I have started this column multiple times over the past month and have had to stop as the information I want to communicate changed from week to week and even, at times, daily. The topic being the answer to the question, “When can I get the covid vaccine?” The covid vaccine is top of mind in our community, state, and the country as we hear about the short supply, the variations in distribution channels, mass vaccination clinics, and the imminent approval of a third vaccine from Johnson & Johnson. We have a list of high-risk individuals, some of whom we have been able to vaccinate, as well as a fast-growing list of individuals on a wait list. Our desire is to ultimately ensure that anyone who wants to get vaccinated can do so. Ok, so what is the problem? For starters, and likely the most significant barrier, is the limited supply of vaccine coming into the state of Minnesota. We have over 5 million people in the state and only 68,000 (with recent increases to 78,000+) doses coming in each week. The math on that suggests multiple years before everyone would be vaccinated. However, as supply increases via the manufacturers, and new vaccine entrants expand the supply, that timeline will be shortened quite a bit. Criteria for getting the vaccine comes next. From the start we have had a clear protocol, provided by both CDC and MDH, with two main objectives: reduce mortality and reduce the spread of the virus. The populations targeted to achieve these goals included healthcare workers and the elderly. Regarding the elderly, the focus has been on nursing homes, assisted living residences, group homes and the like and then, more broadly, that same population living independently in the community. So far, this all makes sense. Additional populations follow in the protocol including educators, childcare workers, grocery store workers, and so forth. Eventually, it is assumed we will be flush with vaccine and we can simply have open access to everyone. We are not there yet. Next are the distribution channels for the vaccine. We have two great infrastructures in Minnesota that other states have envied: our Minnesota hospitals and health systems and the regional coalitions. These were essential throughout all of 2020 as the virus moved across the state. Collaboration, resource allocation, communication, and a shared objective of taking care of our community members across the state were greatly enabled through these systems. These same structures were used when the vaccine first arrived in Minnesota. The large systems in the metro, Duluth, St. Cloud, and Rochester and the regional coalitions allowed for discussions about allocation of this scarce resource. The regional coalitions focused on the partnerships we all have in place to ensure equitable allocations across the designated region. Our Southeast Regional Collaborative is highly engaged and respectful of all participants. I have heard the same from my colleagues across the state. Of particular interest to all of us is that greater Minnesota communities received some allocation of this limited vaccine supply. The initial allocation worked well. And then things changed. Over the past month, the distribution channels have changed dramatically with the addition of various other options, including the state sponsored sites that turned into a “lottery” process. MDH put greater Minnesota healthcare organizations into its own “lottery” system that has eliminated or drastically reduced the amount vaccine coming into our respective organizations and communities. Going back to the first point—the limited supply. Throughout this expansion of distribution channels there was no increase in the supply of vaccine. Thus, as new channels were opened vaccine had to be taken away from others. It has been only recently that the state received a small increase in the amount of vaccine coming to Minnesota. We are all in a tough position. Unfortunately, the situation with the vaccine has not brought out everyone’s best, but rather frustration, anger, and division. It is unpleasant. However, stepping back from all that emotion, it is important to know that this comes from a deep desire to do what we do best—and that is take care of people. Big, small, or in between no organization is more important than the next, no one cares about their patients or communities more than the next, no one does a better job of giving vaccines than another. I can tell you that it is deeply gratifying to be able to provide vaccine to folks who have not been able to leave their homes for months, to call someone and say we have a dose for them, to know that the burden of worry of contracting the virus has fallen away, and that reductions in deaths due to the virus is in reach. 2020 was a hard year for everyone. There is devastation everywhere and the vaccine is the first hope for a recovery of some normal. No wonder we are fighting over it. So, while we have not received vaccine for weeks from the state, we have been fortunate that Mayo in Rochester gave us 100 doses when we had none, and our local coalition has been willing to share, as we have shared with them. There may only be a few hundred total doses coming into Winona County, but we are collectively following the criteria and sharing doses. We remain united in our goal of providing covid vaccine to everyone as the vaccine trickles in and then when it floods in. I want to acknowledge and thank all our regional collaborators as we continue to keep channels of communication and planning open. Regardless of where the covid vaccination clinics are held across our region, it is important to know that there are many collaborators involved in ensuring these happen to serve all of you. I am confident that the supply chain will open—not for a bit, but it is coming.
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