ESTERO, Fla. – Senior citizens spent a chilly night outside in a line that stretched for blocks as they waited to get into a park and rec center where COVID-19 vaccinations were offered on a first-come, first-served basis Monday.
At the front of the line were Marc and Mary Ravis of nearby Cape Coral. They arrived around 7 p.m. Sunday, two hours after the immunization clinic was announced by the Lee County Health Department.
“I really need this vaccine,” Mary Ravis said. She and her husband, 69 and 72 years old, respectively, have underlying health conditions. “We figured it would fill up fast.”
Saturday, Gov. Ron DeSantis issued an executive order that ignored Centers for Disease Control and Prevention guidance for COVID-19 vaccine priority and allowed people 65 and older to jump ahead of essential workers, even as many health care employees in Florida wait for their shot.
“We are not going to put young healthy workers ahead of our elderly,” said DeSantis, whose state has seen more than 21,000 deaths from the virus.
The Ravises were among the lucky ones in the southwest Florida village. By noon – two hours before the clinic was scheduled to begin vaccinations – the county Health Department tweeted the site had reached capacity. Only those already in line could be accommodated.
Tuesday, lines at the county’s three first-come, first-served vaccination sites reached full capacity by 7 a.m. The sheriff’s office had to send out a traffic alert for the sites because of crowding.
Similar scenes of waiting, confusion and frustration played out across the state Monday, as medical systems and counties scrambled to create distribution systems for groups they hadn’t expected to vaccinate for at least a week or two.
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“If you’re opening it up to everyone in Florida 65 and older, then you’d better have a plan,” said Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee.
That hasn’t necessarily been the case in the Sunshine State, where the chaotic coronavirus vaccine rollout for people 65 and older may be a lesson for the rest of the nation, as a decentralized, county-based public health system copes with overwhelming demand.
Florida’s latest vaccination data showed 122,881 people received the first dose of a two-part vaccine as of Monday morning; Johns Hopkins University data showed Florida had been allocated 546,400 doses as of Dec. 16.
Immunizing the general population involves much more than most people imagine, said Glen Nowak, director of the University of Georgia’s Center for Health and Risk Communications and a former communication director for the CDC’s National Immunization Program.
“We know there are broad-stroke ideas of how this is supposed to work,” he said, “but as the vaccine gets distributed deeper and deeper into the system, it’s going to get more complicated.”
We got my 82 year old mother a COVID vaccine appointment! Orange County Florida website took hours of refreshing to get it but we finally got through! She goes Wednesday and follow up shot in January. 👏👏👏
— Claudine Hellmuth (@claudinetweets) December 29, 2020
That complexity resulted in busy signals and hours of redialing in Miami, where people tried to get through to make vaccination appointments at hospitals in the face of sometimes contradictory information.
At Memorial Regional Hospital in Hollywood, the website read, “At this time, the Pfizer-BioNTech COVID-19 vaccine is not available to the community.” The switchboard told callers vaccine was not being distributed.
However, callers to the hospital’s COVID-19 line who could get through Monday were allowed to book vaccination appointments for people 65 and older until midday. Then a recording declared appointments for the vaccine were no longer being taken. A call to the hospital’s media relations department Monday was not returned.
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Mount Sinai Medical Center in Miami began offering vaccine to seniors last week, though getting through to the appointment desk proved difficult for many. Monday, multiple attempts by USA TODAY resulted in busy signals. When the line was answered, staff said vaccine was available only to medical center patients.
That isn’t the case, CEO Steven Sonenreich clarified. The medical center offers vaccine to anyone 75 and older and will drop the age limit to 65 when demand eases. The initial rollout has been “a work in progress,” he acknowledged.
“What occurred has been that the vaccine was not here one day, and then all of the sudden, it was here,” Sonenreich said, adding that the system vaccinated its physicians and as many other medical workers as wanted it, then opened to others.
The hospital hired additional staff members to answer phones and deal with the increase in activity. Though Mount Sinai has always offered immunizations, “no one has a vaccine department,” Sonenreich said.
In counties where public health departments took the lead in distributing vaccine to the public, the process has been bumpy at best.
In Seminole County, the Health Department began administering shots to people 65 and older at a mall Monday. An immunization appointment system crashed repeatedly throughout the day, then immediately filled up through Jan. 9. The county asked for patience as it worked through the issues.
The county level is where such efforts need to be organized, said Dr. Walter Orenstein, associate director of the Emory University Vaccine Center and former director of the U.S. Immunization Program. “It’s the states and counties that know where to send the vaccine and what systems to have in place,” he said.
Nowak, the former CDC immunization official, said they need money and time. “This is one of the reasons you’ve seen so many of the state and county health departments say how important it is that they get additional resources,” he said. “The complexity is going to do nothing but increase.”
The coronavirus relief and spending package President Donald Trump signed Sunday includes more than $8 billion for states for vaccine distribution. The money should have come much earlier, and with federal support for the effort, Dr. Ashish Jha, dean of the Brown University School of Public Health, tweeted in frustration late Monday.
“There appears to be no investment or plan in the last mile,” Jha wrote. “No effort from Feds to help states launch a real vaccination infrastructure. Did the Feds not know vaccines were coming? Shouldn’t planning around vaccination sites, etc not have happened in October or November?”
Orlando’s Orange County announced Monday it would begin vaccinating seniors Tuesday at the county convention center. At a news conference earlier in the day, county health officer Dr. Raul Pino warned the process wouldn’t go smoothly.
“Should you expect mistakes? Yes! We’re going to have issues,” he said. “We’ll work on those issues as they come.”
They came almost immediately. A website to take appointments went up Monday afternoon but quickly faltered as county residents spent hours refreshing their screens to try to get it to work.
Wayne Frongello, 69, a retired teacher, spent a fruitless hour trying to make an appointment for himself and his 95-year-old father.
“This rollout has been out of control in terms of any kind of consistency,” Frongello said.
He said it was “horrible” that people his age were allowed to be vaccinated before doctors and nurses but decided the immunizations available at the convention centers wouldn’t go to health care workers anyway.
Nor did they go to Frongello and his dad Tuesday after the website crashed on him multiple times.
“Every time I get partway through the process, I could see the number of open appointments dwindling,” the Orlando resident said Monday just before midnight. “And now when I try to register, all the slots are filled. I never got to the final booking page at all.”
Contact Elizabeth Weise at [email protected]
Contributing: Mike Stuka
This article originally appeared on USA TODAY: COVID vaccine: Florida’s rollout to seniors gets off to a rocky start