette Stadium, Fenway Park, and others.
“This was unexpected and problematic.”
The Baker Administration and state DPH apparently believes the smarter policy is to have seniors get vaccinated at a Fenway Park beer stand (no, seriously, that’s one of the places grandma can get a shot) rather than at a clinic located in their home community, managed by people they know and trust.
This is a non-sensical approach that raises so many questions.
For example, Gov. Baker lumps pharmacies alongside sports stadiums as high “throughput” sites, or a site capable of vaccinating large numbers of people at a time. Are we to believe that a single CVS can vaccinate 1,000 people a day, like Abington’s clinics are set up to do? And out of curiosity, while hanging around for their 20-minute post-shot observation period, should seniors wait by the allergy medicine or the greeting cards?
Does the Baker Administration think seniors would rather get their shot in an out-of-town grocery store than the local senior center?
Do we really want seniors traveling upwards of 20 miles, in February, through wintry weather, for a shot that could be administered as efficiently down the street from their house?
Also, what is the state’s plan for homebound seniors who can’t travel several towns over? Abington’s vaccination plan includes bringing shots directly to this population.
But the Baker Administration and DPH’s most unforgivable transgression is that it has yet to explain its reasoning to the communities forced to stand by. Transparency and open lines of communication are two critically important pieces of an effective emergency response. State officials have failed on both these counts.
Golightly said DPH has never reached out to explain how cities and towns fit into the larger vaccination rollout strategy. He has to watch Gov. Baker’s press conferences to glean any insight.
(DPH has also not responded to multiple requests from Abington News for more background on its decision making.)
During a news conference last week, Gov. Baker called mass vaccination sites “the most productive operating model.”
“If you look at the performance across the country, the states that have done the best at getting shots into people’s arms are the states that have the big sites,” he said.
But again this fails the sniff test. Better performing states like West Virginia have county-based governments, and miles of rural space in between population centers. So it probably makes sense to have regional distribution sites.
Massachusetts, however, has 351 incorporated cities and towns, each with trained public health and emergency response teams. The infrastructure to deliver vaccinations from Pittsfield to Provincetown, Salisbury to Seekonk, was already in place. And it’s now largely sitting unused.
The Baker Administration and DPH’s fickleness could be forgiven if its strategy was working. But it’s not. A recent Harvard University study gave Massachusetts failing grades in three out of four key categories for its vaccine rollout efforts, placing it 42nd out of the 50 states – an embarrassing statistic for a supposed life sciences and health care mecca. Less than 74 percent of the state’s stockpile of vaccine doses have been administered to date.
The state’s new and improved plan required seniors to find and register for appointments online. The website was widely panned as confusing and inconvenient to the point the state immediately pivoted and set up a telephone help hotline. Seniors also complained about lack of transportation to regional vaccination sites. The state pivoted again, allowing those who transport seniors to get vaccinated as well. But this resulted in a secondary problem — healthy adults posting ads online offering to drive seniors so they can jump the line. The state is expected to pivot again.
“There’s an incredible disconnect with reality,” Nuttall said. “We’re way behind everyone else.”
Abington has done what it can. It’s vaccinated about 300 emergency responders and seniors during four smooth-running, small-scale clinics without wasting a single dose or forcing anyone to wait outside in the cold.
Pharmacies and grocery stores and sports stadiums have a role to play in a comprehensive vaccination plan, where convenience becomes important. But the Baker Administration and state DPH’s model is backwards: these facilities should fill in the gaps, with cities and towns (and hospitals!) making up the primary distribution network.
Year after year communities like Abington diligently did what the state asked of them: they planned, they prepared, and they practiced for a day everyone hoped would never come. But when the worst-case scenario happened, the state immediately ghosted the cities and towns of Massachusetts without so much as a Dear John letter.
The Baker Administration and state DPH owes Abington, and everyone else who worked in good faith for years only to find their services suddenly not required, an explanation and an apology.