Hospitals short on vaccines referred to health departments

Rae Austin, the Ocala Regional Medical Center pharmacy operations manager, draws the COVID-19 vaccine into a syringe as she prepares the vaccinations for health care workers at the hospital on Wednesday. [Bruce Ackerman/Ocala Gazette]

Rae Austin, the Ocala Regional Medical Center pharmacy operations manager, draws the COVID-19 vaccine into a syringe as she prepares the vaccinations for health care workers at the hospital in December. The state recently told hospitals short on vaccines to look to local health departments for help.  [Bruce Ackerman/Ocala Gazette]

TALLAHASSEE – With frustrations mounting amid a constrained supply of COVID-19 vaccines, Florida’s top public-health official urged hospital executives on Tuesday to turn to county health departments if they need to vaccinate newly hired staff members and patients.

During a statewide phone call, Department of Health Secretary Scott Rivkees told hospitals they cannot use “second dose” vaccine supplies to give initial vaccinations to more people. Rivkees’ remarks came as Gov. Ron  DeSantis makes vaccinating people ages 65 and older his top priority.

But hospital executives pressed Rivkees about the state’s limited supply of “first dose” vaccines and how they can get a share of them.

Patrice Vance, a vice president of quality and risk with the HCA hospital company, asked about the availability of COVID-19 vaccines for newly hired employees. 

“As we have new staff that come on … is there any allocation being planned to provide first dose to the organizations?” she asked.

Rivkees, who doubles as the state’s surgeon general, gave no firm answers but told hospital officials that “this is a situation where you can reach out to your county health department. Health departments are playing a role in terms of vaccinating health care personnel in the community. So speak with them, and we’ll be able to work with you in this situation.”

Windell Smith, operations administrator at Mayo Clinic Jacksonville, said it had been five weeks since his facility had received any additional first doses of COVID-19 vaccine.

“We have several thousand patients who are 65 and above, many have higher risk comorbidities and they are waiting to schedule an appointment with us. We support a lot of staff and facility resources, and we can provide up to 1,000 or more vaccines per day,” he said. “But should we now be directing our patients to the county health department or to the commercial pharmacies? And if we should do that now, will it be temporary or will we be receiving additional first doses in the future when we get more supply?”

State Rep. Carlos Guillermo Smith, D-Orlando, said hospitals are the only providers authorized to vaccinate frontline health care workers and vulnerable populations that DeSantis also vowed to protect in a Dec. 23 executive order about vaccinating people 65 and older. The lawmaker sent a letter Tuesday to hospitals telling them to develop strategies to target people who are at risk and to use whatever supply they have to do so.

“By reserving any currently remaining or available first dose supply to those high-risk individuals under 65 who desperately need the vaccine, hospitals would be following the intent of the governor’s executive order while doing their part to ensure as many individuals as possible from within this vulnerable population are not left behind,” the letter said.

During the phone call with hospital executives, Rivkees said Florida’s allocations from the federal government are announced on a week-to-week basis and that the state is “hopeful” that the supply of the Pfizer and Moderna vaccines will increase. Moreover, Rivkees said the state hopes the federal Food and Drug Administration will in the coming weeks give emergency-use approval for new COVID-19 vaccines.

Rivkees’ direction to hospitals came as DeSantis has started criticizing President Joe Biden’s administration over its plan to use the Federal Emergency Management Agency to help distribute vaccines. The governor dubbed the proposal “FEMA camps” and said the state just needs more doses, not to help with distribution.

The Biden administration shot back Monday, noting that 2.9 million doses of the Pfizer and Moderna vaccines had been delivered but that 1.54 million had been administered in Florida. State officials contend that 907,000 doses are being held in reserve, targeted for “second doses.” Both vaccines require two doses to be effective.

Also, despite a requirement that hospitals, county health departments and pharmacies update vaccination information daily, DeSantis has repeatedly said there’s a lag in the data.

The federal government gave emergency authorization for the Pfizer and Moderna vaccines in December. 

Rivkees and Agency for Health Care Administration Deputy Secretary Molly McKinstry, who was also on Tuesday’s phone call, warned hospitals against using any second-dose vaccines that have been delivered for first-dose vaccinations. Doing so, McKinstry said, could result in a shortfall of second doses.

“There is not a second dose allocation if a second dose is inappropriately used as a first dose,” she said. “That does create a gap.”