INVESTIGATION: RI’s Vaccination Plan Is Outdated and Includes Major Errors
GoLocalProv News Team
INVESTIGATION: RI’s Vaccination Plan Is Outdated and Includes Major Errors
Rhode Island Department of Health (RIDOH) officials can’t identify how many Rhode Islanders need to be vaccinated. More disturbing is that the State’s definition of how many need to be vaccinated to achieve “herd immunity” is significantly lower than President-elect Joe Biden’s Chief Medical Advisor Anthony Fauci's number.
These are just a few of the problems facing Rhode Island's vaccination program, according to an investigation by GoLocal.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTIn December, approximately 400 Rhode Islanders died from the coronavirus -- thus, delays in efficiently implementing the state's vaccination program will continue to cost lives.
Since March, 1,870 Rhode Islanders have died. And to date, Rhode Island has received 64,000 doses of vaccine and only vaccinated approximately 26,000. And 18,000 doses are being transferred to pharmaceutical chains like CVS intended for vaccinations at the nursing homes. Approximately 20,000 doses remain on the shelves.
According to RIDOH, the guiding plan for the rollout of the vaccine is a document prepared by the RIDOH and submitted to the CDC in October of 2020.
The problem is the state’s plan has major errors and has not been updated.
The 53-page document submitted to the federal government outlines that one of Rhode Island’s priorities is to immunize children. The document formally submitted to the CDC states, “Rhode Island will nonetheless prioritize the following critical populations for vaccination: Young adults, children….”
Just one problem -- neither of the two vaccines now approved for usage by the FDA and the CDC were approved for use by children.
Moreover, as early as March when Moderna and then Pfizer announced for Phase 1 trials of their respective vaccines that they never intended to seek approval by federal agencies for use by children.
But seven months after the two pharmacy giants announced their drug trials, RIDOH officials were either confused or were unaware of the two vaccines' intended usage.
When GoLocal asked RIDOH about the plan the including children the RIDOH admitted the error and said, “Children are not being vaccinated now. Children were listed in Phase 3 of that plan, with the understanding the plan was adaptable. Both Pfizer and Moderna recently began new vaccine trials including children. If children become eligible for an existing vaccine or a new vaccine, they will be included in future phases of the vaccination campaign,” according to RIDOH.
After GoLocal raised concerns about the flaws in the plan, RIDOH wrote in an email, "We have been using the October plan as a reference and guide, and have been making adjustments as we have gone along as the situation has evolved. We will be sharing an updated written plan."
RIDOH did not disclose when the updated plan would be distributed.
Key Legislative Leaders Not Aware of the State's Plan
In November, then Speaker-elect of the House of Representatives Joseph Shekarchi announced the formation of a House Task Force to oversee the state’s implementation of COVID-19 vaccine distribution.
The Task Force began meeting in October, hearing from Dr. Michael Fine, the former Rhode Island Director of Health and other health experts at the first meeting and CVS officials at the second meeting. State Representative Raymond Hull of Providence is the chair of the Task Force. He had never seen the RIDOH plan until GoLocal sent him a copy on Tuesday.
He also confirmed that RIDOH officials have not briefed him or his committee on the proposed plan.
RIDOH Doesn't Know How Many RIers Need to Be Vaccinated
After the Department admitted that children cannot be vaccinated and are not likely to be vaccinated in 2021, the agency could not identify how many Rhode Islanders need to be vaccinated. Both Moderna and Pfizer require a two-shot protocol.
Approximately, 80% of Rhode Island's population is over 18 years of age. Therefore, more than 800,000 are potentially eligible for vaccination. Presently, those that have previously tested positive -- more than 93,000 -- will not be vaccinated. Thus, the total universe may be around 700,000 residents who need two shots -- a total of 1.4 million. But there is more confusion in Rhode Island as to what is needed for herd immunity.
The state's inability to determine how many need to be vaccinated is that they are working off an incorrect or outdated standard for the percentage of the adult population that needs to be immunized. "Nationally, the herd immunity threshold being considered is 50% to 70%," said Joseph Wendelken, spokesperson for RIDOH in an email to GoLocal.
In response, GoLocal provided significantly different guidance provided by Dr. Anthony Fauci. "I would say 50% would have to get vaccinated before you start to see an impact," Fauci said in an interview on NPR on December 15, 2020. "But I would say 75 to 85% would have to get vaccinated if you want to have that blanket of herd immunity."
When GoLocal notified RIDOH of the conflict between the agency's standard and Fauci's statement, the agency did not respond.
The difference between RIDOH's number and Fauci's is tens of thousands of individuals needing to vaccination shots.
Need to Change Strategy
Dr. Fine, who was recently featured on CNN on the Central Falls vaccination initiative and appears daily on GoLocal LIVE, says the state needs to transform its program.
“I haven't seen any coherent or clear plan that lets Rhode Islanders or Rhode Island communities know when they will be getting a vaccine," said Fine. "There is a prioritization, but that is not a plan with locations, timelines, and logistics. Our Medical Reserve Corps and Local Emergency Management Agencies are second to none when it comes to organizing and executing operations that serve entire populations, like mass vaccinations. But nothing I've seen suggests they have been resourced and are ready to deploy for this kind of intervention."
Fine said it is critical for RIDOH to utilize the Mayors across the state and become more transparent. "A detailed plan with logistics, locations and timelines helps everyone get ready to share the work, and helps the public know what to expect," he said. "Vaccine supply is a challenge, but having people know when their turn is likely to be, based on supply and their risk group, is important to help people plan and also to help people remain calm, particularly in a time that is politically unsettled and many people are anxious already."
In addition, Fine said, "I think we over-emphasized testing for its own sake, and under-resourced/emphasized isolation, targeted testing, enforcement and vaccine planning. It looks like the state was trying to do this on its own, without involving the state's usual partners (primary care clinicians, cities and towns, and EMAs) in building a town by town and neighborhood by neighborhood strategy. My sense is that we overestimated the capacity of community based organizations to carry out this work, and undervalued cities and towns, which know their own communities best."
- Project vaccine allotment week by week
- Identify all primary care physicians who can vaccinate their own patients. Have them count the number of the patients who are over 75, from 65 to 74, from 50 to 65, and the number younger than that who are at high risk because of obesity, diabetes, heart disease and cancer.
- Create one central vaccination station for every 10,000 people. Identify location, layout the workflow, and identify staffing.
- Train volunteer staff.
- Ask all Rhode Islanders to register for vaccination now. That will give [the state] ages and locations and perhaps information about occupation.
- Prepare prioritized lists by community and primary care practice.
- As vaccine becomes available, distribute it immediately, asking each site to call in the people on its list in order of priority. "That's a big picture approach. Needs a more detailed treatment, of course, but that's the rough outline," said Fine.
- Don't take no for an answer. No roadblocks, Only opportunities for innovation.
- Create a comprehensive registration list.