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Pima County faces 40% cut in COVID vaccination doses from state

County moves to begin vaccinating those over 65, struggles with appointments at TCC

Pima County will receive just 17,850 doses of COVID-19 vaccine next week, a 40 percent cut from the 29,850 doses per week that Arizona state officials have provided through late January.

The decrease comes as the county has announced that it is adding those who are 70-74 years old to the group that can sign up to receive the vaccine, adding them to the 75-and-older group that has already been eligible. The cut also comes at a time when the county has struggled to fill vaccination appointments available at the Tucson Convention Center, leading to confusion caused by social media conversations about people lining up at the site.

In a letter to U.S. Sen. Kyrsten Sinema, Pima County Board of Supervisors Chair Sharon Bronson said that on Thursday she was notified by the Arizona Department of Health Services that the county's weekly allocation had been cut. 

"We have made significant progress as a county and have a very high, if not the highest, vaccination rate per 100,000 residents in Arizona of those counties with significant population," Bronson wrote. "We had hoped for an increasing vaccination supply as in the past we typically received 12,500 vaccines per week," she wrote.

Bronson sent similar letters to U.S. Sen. Mark Kelly, and U.S. Reps. Raul Grijalva and Ann Kirkpatrick.

"This number had increased over the last two weeks to 29,850 vaccines, consistent with our increased vaccine delivery infrastructure as well as our priority population; however, this week we have been notified by the Arizona Department of Health Services that our allocation has now decreased to 17,850. ADHS informed our Health Department this morning that we should expect to see a similar allotment for next week," Bronson wrote.

"We have the vaccination infrastructure to significantly exceed this amount," she said.

Bronson wrote to Arizona Gov. Doug Ducey as well on Thursday, noting that "based on the age distribution of our residents as well as minority and low income populations, we clearly should have additional vaccines in Arizona if we are to reduce community public health disparities."

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State officials have not provided any reasons for the cuts to Pima's vaccine allotment.

In mid-January, the county unveiled a plan to vaccinate 345,000 residents by the end of March, and possibly more than 775,000 people by June under an accelerated COVID-19 plan, but only if the "vaccine supply is not an issue" and federal funding is available.

"Based on the present supply of vaccines, it is clear we will have vaccination capacity in excess of vaccine supply," wrote County Administrator Chuck Huckelberry in January. "An accelerated immunization plan is the quickest way  to reduce the present hospital capacity emergency, as well as reduce the number of community infections occurring with the coronavirus." 

Bronson told TucsonSentinel.com that the state's move will force the county to limit the number of people who get their first dose, as the county will need to focus on those who have already received their first dose of the vaccine, and are due for a second dose. 

"This is disturbing," Bronson said. "We're hoping we can get some answers about the metrics that the state uses, and get help from our federal partners, as to why we're getting reduced dosages." 

According to a chart published by ADHS on Thursday, Pima County has administered 130,588 vaccine doses thus far. Maricopa County has administered 324,716, and two state run distribution centers in Maricopa County have administered 137,642 vaccine doses.

While Pima County's "utilization" rate is at about 73 percent, the county's rate of vaccinations per 100,000 is the second highest in the state, at 12,500 doses per 100,000 people. Greenlee County's rate per 100,000 is significantly higher at 21,793 doses per 100,000 people, but that measurement is distorted by the county's tiny population.

Pima expanding vaccine to 70-year-olds

Despite this change, the Pima County Health Department said Thursday that it will expand the 1B priority group to people over 70 years old, and allow people to start registering for appointments starting on Monday, February 8, at the department's website.

Those who are 70 or older, along with educators, and those employed in law enforcement and other protective services will be able to register for vaccination appointments at four sites, with a fifth under consideration. 

Currently, those in this group can register for vaccinations at:

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  • Tucson Medical Center, 5301 E. Grant Rd.
  • Banner UA Cancer Center, 3838 N. Campbell Ave.
  • Banner UMC-South at the Kino Sports Complex, 2500 E. Ajo Way
  • Tucson Convention Center, 260 S. Church Ave.

The county said that a fifth vaccination center at the University of Arizona is also under consideration, though this will be limited to educators. 

"We have made a lot of progress over the past six weeks in the 1A and 1B priority groups, vaccinating more than 130,000 people," said Dr. Theresa Cullen, the county's Health Department Director. "The pace of appointments for educators and protective services has slowed as we think we’re nearing saturation of the people in those groups who want to be vaccinated, so we’re opening appointments to 70 and older," Cullen said. 

While the state moved up people who are 65 and older into the 1B priority group in January, Pima County officials focused vaccinations to people 75 and older because they "statistically have worse outcomes if they contract COVID-19, and because there are so many people in Pima County over age 65 (more than 212,000) allowing them all to register for appointments at once would have crashed the registration system." 

There are more than 54,400 people between the ages of 70 and 74 in Pima County.

"We're only opening vaccination to 70-plus because we still have a lot of 75 plus people to vaccinate and we don’t want to overwhelm our registration system or create more demand than we have vaccine supply," Cullen said.

TCC immunization site a registration 'struggle'

As the county has charged forward on giving out vaccines, on Thursday, county officials outlined a "struggle" with scheduling issues at the regional vaccination center at the Tucson Convention Center. The TCC was limited to protective services and educators, however, "despite the ability to register for ample appointments available at TCC, educators and protective services 1B priority qualifiers have not been choosing TCC that often, only a few hundred a day when the site can handle as many as 1,500 a day." 

To fill those slots, the county and officials from the city of Tucson began contacting organizations that have employees within the 1B priority classification to send to the TCC their qualifying staff who still need to be vaccinated and who have not already registered or chosen an appointment.

"But we’re hitting a saturation point for teachers and law enforcement and it has become harder to round up 1B priority qualifying people to send to the TCC to fill the open appointment slots," officials said.

Additionally, officials at the TCC point-of-delivery, or POD,  found they occasionally had "left over" doses in vaccine vials, so to prevent wasting those doses, TCC has been vaccinating people who "had learned from social media that they could hang around the TCC late in the day and they might be able get vaccinated. That has ranged each day from a few dozen people to none." 

"The TCC scheduling problem, combined with the end of the day shots, has created the public impression that 'anyone' can walk up at the TCC and get vaccinated," officials said. This was compounded when city officials decided that rather than turn people away who didn't fit the priorities, including those over 65, they instead vaccinated people who were in line "as long as it had available vaccine. That also has been spread on social media as an official change in county vaccination policy." 

"This is incorrect. You currently must be an educator, in protective services, or older than 75 to get vaccinated at the TCC," county officials said. 

However, on Thursday, "because the line has gotten so long"at the TCC, the county began allowing people over 70 who are already in line to get vaccinated. Those between 65 and 69 will be asked to register for an appointment when the next priority group opens. 

"We’re sorry for the confusion about who can get vaccinated at the TCC, however the ultimate goal of the county is to get as many people vaccinated in the current priority groups as fast as possible so we can move on to the next priority group. Making sure as many people as possible in the 1B priority groups could get shots at the TCC helps achieve that goal," county officials said. 

On Thursday afternoon, the county said that vaccinations for people who are 65 to 69 years old may be able to start getting vaccinated by the end of February, but that depends on vaccine availability.

"Vaccine supply is the ultimate limiting factor in how many people we can get vaccinated and how quickly. We are wary of getting too far ahead of the available vaccine with our appointments," said Dr. Francisco Garcia, chief medical officer for the county. "It’s hard to estimate how fast we can move to vaccinating 65 to 69 folks because the state’s system for vaccine distribution is opaque, as evidenced by today’s announcement that the state has reduced Pima County vaccine allotment by more than 12,000 doses next week, going from 29,000 this week to only 17,800 next week." 

Garcia has complained about the state's distribution system for weeks, and how county officials are operating in an "environment with severe scarcity" in vaccines doses. "We're not going to sit on our hands, but at the end of the day, it's all about vaccine stock," he said. 

"We ask for your assistance in obtaining additional vaccination supplies for Arizona as well as Pima County in particular," Bronson wrote in her letter to Sinema. "Our state, with a higher elderly and Hispanic population than other states and higher low income population, needs more vaccines if we are to make any inroads in reducing historical public health disparities so prevalent in the past." 

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"Every day is a challenge," Bronson told TucsonSentinel.com. "I'm respectful of the governor's position, but I'm hoping that he will share the metric with us about why the dosages have been cut. It's not just Pima County that's facing these issues, the other counties are too. The vaccines can't just all go to Maricopa County." 

"I'm at a loss to understand this," she said. 

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Paul Ingram/TucsonSentinel.com

Fred Boice receives a COVID-19 vaccination on Jan. 15 at the Tucson Medical Center's Marshall building.

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