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Rural counties struggle to get vaccines

Baylor Scott and White Medical Center-Marble Falls

The Texas Department of State Health Services designated Baylor Scott & White Medical Center-Marble Falls as one of 82 COVID-19 vaccine hubs statewide. The state, however, hasn’t designated a hub in Llano County and hasn’t distributed additional COVID-19 vaccines to the county’s healthcare providers since a 100-dose allotment the week of Jan. 4. Staff photo by Daniel Clifton

Earlier in January, the state of Texas announced its COVID-19 vaccination plan would follow a “hub” approach to vaccine distribution, which has Llano County Judge Ron Cunningham concerned about future allotments to his rural county.

“We had one allotment of a hundred doses, but that’s been it since then,” he said. “Thirty-seven percent of our population is over 65, which puts a lot of our residents in line for getting a vaccine, but we just aren’t getting any.”

Starting the week of Jan. 11, the Texas Department of State Health Services began emphasizing the hub approach to distribution with the idea of getting doses to facilities and providers that could serve a large number of people in a relatively short period of time. 

Llano County has no hub provider, as of yet.

The DSHS has designated Burnet County’s Baylor Scott & White Medical Center-Marble Falls a hub, starting the week of Jan. 25. It’s scheduled to receive 975 doses of the Pfizer vaccine. 

Currently, Texans who fall under the state plan’s Phase 1A and Phase 1B categories are eligible to be vaccinated against the coronavirus that causes COVID-19. These groups include healthcare workers, long-term care facility staff and residents, ages 65 and older, and ages 16 and older with serious medical conditions. 

Cunningham said in October that four Llano County locations submitted paperwork to become a COVID-19 vaccine provider, and possibly a hub site, but only one location, Hill Country Direct Care, has made a DSHS list. It’s still not a hub.

The county judge said the other three sites are following up with the state and could become distribution sites. 

However, with the state emphasizing hubs, Cunningham is worried the DSHS is overlooking rural counties such as Llano County. He wrote a letter to Dr. John William Hellerstedt, DSHS commissioner, outlining his concerns. 

“I would like to see the rural counties better represented by the (Expert Vaccine Allocation Panel),” Cunningham added. 

The panel is an appointed team of health experts that makes recommendations to the commissioner on COVID-19 vaccine allocation. Hellerstedt has the final approval. 

Cunningham said Llano County has developed a COVID-19 vaccine distribution plan, something required by the state to become a hub. 

“It’s a pretty detailed plan,” he said. “We could probably do 400 doses a day.

“If we could become a hub, we could take vaccines to Mason and San Saba counties,” Cunningham added. 

Texas receives a regular allotment of vaccines from the federal government and then distributes those across the state. Each week, the DSHS announces where the vaccines — both the Moderna and Pfizer versions — are going. The federal government is providing 332,750 first doses of the COVID-19 vaccine to Texas the week of Jan. 25. The DSHS will distribute those doses to 212 providers across Texas, 82 of which are designated hubs.

The biggest hurdle, state and federal officials say, is the limited amount of vaccine doses available. Currently, only Pfizer and Moderna have been granted U.S. Food and Drug Administration emergency use authorizations. Both vaccines require two doses to be effective.

However, Johnson & Johnson is expected to present a vaccine for FDA review as early as late February. Early indications are that this could be effective against the virus as one dose. The addition of this vaccine and others could help address availability issues.

Cunningham said he and several local leaders meet at least twice a week by phone or Zoom to discuss COVID-19 and related issues in the county. 

“We want everyone to know that we are working hard for them,” he said. 

If Llano County officials submit an application this week to the state for consideration as a hub, Cunningham said they could find out in as little as a week if they receive it. 

“We just have to prove to the state we can do it, and I believe we can,” he said.

Visit the COVID-19 Resources webpage for more coronavirus-related stories and information, including a COVID-19 FAQ and where to sign up for vaccinations.