DHEC board, not agency health experts, to have last say on COVID vaccine allocations
The state Department of Health and Environmental Control’s politically appointed governing board, not agency health experts, will determine how limited supplies of COVID-19 vaccine should be allocated to counties.
DHEC acting director Marshall Taylor said Thursday that agency leaders felt uncomfortable deciding how to apportion the vaccine equitably across the state and had, therefore, asked DHEC’s board to make the call.
“Our board, they represent each of the congressional districts, and so they are out in those communities, and they have both rural communities in their districts and they have urban communities or counties in their districts,” Taylor testified Thursday before an ad hoc House committee convened to study DHEC’s COVID-19 vaccine rollout. “And so our leadership team came together and said this is not a decision DHEC (agency officials) should make.”
He said he expected the DHEC board, which is composed of eight members appointed by the governor, to make a decision Tuesday after the agency’s leadership team presents them with a range of vaccine allocation models.
Among the options are allocating vaccine doses to counties on a per capita basis or distributing them based on certain county health factors, Taylor said.
“You’ve got 63,000 doses a week,” he said. “How many doses go to Colleton County? How many doses go to Charleston or Greenville, et cetera? You can do that a couple of different ways.”
Taylor said the agency’s goal is to set a baseline rate for each county by the week of Feb. 1.
“The baseline doesn’t stick forever and, of course, allocations can change,” he said. “But we want to be able to tell providers you’re going to get this number of doses for the next two or three weeks and we’ll let you know if that’s going to change.”
State Rep. Russell Ott, D-Calhoun, expressed concern during Thursday’s meeting that DHEC’s board would play a pivotal role in deciding health policy.
“This is a board that is politically appointed by the governor, and I’m sure that each one of those members are going to be fighting for their congressional district that they represent,” he said. “That certainly injects a level of concern for me that, again, we’re not going to be allocating the vaccine in necessarily the way that it should” be distributed.
When asked why DHEC leadership had tasked its governing board with deciding how to allocate the state’s limited vaccine supply, an agency spokeswoman provided the following statement:
“As a state agency whose operations are overseen by the S.C. Board of Health and Environmental Control, DHEC has requested that the board consider and provide direction to DHEC regarding the method to be used to distribute vaccines equitably across the state.”
It’s not clear why agency leadership, which has not leaned on the board to decide other vaccine distribution policies, is now seeking its direction.
Only two of the board’s members appear to have relevant health care experience, according to their bios on the DHEC website.
J.B. Kinney, who represents the 1st District on the board, is a former senior vice president of operations for National Healthcare Corporation in South Carolina and past president of the South Carolina Health Care Association, and 4th District board member Robert Morgan is an anesthesiologist and medical director of the Greenville Healthcare Simulation Center. The board’s other six members have backgrounds in law, business and engineering, among other fields.
Vaccine shortage made equitable allocation necessary
The need to ration the COVID-19 vaccine comes as demand for it continues to outpace supply and more providers, including retail pharmacies and federally qualified health centers, start receiving and administering doses.
“We’re just not getting enough vaccine in to meet the demand,” Taylor said.
Prior to last week, DHEC had been able to fulfill most of the vaccine orders hospitals were placing. But as more residents have become eligible for vaccinations and new providers continue to come online, the number of doses the state receives from the federal government has not kept pace.
Hospitals received only 20% to 25% of the doses they requested the week before last, forcing some to cancel scheduled vaccination appointments for lack of supply. To prevent that from continuing to happen, Taylor said it was necessary for DHEC to devise a system of equitable allocation across the state.
“We want to be able to set a baseline for these providers so that they have some assurance that I’m going to get about what I expect so I can set my appointments,” he said.
To prepare them for a possible reduction in vaccine allocation, the agency recently sent providers updated guidance regarding what to expect from future vaccine shipments.
DHEC officials told providers they didn’t think the number of first doses the state receives each week from the federal government would increase any time soon and said they should request only the number of vaccine doses they expect to be able to administer in the week ahead.
South Carolina has received about 63,000 first doses of vaccine each week for the past month and has been allocated about 470,000 first doses total since the week of Dec. 14, according to the U.S. Centers for Disease Control and Prevention.
At the current pace of vaccine distribution, it would take another nine weeks before the state received enough first doses to inoculate all approximately 1 million Phase 1a individuals.
DHEC officials are hopeful the state’s weekly vaccine allotment will ramp up sooner than that.
Interim public health director Brannon Traxler said Friday she expected the state’s weekly vaccine haul to increase by spring, either because the Pfizer-BioNTech and Moderna vaccines become more widely produced, or because other vaccines currently in clinical trials receive emergency use authorization and hit the market.
In the meantime, DHEC has advised providers against planning any large-scale vaccination clinics requiring in excess of their baseline allocation without consulting the agency first and said such events would likely not be feasible until the state begins getting larger vaccine allotments from the federal government.
South Carolina Hospital Association spokesman Schipp Ames said health systems are aware that they’ll likely receive fewer weekly doses in the near term and are working to get shots in the arms of South Carolinians as quickly as possible.
As of Saturday, 203,367 people, or about 3.9% of all residents, had received their first dose of the COVID-19 vaccine, according to DHEC.