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Counties Create Priority Tiers, Lists For Who Gets COVID-19 Vaccine Next

A COVID-19 vaccination center at the Gallatin County Fairgrounds, January 6, 2021.
Nick Mott
Montana Public Radio
A COVID-19 vaccination center at the Gallatin County Fairgrounds, January 6, 2021.

Montana counties are taking varied approaches about who in the current COVID-19 vaccine distribution Phase 1B should receive the very limited number of doses each week.

NICKY OUELLET: This month, health officials in Montana entered the state into Phase 1B of the COVID-19 vaccine distribution plan. Kaitlyn, can you remind me who's up next?

KAITLYN NICHOLAS: Those in Phase 1B are people over 70 years old, people between 16 and 69 years old with specific health conditions like cancer, obesity, heart problems and diabetes, as well as Native Americans and other people of color who are more at risk of COVID complications.

OUELLET: And statewide there's about a quarter of a million people who fall into this phase, but we know vaccine supply is still in really short amounts. The federal government is only allocating about 13,500 vaccines each week to the state of Montana. Kaitlyn, how are counties approaching giving out this super limited supply of vaccine doses when there's so many people eligible to get the vaccine right now?

NICHOLAS: Yeah, vaccine distribution has a certain hierarchy. So, the state is dependent on vaccine allocation from the federal level, and so far that's been really limited and unreliable. So, the state is giving each county and facility, like hospitals, a certain allocation of their supply. And then each county decides how to distribute it to those in Phase 1B.

OUELLET: What might that look like?

NICHOLAS: Several counties are creating eligibility tiers within the phase. For instance, some counties are prioritizing older residents first, like in Silver Bow, Jefferson and Park counties, only those over 80 are eligible for the vaccine right now.

In Mineral County, which borders Idaho, the health department is asking people eligible for Phase 1B to leave a voice message. As the department has vaccines, it'll reach out to those callers to set up appointments on a first call, first serve basis.

And most larger counties are also offering the vaccine on a first come, first serve appointment basis. But Valley County, in the northeast, asked everyone in Phase 1B to sign up by phone or email. Then the health department is using a random computer generated selection to choose those who will receive the hundred vaccines allocated to the county each week. There are 2,600 people eligible in Valley County.

OUELLET: But vaccines aren't just coming from the state’s federal allotment each week. There are other sources of vaccine coming into the state.

NICHOLAS: That's right. Indian Health Service clinics are receiving their own allotments of the vaccine and have been several weeks ahead in vaccine distribution compared to county departments. Rocky Boy Health Center made it through health care workers and elders earlier, and now they're vaccinating adults living on the reservation with high risk medical conditions.

And the Montana VA is leading a national pilot program to bring the vaccine to veterans in rural areas, which they launched last week with a flight to Havre.

OUELLET: How are counties letting residents know when it's their turn to be vaccinated?

NICHOLAS: Well, people with eligible underlying conditions like cancer and diabetes are likely to already have a health care provider who can talk about the vaccine with them and get them on the list when it's their turn.

But for everyone else, getting in line for the vaccine varies from county to county. Some counties, like Yellowstone and Cascade, residents can call into phone scheduling lines on certain days of the week to make an appointment.

On Monday (Jan. 25) Billings Clinic received 27,000 calls in less than three hours. And they had less than 1000 vaccine doses for the entire week.

And on Thursday, Cascade County lines were overwhelmed from too many callers calling in at the same time.

But other counties are making appointments through their websites.

Lewis and Clark uses a drive-through vaccine clinic and they offer online reservations for appointments. The first time they launched the website earlier this month, their first round of 900 appointments were booked within 10 minutes.

Missoula did something similar except the appointments were available only for people of color and those over 70, and all 400 available appointments were reserved within an hour on Wednesday (Jan. 27).

OUELLET: I imagine some of the folks who are eligible to get the vaccine might be a little hard to reach. Are counties having problems communicating with people about how and when they can get vaccinated?

NICHOLAS: Well, Lewis and Clark county actually issued a warning this week about non-official websites, like Eventbrite, advertising vaccine clinics. Health officials say the public should only rely on county websites for information and should contact the police if they see scam vaccine events.

To help residents who aren't as computer-savvy, a lot of counties are also printing vaccine information in local newspapers and opening phone lines for appointments. For example, both Carbon county and Roosevelt county run regular print updates about the vaccine for those residents who aren't on social media.

But really the biggest problem is there's just not nearly enough vaccine available from the federal level to match the demand. Local health departments are doing all that they can to get the vaccine out, in addition to everything else they do, including contact tracing and testing for the virus.

Matt Kelley, the Gallatin City-County health officer, he explained this gap between demand and supply really well last week.

KELLEY, SOUNDBITE: Everyone needs to understand, we don't have enough vaccine to meet the demand for everybody in that group. It's not even close. You’ve got a shot glass full of vaccine and we need a swimming pool.

OUELLET: And in the meantime, health officials are still recommending to wear a mask, maybe double them up, wash your hands, keep your distance, all the stuff we've been doing since last March. Thanks Kaitlyn for sharing your reporting.

NICHOLAS: Thanks, Nicky.

Kaitlyn Nicholas covers tribal news in Montana.