Why some Vermonters still can’t get a COVID vaccine
Since the latest vaccine became available in September, many Vermonters who want a COVID shot haven’t been able to get one, especially people 65 and older, and families with young kids.
Supply is slowly improving, but as of last week, around 12% of Vermonters had received an updated COVID shot, about half the number of people who’ve had a flu vaccine.
Health care workers say that lack of availability is largely because the federal government is no longer covering the cost of these shots.
“Prior to this year, we experienced this lovely, wonderful place where we were a little spoiled — the vaccine was there when we needed it, and it was there all over the place,” said Georgia Maheras, an executive at Bi-State Primary Care Association, a nonprofit that represents over a dozen community health centers in Vermont.
“Now we're in a situation where there is generally a slower production of vaccines,” she said.
For some people, this feels like a big step backwards, like for Steve Crimmin, who’s 69 and lives in East Thetford.
"This commercialization — this is the best argument I can think of for a single payer health care plan, because it just doesn’t work well,” he said.
How most doctor’s offices get COVID vaccines
The Vermont Department of Health has a contract with the Centers for Disease Control and Prevention, where they order the vaccines from the federal agency, then distribute the shots to doctor’s offices and community health centers throughout the state. Those providers don’t have to pay for the vaccines up front.
But the CDC has a limited number of shots. Every two weeks, they tell the Health Department how many vaccines they can send, apportioned based on the size of Vermont. The department has always ordered the maximum amount they can. Still, so far, there hasn’t been enough vaccines to meet demand.
“We only have access to the doses that CDC allocates to us,” said Patsy Kelso, the state epidemiologist.
“This commercialization — this is the best argument I can think of for a single payer health care plan, because it just doesn’t work well."Steve Crimmin, East Thetford
And the program is only meant for people under 65.
“Medicare does not pay into our program, and neither do the insurers who insure people 65 and older,” Kelso said. “Because they don’t pay into our program, we can't use our program funding to purchase vaccines for people 65 and older.”
So people who fall into that older age bracket, like East Thetford's Steve Crimmin, are often told by their doctors that they have to go to a pharmacy to get a vaccine.
Pharmacies purchase vaccines from wholesalers on the commercial market, but this has its own complications.
How most pharmacies get COVID vaccines
While pharmacies provide a huge number of vaccines every year, COVID vaccines pose distinct challenges. They have to be shipped and stored frozen, which usually means there's a minimum number pharmacies have to order from suppliers.
Then once the vaccines are thawed, they lose their potency shortly thereafter.
“You have to give it within the 30-day window, which is causing a very big logistical headache,” said Ryan Quinn, a pharmacist at Lakeside Pharmacy in Burlington.
He said that's different than a flu shot, which only requires refrigeration and doesn't expire for nearly a year.
The COVID vaccines are also more expensive than a typical flu vaccine, over $100 for a single dose. And many private insurance companies will only reimburse independent pharmacies like Lakeside for the cost of the vaccine.
"We lose money on each and every vaccine that walks through the door some days,” Quinn said.
A few weeks ago, Lakeside Pharmacy stopped administering COVID vaccines. Quinn said they couldn’t afford to keep offering the shots.
“Because of this now insane risk, where if we misjudge what we’re seeing, our pharmacy can be on the hook for a couple boxes of shots that are worth thousands of dollars that we just burn,” he said.
What to expect over the next few months
For many of the big pharmacy chains though, offering COVID vaccines is still profitable. And as more people get vaccinated, there will be less competition for limited appointments.
The Vermont Department of Health Access also enacted a change earlier this month allowing people with Medicaid to be reimbursed for vaccines at pharmacies, including kids ages 3 and older. That creates more opportunities to be vaccinated outside of a doctor’s office.
Meanwhile, the state program will continue to provide vaccines, and as supply improves, more health centers will offer walk-in clinics.
“The hope is that there will be clinics all over the state through our health centers and the free clinics,” said Georgia Maheras, with the Bi-State Primary Care Association. She expects those to ramp up in December, with a focus on serving people who are uninsured or underinsured.
“But they will accept any takers — anyone who walks in," Maheras said.
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Lexi Krupp is a corps member with Report for America, a nonprofit national service program that places journalists in local newsrooms to report on under-covered issues and regions.