Here’s how DHEC plans to ration COVID-19 vaccine doses in SC
Lacking the supply necessary to meet South Carolina’s demand for COVID-19 vaccine, state health officials will begin planning to ration doses to counties on a per capita basis.
The S.C. Department of Health and Environmental Control board decided Tuesday that allocating the state’s scarce supply of vaccine on a per capita basis was the most efficient solution until a greater number of doses are flowing into the state.
The move comes as the state remains unable to distribute providers as many vaccine doses as they’re requesting following the expansion of Phase 1a eligibility earlier this month to include nearly 1 million South Carolinians.
The DHEC board chose the per capita distribution model over another model presented to them that considers age and various social factors such as race and socioeconomic status.
State health officials will spend the time until DHEC’s next board meeting ironing out details of a per capita distribution model, preparing providers for a shift in allocations and working through any possible issues, such as ensuring fair distribution to rural areas, in preparation for a more thorough discussion of the plan on Feb. 11.
“I think (at the next board meeting) we can come back with data to show you where the doses are being used, who’s using them and better information,” acting director Marshall Taylor told the board Tuesday. “And based on that you might decide to make a change then, too. But at least we have a path now of where we’re going and I think that will help the entire state from a planning perspective.”
DHEC board member Rick Lee said he favored a per capita distribution model because he thinks vaccines should be allocated in a “very simple and straightforward” manner so that everyone understands how the process works.
“Whatever gets it out the fastest, to me, we just got to follow that path,” said Lee, a Rock Hill resident who represents the state’s 5th Congressional District on the DHEC board.
Lee also made the recommendation, adopted by the board, to give health officials time to review the per capita distribution model and report back at the next board meeting with any problems that require adjustment before final implementation.
“I think if we can give them that leverage and that leeway that it’ll allow us to have something that when we roll it out, it works,” Lee said.
South Carolina, like many states, is dealing with a COVID-19 vaccine shortage that has forced many providers to delay scheduling appointments or, in some cases, cancel existing appointments for lack of supply.
The state continues to add more vaccine providers, including retail pharmacies and federally qualified health centers, but still receives the same weekly allotment of doses from the federal government.
As more providers come online, each provider’s share of vaccine is likely to decrease until South Carolina starts getting more than the roughly 63,000 first doses it currently receives each week.
Prior to a report Tuesday that the federal government would be increasing weekly vaccine allotments next week, DHEC officials had said they didn’t know when the state’s federal vaccine allotment would increase and didn’t expect it to happen in the near future.
A DHEC spokeswoman did not immediately confirm whether the state would be receiving 16% more doses next week, as the Washington Post reported. Even if it does, the supply of vaccine would not be nearly enough to meet current demand.
Until vaccine supply meets demand, DHEC will ration doses in a manner determined by its board.
Taylor said Thursday at a legislative oversight committee meeting on vaccine distribution that the DHEC board, whose members are politically appointed and represent each of the state’s congressional districts, knew more about the needs of their districts and were thus better equipped to decide allocation strategies.
To help inform the board’s decision, DHEC interim public health director Brannon Traxler on Tuesday presented the governing body with two allocation options — a per capita model (Model A) and a model that considered population, age and a U.S. Centers for Disease Control and Prevention metric known as social vulnerability index (Model B).
Under the per capita model, 95% of the state’s weekly vaccine shipments would be doled out to counties based on their relative share of the state’s population with the remaining 5% set aside as a reserve.
The alternative model would use a formula that weighed a county’s relative population (70%), its social vulnerability index rating (15%) and its over 65 population (10%) to render an allocation amount. Model B also would place 5% of weekly vaccine doses in reserve for unexpected situations.
The reserve doses would not serve as a stockpile that would accumulate over time, DHEC officials said.
Traxler said she wasn’t aware of any states that currently used either of the models presented, and said many states had not publicly disclosed their allocation methods.
Board members Alex Singleton, of the 6th District, and Jim Creel, of the 7th District, who both expressed concern about equitable vaccine distribution to rural counties, posed the primary objections to adopting a per capita distribution model.
“We have to pay attention to not just a numbers game, but the most vulnerable,” said Creel, the lone board member who voted against moving forward with the per capita distribution plan. “Those that are at greatest risk, the most vulnerable, need to be at the head of the list.”
Taylor said the agency was focused on ensuring equitable distribution to rural communities and that it had been the state’s top priority, even before the first doses of vaccine had arrived in South Carolina.
This story was originally published January 26, 2021 at 4:22 PM.