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Hospitals Fume As Governor Shifts Coronavirus Vaccine Strategy

A pharmacy technical worker at Boston Medical Center removes two trays of Pfizer's COVID-19 vaccine, each containing 975 doses, from a box. They will be placed into a freezer kept at a temperature between -60° and -80°. (Jesse Costa/WBUR)
A pharmacy technical worker at Boston Medical Center removes two trays of Pfizer's COVID-19 vaccine, each containing 975 doses, from a box. They will be placed into a freezer kept at a temperature between -60° and -80°. (Jesse Costa/WBUR)

Most hospitals in Massachusetts have stopped scheduling first-dose vaccination appointments, and some are ramping down operations at community vaccination sites, after learning the Baker administration will not send them additional doses for the time being.

“Earlier today, we were notified by the state that it will be greatly reducing the supply of vaccines to hospitals and health systems in order to consolidate vaccine doses for use at state-run vaccination clinics,” said Beth Israel Lahey Health spokeswoman Jennifer Kritz, in a statement. “Any already-scheduled first or second dose vaccines will be administered as planned.”

Some hospital leaders expressed frustration at the sudden change, which comes after weeks of planning and significant financial investment in outreach to patients and the creation of new community-based vaccine clinics.

State officials indicated that the move is intended to deliver vaccines more efficiently to as many residents as possible, at a time when supply remains tight.

“The Commonwealth will distribute more vaccines to high throughput locations, like mass vaccination sites, retail pharmacy sites, and community health centers until more vaccines are made available by the federal government,” said a spokesperson for the state’s COVID-19 Response Command Center in an email. “The Command Center and Massachusetts Health & Hospital Association are working together to plan for a more predictable supply for the next few weeks.”

An emergency use authorization for an additional vaccine, developed by Johnson & Johnson along with Boston researchers, is expected to boost supply across the country in March.

Some hospitals dispute the state’s suggestion that they’ve been slow to inject patients and staff. BILH, for example, says it has been using 95-99% of doses received.

“And we have done this in multiple communities throughout the state, many that have been hardest hit by the virus, including communities of color,” said Kritz.

At a press conference on Wednesday, Baker stressed the importance of large sites in speeding up delivery of vaccinations in Massachusetts.

"If you look at the performance across the country, the states that have done the best job in getting shots into people's arms are the states that have big sites,” he said. “For us, with the limited amount of doses we have and the incredible pressure to get as many doses into people's arms as we possibly can as quickly as possible, following what is proven to be most successful in most other places in the country is to use very big sites.”

Baker has been under fire for the slow rollout of vaccines in Massachusetts. The state update released Thursday shows 68% of doses shipped to Massachusetts have been injected.

Some doctors argue that directing residents away from hospitals and their doctors will only make things worse.

"While I applaud the success that Massachusetts has experienced in setting up mass vaccination sites, physicians have heard from many patients how challenging and frustrating it has been to sign up and access these sites," said Dr. Chris Garofalo, a family physician affiliated with Sturdy Memorial Hospital in Attleboro. "In contrast, my patients know how to contact my office. We have years to decades of a trusting relationship, which allows us to convince those who may be hesitant to agree to be vaccinated.”

Dr. Sheena Sharma spent weeks setting up a clinic at her practice in Webster so she could vaccinate patients and other local residents. Now, with the redistribution to mass sites and the option of taking a companion there, her appointment schedule is a mess.

"People do not want to come for their weekend appointments and are holding appointments to see if they can get something at Gillette and go with a family member,” Sharma said. “They will likely not show at our location. We also have people who want to cancel their second doses with us so they can go out to those locations and get two doses."

Two of the state’s mass vaccination sites are in Boston: one at Fenway Park and the other at the Reggie Lewis Center. But there's concern that concentrating distribution at mass sites, many of which are located in suburban areas rather than urban hot spots, will make the shots less accessible to residents of some of the state's hardest hit communities.

There’s a growing tension in Massachusetts and other states between vaccinating as many as possible as quickly as possible and targeting hot spot communities where Black and brown residents have been hospitalized and died at two to four times the rate of whites. Some public health experts question whether a focus on speed alone will save more lives.

Much of the state’s effort to achieve equity in the distribution of vaccines leans on community health centers. But hospitals had opened 20 clinics in coronavirus hot spots with a significant investment of time, money and staff. Governor Baker praised one of those facilities in the past week, a clinic at a Dorchester church run by BILH. Now those clinics and others are closing to new appointments.

“We have always highly prioritized equity,” said Mass General Brigham’s chief equity officer, Dr. Tom Sequist. “And we do look forward to partnering with the state around any plans it has in the distribution of vaccines and ensure that our hardest hit communities can receive vaccination.”

Sequist said MGB had planned to vaccinate 10,000 patients and some staff every week for the coming weeks, including at sites in Chelsea, Revere, Lynn and Jamaica Plain.

BILH has opened seven vaccination clinics and booked 26,414 patients who are 75 or older.

At least one hospital will keep its community vaccination clinics open for new patients while the state stops supplying hospitals across the state. Boston Medical Center’s COO, Dr. Alastair Bell, says the difference is that BMC’s clinics are not just for patients.

"Anyone can book into them," he said. "Our primary focus is on residents of the city of Boston and people in the communities that we predominantly serve, but anyone can book into them."

Polls show doctors and nurses are the most trusted source of vaccine information and access in the U.S.

When vaccine supply increases and the state allows hospitals to resume booking new patients, the Massachusetts Medical Society will continue to urge Governor Baker to send vials to independent physician practices, not just hospital-based doctors, so that they can vaccinate their patients as well.

The Baker administration says hospitals have been the largest recipient of vaccine doses in Massachusetts to date.

This article was originally published on February 11, 2021.

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Martha Bebinger covers health care and other general assignments for WBUR.

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