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By Hannah Yang, Minnesota Public Radio News

A week into Minnesota’s expanded COVID-19 vaccine eligibility, at least one regional health department is beginning to feel the pinch.

Human Services of Faribault and Martin Counties, a two-county public health department in southern Minnesota, requested 300 doses of vaccine to administer this week, but they’re struggling to fill appointment slots — and dealing with no-shows.

So next week, the state won’t be sending any vaccine for the department to administer. Public health director Chera Sevcik said it was her call to decline another round of doses.

“We’ve started to see a decrease in interest for vaccines, and there are other providers available in the community,” Sevcik said.

The local public health department’s decision to decline their next shipment of vaccine won’t affect shipments to other providers in the region, some of which — major pharmacy chains, for example — get their vaccine allocations from the federal government.

Residents in Martin and Faribault counties — and in the county seats of Fairmont and Blue Earth — have a plethora of options for vaccine appointments nearby. Several providers — including Walmart, Walgreens, Hy-Vee and local pharmacies and clinics — are also offering COVID-19 vaccine in the counties, and will continue to do so.

But when her department began to have trouble filling appointment slots at its clinics around the region, Sevcik said, it seemed like a good time to sit out a week.

“It’s maybe time to step back, and kind of see what happens,” she said.

Sevcik said she hopes the state Health Department will redistribute the vaccine allocation she’s declined for next week to somewhere else where it’s needed — and she suspects that place might be the Twin Cities metro area. Over the past week since eligibility opened up to people 16 and older, many of the people her public health clinics vaccinated have made the drive from the metro area.

“It’s people from outside of our two counties who are coming in to get the vaccine at this point, and are taking those appointments versus individuals from our communities,” Sevcik said.

As a public health professional, she said, she’s thrilled to be able to offer a COVID-19 vaccine to anyone who wants it. But driving two-plus hours from Minneapolis to Fairmont — twice, if they’re getting a Pfizer or Moderna vaccine — is a major time investment for a patient, she said.

“In my opinion, it’s like, ‘Well, then let’s make sure that the vaccine gets to those counties, so people don’t have to drive three hours to get the vaccine,’” she said.

The Minnesota Department of Health works with local providers and regional networks to gauge the vaccine need in communities around the state on a given week. They typically plan two weeks ahead, with providers estimating how many doses they’ll need, given the demand and their capacity to administer vaccine. Then state health officials determine how the vaccine will be distributed statewide.

If providers find themselves with more vaccine doses than filled appointments, they are able to work with the state to redistribute, often to another provider who might be able to use them.

State Health Commissioner Jan Malcolm said Minnesota’s process for distributing vaccines to local public health departments, major healthcare providers and partners statewide was designed with flexibility in mind.

“One of the good things about having a really diverse vaccinator ecosystem, is that there’s lots of places to be able to redirect those doses,” Malcolm said Thursday. “So the doses aren’t just sitting unused.”

Local health departments’ decisions to accept or reject vaccine shipments are made on a week-by-week basis. Even though Faribault and Martin counties’ human services department won’t be distributing the vaccine itself to the public next week, it will have the opportunity again to request doses when needed.

Steady rates, plentiful vaccinators

Both Faribault and Martin counties’ vaccination rates are running apace with the statewide rate. In Faribault, 42 percent of the eligible population has been vaccinated; in Martin, it’s 43 percent. Statewide, the percentage is the same.

Sevcik said she’s concerned the area might have hit a moment of vaccine saturation. In Fairmont — the seat of Martin County — the Walmart, Walgreens, Hy-Vee and Sterling pharmacies and the Dulcimer Medical Center line the main road, State Hwy. 15. All are taking appointments for the COVID-19 vaccine. The twice-weekly public health clinic, Sevcik said, might just make for too many options.

“That’s why I felt comfortable saying, ‘Let’s take a pause and see where things are at,” she said. “If we see this surge in people needing vaccines, and it looks like local public health needs to come in and fill that void, then I would be happy to request a vaccine and plan additional clinics. But with just the struggles that we’ve had, we kind of have come to a point where we need to take that pause.”

It wasn’t for lack of trying to get the word out.

Sevcik’s department has maintained a heavy presence on social media throughout the pandemic and launched a vaccine-specific outreach campaign to advertise available appointments on social media and in the local paper.

County staff had also done outreach at grocery stores and food manufacturing plants, and stuffed fliers into backpacks to send home with students.

“[We’re] really just trying to hit every possible avenue to make sure everyone who wants a vaccine has had the opportunity to get one,” Sevcik said. “So even with all of that outreach effort, we’ve just continued to see maybe not as much interest as we hoped in getting these appointments filled.”

Sevcik says she worries a bit that some of the decrease in interest might be happening because some people don’t plan to get vaccinated. She said she’s heard anecdotally about people skeptical of the vaccine, or worried about its side effects. But she said she hopes that, as more people are vaccinated and share their experiences, others will see that the vaccines available are safe — and will sign up to get one themselves.

“There’s a lot of misinformation circulating the community, which we’ve seen play out throughout the entire pandemic, in all different facets of pandemic response and mitigation efforts,” Sevcik said.

So in the meantime, she’ll continue to focus on connecting residents with solid information “to continue to build that trust,” she said, “being that source of reliable information or trusted place to identify if the vaccine is right for individuals or not.”

The challenge of the three-day turn

In an effort to vaccinate broadly and quickly, Gov. Tim Walz in late January implemented guidelines requiring providers to distribute 90 percent of their vaccine doses within 72 hours — three days — of receiving them.

According to state Health Department data, 92 percent of providers statewide are hitting that goal — and Sevcik’s department has hit it 100 percent of the time. But the tight turnaround has proven challenging, particularly for smaller providers.

Eric Weller, director of the South Central Health Care Coalition, a collaborative of local agencies and organizations in the region that coordinates emergency response, said providers in the region have received 600 fewer doses this week than last, and their local public health partners have also seen a decline, due to decreasing demand.

“As clinics decline in appointments, it takes us longer to fill up those appointments,” Weller said. “We can probably fill those appointments, but we need more than 72 hours, and so that 72 hours is a barrier for us in Greater Minnesota.”

Weller said he understood the need for the rule when vaccine distribution began. Back in January, when it was implemented, it was a way for the state to hold providers accountable for quickly administering vaccines to priority groups in an uncertain time, when only two vaccines were available and the urgency was clear.

“The rule was great, initially, but it has worn out its life,” he said. “We need to open that window for vaccines so that we can be a little more proscriptive as we schedule appointments.”

At the Sterling Drugs pharmacy in Fairmont, manager and head pharmacist Jacob Reuter said he hasn’t had trouble filling appointment slots. And he has been seeing a lot of familiar people arrive for their vaccine appointments — and with questions.

“Most people that come to me to talk about it are the ones that are already kind of thinking about getting a vaccine,” he said.

And the overall reception to getting shots has been positive, Reuter said — and that the majority of people who come through the doors have been eager to get vaccinated — even patients who haven’t been regularly vaccinated before.

“I’m looking at their past vaccination records and they don’t get much for vaccines,” Reuter said. “So you can tell that they don’t really get vaccines very often, but they wanted COVID-shots.”

In addition to those familiar faces, Reuter said he’s seen lots of new ones, as patients from farther away, like the Twin Cities area, have come for vaccines. He hasn’t wasted a single shot yet, he said, and doesn’t plan to start. So he’s urging those who make the trip to be prepared to come back in the next couple weeks.

“If you took that first shot and don’t intend to get the second one or skip that second one, [you] essentially just took a shot away from someone, because that one’s going to get wasted,” he said. “If they skip their second dose, it’s a wasted shot. It’s a shot down the drain.”