By Rebecca Spalding, Tina Bellon and Carl O'Donnell
Jan 8 (Reuters) - At Don's Pharmasave in Louisiana's rural Avoyelles parish, pharmacist Constance Rabalais and colleagues have had to come up with their own policies and procedures for doling out their first 100 COVID-19 vaccine doses amid overwhelming demand.
More than a dozen states looking to deploy unused coronavirus vaccines are starting to give shots to older members of the general population while others have not, meaning protection for more than 20 million Americans aching to hug their grandchildren may depend on where they live.
“We're glad to get it out. We just wished we’d had a little more time to understand the scheduling and appointment process,” Rabalais said.
States have received 21 million doses since the Food and Drug Administration in December authorized two vaccines - from Pfizer Inc with partner BioNTech SE and Moderna Inc - but only about 6 million have been administered.
Healthcare workers and people in nursing homes have been at the front of the line. But states left to distribute vaccines with little federal funding or direction are now plotting their own courses of action.
“It has created a situation where it’s confusing to the public," said Jen Kates, a senior vice president at Kaiser Family Foundation. "Even within states, if you live in one county you may have a different priority than if you live in another county."
Texas, Louisiana, North Carolina, Mississippi, Colorado, West Virginia, Alabama, Alaska, Arizona, Michigan, Florida, Georgia, Oklahoma, Indiana, Wyoming and Tennessee have either begun or will allow the vulnerable older generation to get shots this week or next in some or all counties.
In Texas, Florida and Georgia people over 65 are eligible for a shot, while West Virginia and Indiana are limiting the vaccine to those over 80.
Other states are holding off on moving into the next phase until more healthcare workers and nursing home residents are vaccinated, or have not yet announced a timeline for the general population.
The Trump administration has conceded that the biggest vaccination campaign in history aimed at stopping the deadly pandemic is off to a slower than hoped for start.
The government has advised states to expand eligibility and said it would start pushing vaccines directly to pharmacies this week.
President-elect Joe Biden wants to release the doses being held back for second shots into the supply, his spokesman said on Friday. Such a move would require that manufacturing is consistent enough to supply required second doses on schedule.
“I think the overarching goal of getting all eligible people vaccinated has to take precedence,” said Amesh Adalja, senior scholar at The Johns Hopkins Center for Health Security. “We can’t let an overly dogmatic adherence to priority groups to cause inefficiencies in vaccine administration.”
Distributing doses at pharmacies could help speed the process, but risks wasted doses, fraud, and confusion among the pubic, experts said.
Some states have internet portals for vaccine sign-ups, which may be challenging to access for those without internet. Other states have no centralized sign-up system at all, Kaiser's Kates said.
PHONES RINGING OFF THE HOOK
Rabalais said the phones have been ringing of the hook at her pharmacy with its staff of three, and that the store has done little besides organizing the vaccine rollout and navigating the state’s vaccine registry.
Erin Zwiener, a Democratic representative in the Texas state legislature, said the haphazard vaccine rollout echoes earlier phases of the pandemic, when testing and personal protective gear were scarce, and that ultimately the state’s poor will bear the brunt.
“My big concern is because we are so intensely privatizing this rollout and relying on pharmacies, we really are giving our wealthier folks more access to this vaccine,” she said.
Florida's Seminole county has set up vaccination clinics and wants to distribute in pharmacies next, but has not been told when it will receive more doses or how many, said Alan Harris, an emergency manager for the county.
Even though Texas broadened access, some hospitals and pharmacies are still prioritizing healthcare workers. That has led to confusion and frustration among the general public who thought doses were more widely available.
At multiple Brookshire Brothers stores, a Texas and Louisiana grocery and pharmacy chain, an automated message tells customers the stores' vaccine waiting lists are full.
Wimberley Pharmacy, an independent store in Wimberley, Texas, said they received thousands of calls from members of the general public after the state posted locations with vaccine supply on a public website to help Texans find shots nearby.
The store's first 100 doses went quickly to healthcare workers and first responders. The next batch of doses they receive will be open to the general public.
Said the store's manager Cody Gass: “We definitely don't have any sitting around." (Reporting by Rebecca Spalding, Tina Bellon and Carl O'Donnell; Editing by Caroline Humer and Bill Berkrot)