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Colorado’s coronavirus vaccine rollout is confusing and frustrating — but also working, state leaders say

Regional disparities have emerged, as counties, schools and hospitals all chart their own paths

Gretta Wyman, 88, received her first of two Moderna COVID-19 vaccine shots at the Della Cava Family Medical Pavilion in Boulder, Colorado, on Monday, Jan. 4, 2021. She received a card that documents her first shot that she must bring to the appointment when she is given the second dose of vaccine. (Steve Peterson, Special to The Colorado Sun)
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On Thursday, Colorado Lt. Gov Dianne Primavera did what hundreds of thousands of Coloradans her age are wishing they could also do.

“I’m in the wave that’s getting the COVID vaccine,” Primavera, who is 70 and a cancer survivor, said in a video posted to Facebook as she sat next to a health worker preparing to put a needle into her arm. “I’m excited to be here and I want to encourage everyone who is 70 to sign up, get vaccinated and let’s see an end to this pandemic.”

Almost immediately, the comments on the post began filling up with stories of frustration from across the state, illustrating the turbulent way the coronavirus vaccine has rolled out.

“Pueblo we don’t even have a list for me to get on!” one commenter wrote. “I’m 70+ and nothing from our health department!!”

“I am also a cancer survivor and over 70 but on a wait list,” another wrote.

Months ago, Polis, medical experts and state public health officials mapped out an orderly plan prioritizing when different groups of Coloradans can get the vaccine. But as that plan — now twice revised — has been put to use, the on-the-ground reality so far has been much less orderly.

A health care worker consults with Gretta Wyman, 88, before giving her the first of two Moderna COVID-19 vaccine in Boulder on Monday. (Steve Peterson, Special to The Colorado Sun)

Communities are winding their way through their own vaccination lines at dramatically different paces. Seniors in Summit and Eagle counties — among the wealthiest communities in the state and the healthiest in the nation — have already begun receiving shots, while hospitals and health departments in the Denver metro area largely don’t yet have any vaccine to spare. Cherry Creek School District developed a partnership with Centura Health to access vaccines for its staff members beginning at the turn of the year, while other districts were left scrambling to come up with their own plans. 

But the emerging disparities are also unpredictable and don’t necessarily match with an easy understanding of haves and have-nots. Among the first older Coloradans to receive the vaccine were seniors in the small, economically disadvantaged southern Colorado towns of San Luis and Center, after the state helped the communities stage drive-thru vaccination clinics.

“These are exactly the kind of events we are looking to replicate across the state,” Polis said gleefully during a Wednesday news conference. “We want to go where the need is.”

Rural hospitals have been able to move faster at vaccinating their employees than large urban hospital systems. And some small hospitals, like the one in Hugo, have been able to secure enough vaccine to also inoculate people living in attached long-term care facilities, rather than waiting for a federal program that state officials have complained is moving too slowly in providing vaccinations to nursing homes.

Even as individual communities are left guessing about exactly how and when they’ll be able to inoculate their own populations, state leaders have expressed confidence that Colorado’s rollout will not lead to the same kind of persistent inequities that have made the pandemic so punishing for communities of color and the poor. Instead, they argue, everyone within the state’s priority groups will have the chance to be vaccinated with their group. It just may take a few weeks or months to get to them.

“I think really the disparity is one of timing,” said Julie Lonborg, a senior vice president at the Colorado Hospital Association. “In the end, everyone will get vaccinated who wants to. It’s going to be a timing disparity, instead of a disparity of one group getting the vaccine and one group not.”

Two conflicting goals: vaccinating people quickly and in the order they deserve 

Colorado has been preparing for months to distribute coronavirus vaccines, but key variables remained uncertain throughout that long process.

For one, the state was never sure how much vaccine it was going to get and when. And neither the state nor federal governments settled on a priority scheme until after vaccine doses were already on their way.

Polis amended the state’s prioritization plan on Dec. 9, just days before the first doses arrived in the state. The Polis administration amended the plan again on Dec. 30 to change who would be next in line for vaccination in Phase 1b of the state’s plan, after thousands of doses had already been given and some communities were fast approaching that phase. The second set of changes came after a federal committee issued new guidance on prioritization in mid-December — recommendations came after states had already assembled their own plans.

In a news conference on Dec. 30, Polis declared, “Any Coloradan 70 and up can now legally receive the vaccine.”

But the changes caught hospitals, pharmacies and local public health agencies, which will do the grunt work of administering the vaccine, off guard. Some hospitals still haven’t finished vaccinating all of their workers and aren’t expected to do so until next week. Several local health agencies released statements saying they were still working through their plans for vaccinating older Coloradans.

That confusion persisted into this week. On Tuesday, in response to questions from The Sun, Boulder County Public Health spokesperson Chana Goussetis said her agency had received verbal guidance from the Colorado Department of Public Health and Environment to treat Phase 1b like two sub-subphases. The guidance highlighted the location of a previously unexplained dotted line in a chart the state had distributed showing who is eligible to be vaccinated in the phase. CDPHE confirmed this later in the day, when it announced that first responders and those 70 and older should be vaccinated first, ahead of other groups also in Phase 1b, such as teachers.

This chart shows Colorado’s prioritization plan for allocating coronavirus vaccine, as of Dec. 30, 2020. The new plan moves Coloradans age 70 and older, as well as a host of essential workers including teachers, higher in priority. (Provided by the Colorado Department of Public Health and Environment)

As they were deluged by calls from older residents wanting to know how they could get vaccinated, local health agencies pleaded for patience.

“We want to reiterate that we are still on Phase 1a and early Phase 1b of residents who qualified for the previously approved tiers,” Cali Zimmerman, the Denver Department of Public Health and Environment’s emergency management coordinator, wrote in an email. “With limited vaccine supply, we are working as quickly as possible to facilitate vaccine distribution to all qualifying residents.”

Meanwhile, concerns began to grow both locally and nationally that vaccine distribution wasn’t happening fast enough. As of this week, Colorado has received 243,000 doses of vaccine. Through Thursday, the state had reported vaccinating 138,607 people — a rate that Polis says puts Colorado among the top states in the nation but that still leaves a lot of doses so far unused.

But Colorado health leaders say these two goals — vaccinating people in the order they deserve to be vaccinated and vaccinating people quickly — are in conflict. And that means Coloradans are going to have to be somewhat flexible.

“This was all done with the intent that we are not going to waste a dose of vaccine,” Lonborg, of the hospital association, said. “If we’ve got it, we’re going to find a way to vaccinate somebody who needs to be vaccinated. That’s maybe a little more confusing than we had hoped for, but I think that’s what’s going to happen.”

Other leaders encouraged people to see the big picture. Colorado is currently receiving about 70,000 doses of vaccine a week. There are nearly 550,000 Coloradans age 70 and older who are eligible for vaccination in Phase 1b, along with 125,000 health care workers and first responders who are also in the phase’s highest-priority level. It’s a pretty serious bottleneck.

“I don’t have to tell you that people are anxious to return to some semblance of a normal life,” said Bob Murphy, the Colorado state director for AARP, which represents older Americans.

Doctor’s offices, hospitals, pharmacies and health departments are all overwhelmed right now with people calling for information. He’s heard a lot of frustration. He urged the federal government to provide more resources and vaccine manufacturers to move as fast as they safely can. But, as for the state’s response?

“I think, all things considered, it’s going reasonably well,” Murphy said.

“A tremendous sense of unfairness”

Questions about the timing of vaccinations have also extended into school communities across Colorado, with many parents, students and educators and the governor eager to get classrooms full of students again.

The state initially prioritized educators and school staff in Phase 2 of vaccination but last week bumped school personnel up to Phase 1b. Under new guidance released this week, teachers and essential workers must take their turn getting the vaccine after first responders and individuals age 70 and older. That puts them on track to get the vaccine starting in early March. The vaccine, which consists of two doses three weeks apart, won’t have much of an impact on the rest of the 2020-21 school year.

Now, many Colorado school districts are coordinating vaccine administration for school staff with their local health departments. District leaders have a cautious sense of hope that toward the end of the school year, their students will no longer face the disruptions that quarantines and transitions between different modes of learning have caused.

George Welsh, superintendent of Cañon City School District, is aiming for 100% of his staff to get vaccinated. He’s focused on an approach that will reward individuals for taking the vaccine rather than requiring his staff to get it. 

The district, which educates 3,400 students, is considering offering incentives to employees who receive the vaccine. One possibility: those who agree to being vaccinated won’t have to use any of their leave time should they have to quarantine this school year. Another idea involves handing out bonus checks at the start of the next school year to employees who commit to taking the vaccine and then return to work in the district.

Those who are vaccinated are helping keep schools open, Welsh said. “And it’s going to create a more positive work and learning environment.”

After Cañon City School District school nurses get vaccinated – which Welsh thinks will likely happen in the next week or so – and the attention turns toward vaccinating other staff, Fremont County Department of Public Health and Environment will bring a vaccination truck to every school and employees will be able to step away from their job to get their shot, Welsh said.

Alamosa School District — which has about 2,200 students — also hopes to offer vaccination clinics in March in school gyms on Fridays, when students are distance learning, interim Superintendent Marsha Cody said.

Cody’s goal is to vaccinate 70% of the district’s staff and she is contemplating incentives, too.

Distribution of the vaccine in Colorado communities has, for the most part, been equitable, Cody said. But at least one incident of a suburban school district getting access to the vaccine through a partnership with Centura Health has stirred up controversy among school districts and further elevated the disparities that exist between communities and families with means and those living in poverty.

Jessi Puga, a nurse at Pine Ridge Elementary School, receives the coronavirus vaccine on Friday, Jan. 1, 2021, at Parker Adventist Hospital. Cherry Creek School District is partnering with Centura Health to vaccinate school staff, though the partnership has drawn criticism from some Colorado school district leaders who say it creates inequities. (Handout)

Last week, school nurses from Cherry Creek School District began receiving vaccines at Parker Adventist Hospital with vaccinations for teachers to follow in the near future.

“As you know, school districts have no control or authority over vaccines, distribution processes or timelines,” Superintendent Scott Siegfried wrote in a letter circulated to staff on Wednesday afternoon. “As with most everything else during the pandemic, we were left on our own to actively seek partnerships with outside entities. Over winter break, we were fortunate to enter such a partnership and then immediately began to share and expand to other districts.”

But with new guidance directing educators to be prioritized for vaccines after first responders and elderly Coloradans, the district has had to abruptly change course. In the letter, Siegfried said the latest guidance “stops our efforts midstream.” 

Centura will honor current invitations and appointments and will continue encouraging school employees to schedule a time to be vaccinated but wait until the state clears the way for teachers and school district staff to be inoculated, he wrote.

Siegfried also said in the letter that nine other metro area districts are working with Centura Health. He understands that there is a broader need in the community and advocates for other priority groups to get vaccinated.

“I am, however, disappointed that the state is not allowing us to trust local health systems to find the right balance, develop and implement effective plans and continue to move our educators forward, while also serving others,” Siegfried wrote.

Welsh, of Cañon City School District, said he isn’t surprised that Cherry Creek School District was able to arrange a partnership with a health care system. He’s long observed inequities in Colorado school districts.

“There’s a tremendous sense of unfairness throughout the entire state of Colorado based on that,” Welsh said.

Cody raises her brow at that kind of deal, one that she said feels a little funny. But the Alamosa School District leader said it’s more an issue of timing than one of equal access to vaccines, which is difficult for people to understand.

A key question she poses: Why can’t the state work to shift resources and get counties in need caught up, or show them how to tap into the vaccine sooner through private entities?

Where can you find information about getting a vaccine?

For those in the general public who are 70 and older, finding the vaccine right now will take persistence and patience.

There is not currently a central place for everyone to sign up. People who have a regular doctor or health clinic they go to are encouraged to call those places for more information. During a media briefing this week, Polis showed a Powerpoint presentation with links to various hospital systems’ sign-up pages. Local health departments are also a place to check.

And the state is planning to organize more information on its vaccine website — covid19.colorado.gov/vaccine.

But, for at least the foreseeable future, state health leaders expect the process to be a little bumpy, with different timelines for different counties.

“The last time everyone was all on the same page was the first day of vaccine,” the hospital association’s Longborg said. “And that’s going to be the case as we move forward where they’re all in different places.”

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