Amid escalating criticism of Maryland’s efforts to vaccinate people of color against COVID-19, the state’s largest hospital systems and the Department of Health announced on Monday a pilot program to prioritize people in under-served Baltimore neighborhoods.
The program, to be run out of the mass vaccination site at the Baltimore Convention Center Field Hospital, will use a “custom algorithm” to identify residents in communities where vaccination rates have lagged.
Then, “hospital-based community health teams” will use “aggressive community engagement” to convince residents that the three vaccines approved by the federal government are safe.
The new effort was announced jointly by the University of Maryland Medical System, Johns Hopkins Medicine and the state Health department.
The news did little to take the heat off acting Health Secretary Dennis R. Schrader.
Lawmakers pounded Schrader at the state Senate’s COVID Vaccine Work Group meeting on Monday afternoon, grilling him regarding Maryland’s low minority vaccination rates. One member of the panel expressed anger over Republican Gov. Lawrence J. Hogan Jr.’s suggestion last week that Baltimore had received “far more [doses] than they really were entitled to.”
The state’s three mass vaccination sites are located in majority-Black communities, Baltimore City and Prince George’s County. But more than 60% of the doses administered in Baltimore have gone to people who live elsewhere.
And Schrader disclosed that only 3,558 of the approximately 32,000 doses that have been given out at Six Flags in Largo have gone to residents of Prince George’s. Three times as many have gone to residents of neighboring Montgomery County. More than 9,000 additional shots more were given to Anne Arundel and Howard residents.
Sen. Mary L. Washington (D-Baltimore City) called Hogan’s comments “tone-deaf,” “divisive” and “dangerous.”
“I would suggest that if language and discourse like this continues from the top, it is actually undermining your activities, our efforts to build confidence in the community,” she added.
She pressed Schrader to respond to what she called “this lie that’s being perpetuated that somehow Baltimore City is getting more than we’re entitled to.”
Schrader begged off, saying: “You’re asking me a political question and I’m not a politician, so I’m focused on process and facts. I don’t think I can answer your question.”
Sen. Ronald N. Young (D-Frederick) complained that the one CVS in Frederick that is receiving vaccines from the federal government “is in a wealthy white area.”
“We have pharmacies right in the heart of where the Hispanic and Asian and African-American communities are,” he added. “They’re not getting the shots. They’re well below the average of white people getting them. I’m sure a lot of them — if they had access — would do it.”
Young said he’s being inundated with calls from the public, “and I don’t know what to tell them. The state’s got to do a better job.”
Maryland National Guard Brigadier General Janeen Birckhead, the head of the state’s Vaccine Equity Task Force, told the panel that three mobile units will be “on the street” soon and that Federal Emergency Management Agency trailers were under consideration.
“Three mobiles aren’t going to cover the state well,” Young replied. He suggested that the state utilize existing community centers instead.
Sen. James C. Rosapepe (D-Prince George’s) echoed Young’s statement. He described frustrating experiences he had when he called the state’s toll-free “pre-registration” number, 855-MDGOVAX, including one where “no one answered the phone.”
“You got to up your game here, folks,” Rosapepe said.
Schrader, whose confirmation by the Senate is not considered imminent, said the state will have an improved pre-registration system up and running by mid-March. He also said that modifications to the PrepMod system — to prevent people from forwarding sign-up links to others — will be finished this week.
Maryland has consistently trailed other states in the percentage of doses on-hand being administered. Schrader disclosed for the first time that data used by the CDC, Bloomberg and other sites to track vaccine rollout were distorted by the federal government’s withholding of doses intended for federal workers, making the state’s numbers appear worse than they are.
He said that Maryland is the 19th largest state in the country and consistently ranks between 18th and 21st in shots used.
“We are right on the money with the rate of doses per day administered,” he said. “The federal government is sitting on our inventory.”
He said the state is trying to figure out “what button do we push” to spring the “tens of thousands of doses that are assigned to Maryland… that are not on our books.”
Sen. Clarence K. Lam (D-Howard) pressed Schrader again on an Ernst & Young consulting contract that went into effect on Jan. 21, at a rate of $45,000 per day, to help the state with its vaccine rollout.
Although the secretary defended the agreement, saying that the state and county health departments are gaining valuable expertise, Lam suggested the state is about to miss a requirement that emergency procurements be approved by the Board of Public Works within 45 days.
Schrader said the department intends to meet the deadline.
Johnson & Johnson vaccine to arrive this week
Maryland will soon receive 49,600 doses of the newly-approved Johnson & Johnson vaccine, Hogan announced on Monday.
Officials cautioned that the initial allotment is larger than what the state can expect to receive on a weekly basis.
Nonetheless, the single-shot vaccine, which does not require cold storage, is expected to boost the state’s program.
“The Johnson & Johnson vaccine is safe, effective, and made right here in Maryland,” said Hogan in a statement. “Our plan is to get this vaccine into the community right away and right into arms so that we can continue increasing our vaccination rate.”
Schrader said 55% of the J&J doses will go to M&T Bank Stadium and the fourth mass vaccination site, at Regency Furniture Stadium in Waldorf, which is due to open soon. Local health departments will get 10,000 doses and the rest will go hospitals and federally-qualified health centers.
The federal government has urged states not to target specific populations with the third vaccine, but given the equity issues Maryland has faced, Lam urged Schrader to consider a more focused approach — particularly since the single-dose vaccine is easier to administer and doesn’t require people to return for the follow-up shot.
“I don’t disagree,” the secretary said.
New community outreach initiative
Officials said the new outreach effort being run out of the Baltimore convention center will take “several weeks” to launch, due in part to the need to hire and train staff, and to “operationalize” the pilot’s outreach efforts.
In a letter to Hogan on Monday, Baltimore’s six senators — all Democrats — expressed “grave concern” about the rollout of the state’s vaccination program.
“The racial disparity in vaccination is… alarming, with less than 6% of Black Baltimoreans, who comprise over 60% of the population being vaccinated — compared with over 16% of white residents,” they wrote.
Officials with UMMS, Hopkins and the state health department expressed optimism they will be able to reach people who have not been able or willing to sign-up for a shot.
“These teams will work with community leaders and individual residents to overcome the principal obstacles that have contributed to low vaccine uptake in these areas: the digital divide, access to transportation and dispelling vaccine misinformation and myths,” the organizations said in a news release.