Pima County got a surprise in its next allotment of COVID-19 vaccine – 4,600 extra doses. And some of those doses will go to helping vulnerable populations get vaccinated.
Pima County Health Department Director Dr. Theresa Cullen said plans are in the works to meet the needs of another vulnerable population – homebound people or others with mobility issues.
"We are working also on developing plans specifically for them," she said Friday. "Actually, just this morning we assigned someone to help us really develop what does that look like."
The Health Department estimates there are 10,000 to 20,000 homebound residents in Pima County.
"A very large number of individual people that we are trying to figure out a plan to how we're going to be able to reach out and touch them," Cullen said. "Obviously, we have to do it primarily in their places."
The county used multiple lists to identify homebound residents. But there are likely more people who are still unidentified. A spokesman said the county is in the process of establishing a system to identify, register and vaccinate homebound residents.
About half the known population in Pima County came from a state list.
"The state runs a system that identifies homebound people that would need assistance if there was, for instance, an emergency," Cullen said. "If you recall, during the fire we knew where people lived that might be in an area of evacuation."
The rest of the county's names come from various groups, including those doing home-based care.
Cullen said the county hasn't figured out how to deliver the vaccinations to homebound residents yet. But she said the county might tap volunteers from the Medical Reserve Corps and Federal Emergency Management Agency vaccinators.
"Our hope is that we will be pairing two people going out to different places," Cullen said. "We've done some early work on this this past week with our public health nurses. As you can imagine, it's fairly labor-intensive and time-intensive. And the reason is because of that waiting period after you give a shot – you have to wait either 15 or 30 minutes."
The Health Department is also working with Partners in Health and received a set of best practices on Friday to make the process more efficient.
"I would tell you right now, we're only at the beginning stages of doing that," Cullen said.
Health Department patients 75 and older already enrolled in Arizona long-term care were in the queue. Cullen said the county vaccinated many of them already.
"But that doesn't mean we have figured this out for everybody," she said.
The county is also concerned about vulnerable populations that are considered disadvantaged – often due to a lack of transportation for drive-thru PODs (point of dispensing) or access to online technology.
Cullen said some of the extra 4,600 doses the state allocated to Pima County would go toward mobile clinics better suited to delivering vaccines to these disadvantaged communities. The county already used one such mobile clinic at St. John's Catholic Church on Tucson's south side to reach people two weeks ago.
Cullen said the county would try to run three or four mobile clinics to reach these populations next weekend. The mobile clinics deliver smaller quantities of vaccines, typically 300 to 500 doses.
The use of large, drive-thru PODs has raised questions of equitable vaccine distribution. On Thursday, the state opened a large POD at the University of Arizona.
Arizona Department of Health Services Director Dr. Cara Christ held a press conference Thursday to usher in the POD's move from a county to a state site that day.
Christ said the POD's benefit is its central location in Tucson, but the state is also looking at moving to community-based PODs in rural communities as more vaccine becomes available.
The state's allocation of COVID-19 vaccines to Pima County showed 12,500 on Wednesday night. But Cullen said the state notified the Health Department on Friday it added an extra 4,600 doses of Moderna to the allotment.
The county didn't know where the state found the extra doses.
The county is expecting 17,100 doses in next week's allotment after the increase. The Health Department is also expecting this week's allotment to arrive next week after being stranded in Memphis due to winter storms.
Cullen said the county wasn't sure when it would arrive next week, but she added that it could lead to more rescheduled appointments. The county has already delayed appointments from Thursday through Saturday due to weather delays in the shipping chain.
The county is notifying people affected by the delay directly.
The state's Tucson POD received its allocation from vaccines that would have gone to Pima County.
The state is hoping to get the UA POD to 6,000 vaccinations per day and run 24-hours. However, it will depend on vaccine availability.
Christ said future allocations to the UA POD coming out of Pima County's supply would be a combination of doses intended for the County Health Department and separate shipments.
She said the state would keep appointments at the UA site stable until more vaccine becomes available and wouldn't pull additional doses from the county to increase the POD's distribution.
"As we get more, hopefully, it wouldn't impact the county's quite as much," Christ said.