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Concerns over shortages persist
Area residents who work as frontline healthcare staff, medical support staff, emergency responders, senior citizens and those with underlying health issues are being encouraged to register with Frio Regional Hospital in Pearsall for their COVID-19 vaccines if they have not yet received their first dose.
The hospital administration reported late last week that it had received a new delivery of vaccines for distribution in the community. Vaccination of the next 975 people continued Monday with 240 recipients scheduled to have their first shot.
A registry of names in line for the shots was closed earlier this month at the hospital when staff acknowledged that they had not received word on the expected delivery date of additional vaccines.
That registry has been reopened, according to Frio Regional Hospital CEO John Hughson in a brief announcement Thursday, January 21. When members of the public add their names to the waiting list, hospital staff make follow-up calls to schedule a vaccine as more doses become available. The shots schedule is based on date and time of registration and in accordance with the state heath services recommendations on what it calls phasing of priority recipients.
Hughson said last week that he believed it was possible that the list of those still waiting to receive their first vaccines was be shorter in number than the amount of vaccine doses that will be delivered to Frio County, adding that the hospital is encouraging all those who have yet to receive their vaccine to call for a place on the registry.
The CEO’s assessment of supply and demand has changed, however, and by early Friday, Jan. 22, Hughson indicated “there are now more people than vaccines for next week but we are still taking names.”
Vaccines have been administered in Frio and La Salle counties to hundreds of frontline healthcare workers, firefighters, emergency medics, first responders, law enforcement officers, and senior citizens. Among those to receive the first of two shots have also been staff and residents of local nursing homes and rehabilitation centers, and persons with health conditions that put them at risk of serious illness or death from the coronavirus.
Hughson said last week that he expects the general public to begin registering for vaccines at the earliest opportunity.
A directive from the state health services to all urban and rural healthcare facilities receiving boxes of the vaccine doses in December and January stipulated that all providers distribute the supplies immediately and not hold any in reserve.
“’Use it, use it, use it,’ was basically our directive from the state,” Hughson said of the first deliveries of COVID-19 vaccine doses in December and January at Frio Regional Hospital. Deliveries were made to the hospital in Pearsall and to the FRH Urgent & Primary Care Clinic in Dilley as well as to the family practice of Dr. Oscar Garza in Pearsall. Since then, deliveries have been made to nursing homes for distribution among staff and residents; and a mass vaccination event was held last week in La Salle County, hosted by the Texas Department of Health Region 8 for senior citizens.
The vaccine being delivered to healthcare providers in South Texas is manufactured by Moderna and does not require subzero refrigeration. Once a vial of ten vaccine doses has been opened, however, all of its contents must be used within six hours.
In mid-January, Hughson said he hoped that senior citizens and persons with underlying health conditions take advantage of any opportunity to have their first vaccine at a site convenient to them, even if it meant traveling to San Antonio, as he was unsure when Frio County would receive its next batch of vaccines.
The state health service announced this month that it would dispatch large numbers of vaccines to urban areas for “mass vaccination sites” in areas of population greater than 100,000. The announcement left Frio County’s healthcare providers wondering whether they should refer all vaccine registrants to other distribution sites.
Hughson described the state’s vaccine allotments and decisions on where to send its largest shipments of the Moderna shots as creating a noticeable disparity in the coronavirus immunization effort between urban and rural areas. Not all frontline healthcare workers and emergency responders in Frio, La Salle and other rural counties had received their first vaccines at the time of the state’s announcement regarding a focus on high-population urban areas, he said.
The Texas Department of State Health Services issued a report in December that specified which frontline and emergency workers were to be given priority in the vaccine registry. The first tier – those who should be given the shots immediately – included “paid and unpaid workers in hospital settings working directly with patients who are positive or at high risk for COVID-19.” The medical and support staff would be physicians, nurses, respiratory therapists, custodial staff, and additional clinical staff providing laboratory, pharmacy, diagnostic and rehabilitation service. Next in line would be long-term care staff working directly with vulnerable patients or infectious materials, namely nursing home staff and those working at assisted living facilities, personal care assistants and foodservice staff.
The state stipulated that the next round of vaccines would go to emergency medical service providers, ‘911’ responders, pre-hospital care and transport crews; home health care workers, hospice workers, and residents of long-term care facilities.
The state’s recommendations for priorities in the second tier would include staff at outpatient care facilities who interact with symptomatic patients, namely physicians and nurses, as well as clinic staff, non-’911’ transport workers, and healthcare workers in corrections and detention facilities.
Also listed in the second tier were staff at freestanding emergency medical care facilities and urgent care clinics, and community pharmacy staff who may provide direct services to clients, notably in vaccination or testing of those who may have the coronavirus.
School nurses were also listed in the second tier of vaccine recipients.
Some confusion remains over whether teachers will also be given priority consideration, and Frio Regional Hospital has acknowledged that school district superintendents have made inquiries over the mass inoculation of all those who are in contact with large groups of students daily.
Teachers, aides, support staff, custodians, administrators, coaches, clerks, librarians, secretaries, foodservice personnel and others employed at school districts in Frio and La Salle counties number in the hundreds.
Hughson points to the Texas Department of State Health Services’ guidelines for “Phase 1a” and “Phase 1b,” neither of which includes teachers.
“This population is not in the prioritized list,” the hospital CEO said of teachers, referring to the state’s Expert Vaccine Allocation Panel’s document.
So-called last responders, namely those who work in mortuary services to people who have succumbed to the coronavirus, medical examiners, funeral home staff and embalmers, and all those who may have direct contact with COVID-19 decedents were not omitted and have been given second-tier priority listing by the state health agency.
The Texas Department of Health and Human Services noted in a Dec. 17 statement that immunization remains voluntary and that doses are only administered to those “who choose to receive the COVID-19 vaccine.”
According to the vaccine manufacturer guidelines, recipients must receive a matching second dose of the shot at least three weeks after the first, and the second dose must come from the same supplier as the first. Those who received a Moderna-brand vaccine, for example, must take a Moderna vaccine as the second shot and cannot switch to a Pfizer or other brand for the follow-up, and vice versa.
“Texas will receive regular allotments of vaccine from the federal government,” the health and human services agency reported, but did not specify which variety of the vaccine would be distributed to urban or rural areas.
At Frio Regional Hospital, staff administered the Moderna-brand vaccine from a shipment of 100 doses per box in December and January but took delivery of Pfizer-brand vaccines last week. The latter is shipped in batches of 975 per box and requires subzero refrigeration. Hughson said last week that the hospital has ordered a $12,000 freezer capable of storing the Pfizer vials at the appropriate temperature but that the vaccine is kept in dry ice until the freezer is installed.