As vaccine eligibility expands, local health officials lament communication hiccups with state

Northern Illinois public health administrators talk vaccine rollout kinks, wins four months in

Sarah McCaskey, RN for the Carroll County Health Department, fills syringes with COVID vaccine Wednesday afternoon at a mass vaccination site in Chadwick.

Editor’s Note: This is part 1 of a Shaw Media series investigating the COVID-19 vaccine rollout in northern Illinois since vaccines arrived in late December 2020. For more COVID-19-related news, go to shawlocal.com/coronavirus.

It’s been nearly four months since the COVID-19 vaccine made its way into northern Illinois, and as rollout expands this week to include all Illinoisans ages 16 and older, some local health officials said rocky communication with state officials is one roadblock to a smoother process.

With the global spread of the coronavirus, communication was bound to be a challenge on all levels, McHenry County Public Health Administrator Melissa Adamson said.

“Because this has been a fluid situation and we’re dealing with a novel disease and the science-based learning happens over time, I think some of that is to be expected,” Adamson said. “But, yes, I think some of it has created frustrations.”

Expansion issues

Illinois’ vaccine rollout was a phased approach initially, and upon arrival of vaccine supply in December, the Illinois Department of Public Health began issuing weekly shipments first to counties with the highest virus mortality-to-population ratio, and then to all subsequent counties.

In Will and McHenry counties, for example, the vaccine arrived the week of Dec. 27. In Kane and La Salle counties, it arrived the week of Dec. 13.

Phase 1a included front-line health care workers and adults living in long-term care facilities only, then was expanded to first responders. Next came Phase 1b, which opened up vaccine eligibility to certain essential workers such as teachers, those 65 and older and first responders. Phase 1b Plus then was announced by Gov. JB Pritzker on Feb. 25, including those 16 and older with health conditions making them high-risk for severe complications from the virus. That “plus” portion was expanded weekly in March, with different groups broken up by industry, such as religious leaders, food service workers and media.

On the heels of President Joe Biden’s declaration that all adults in the U.S. would be eligible to receive a vaccine by May 1, many Midwestern governors said their states could do it sooner. In Iowa, all residents of age became eligible April 5. In Missouri, it was April 9. And in Illinois, April 12.

But from February to March, amid a temporary reduction of weekly vaccine shipments announced Feb. 12 for many counties, including DeKalb, local health officials said they couldn’t keep up with the state’s expanded eligibility timeline and a lack of vaccine supply on the ground.

As local health officials balance significant vaccine demand with ever-changing supply from the state and the need to schedule mass vaccination clinics ahead of time for those on the ground, they’re also bearing the brunt of public scrutiny.

When asked whether the state feels confident in its ability to meet vaccine demand after the April 12 expanded eligibility date, IDPH representatives did not respond to requests for comment. The IDPH also hasn’t responded to multiple Freedom of Information Act requests regarding communication between state and local health officials.

Shortly after Pritzker announced March 18 vaccine eligibility would be expanded to reach all residents ages 16 or older, health departments across Illinois, including DeKalb, McHenry, Carroll, Whiteside and Lee counties, elected to withhold expanded eligibility until the current phase, Phase 1b Plus, could be fulfilled due to limited supply.

Mark Pfister, executive director for the Lake County Health Department, said he learned about the governor’s announcement when the rest of the state did.

And in February, many older Lake County residents were “not pleased” with Pritzker’s plan to expand eligibility in the state’s Phase 1b to additional groups with a qualifying medical condition, Pfister said.

“It caused a huge communication issue for us because our hotline just lit up of concerned senior citizens worried that they were now going to have to compete with others,” Pfister said of the February announcement.

Pfister said he still doesn’t learn about certain announcements – including that some counties where demand had slowed would be able to expand eligibility to anyone older than 16 – ahead of time, but now, he said, state officials do a better of job of communicating that not all counties will be impacted by the announced change.

He’d still prefer to have the information ahead of time, but this approach helps.

Lisa Gonzalez, public health administrator for the DeKalb County Health Department, said at the time of the April 12 announcement that it was “hard to believe we’d be able to accommodate that number of people who will all of a sudden become eligible.”

“That’s how it’s been since the beginning, and I don’t see that changing anytime in the near future,” Gonzalez said March 18.

In McHenry County, Adamson echoed Gonzalez’s assessment of the expanded eligibility announcement and said at the time that the department still was working its way through the local 65-and-older population, incorporating some essential workers.

“The changes to the priority groups create additional pressure and expectations on the local health departments or the counties when we were still getting limited doses,” she said. “So that eligibility change does not necessarily correlate with more vaccine [doses being] available at the local level.”

These changes made many people who fell into those newly prioritized groups feel like they should be able to receive the vaccine immediately, but local health departments are moving at different paces based on vaccine supply and demand within their communities, Adamson said.

“So then, when you go and try to register or schedule for an appointment and are unable to obtain one, I think that creates additional frustration in the public,” Adamson said.

When the second change to the Phase 1b priority group came, Adamson said the health department received some advance notice but was asked not to disseminate the information before it was officially released by the state.

“Getting ahead of that message has been a challenge because if we find out at roughly the same time that the public finds out, then we are reacting to the information that’s been put out versus getting ahead of it and putting out information that’s specific to our county,” she said.

Case uptick response rollout

Just before Easter, a rise in the number of COVID-19 cases in Region 1, which includes DeKalb, Lee, Ogle, Whiteside and Carroll counties, prompted the state to send National Guard troops and bumped-up batches of vaccine to the Sauk Valley to staff one-day mass vaccination clinics for which participants would, for the first time, set up their own appointments.

The announcement that followed by the IDPH regarding the clinics was another cog in the messaging.

The IDPH news release, sent at noon March 26, detailed mass vaccination clinics scheduled over the following two weeks – one each in Carroll, Whiteside, Lee, Ogle and Boone counties – which would be run with the help of the state National Guard. The dates were set for March 31 in Carroll, April 1 in Ogle, April 2 in Boone, April 3 in Lee and April 5 in Whiteside.

The news release included information about the type of vaccine and size of shipment to each county, eligibility requirements and how to sign up.

The problem, local health officials said, was that some details in the release were incorrect or missing.

No times or locations were provided for the dates listed for each county’s emergency vaccination event.

In the state’s announcement, the health department websites listed for Lee, Ogle, Whiteside and Carroll counties were incorrect, health officials said, as they initially were not using the sites to schedule vaccine appointments, said Stephenson County Health Department officials, who oversee the Carroll County Health Department.

Many health departments, including Carroll County, which has a staff of five for the county’s population of 15,000 and is overseen by neighboring Stephenson County, still were transitioning their vaccine appointment scheduling to a digital model.

In its March 26 announcement, the IDPH also indicated those five health departments could expand eligibility to the 16-and-older crowd early “at their discretion” but didn’t provide information on how to find out which county would make that call.

And in the mass vaccination clinics set up in Region 1 for emergency COVID-19 case mitigation, the Johnson & Johnson vaccine was used. That vaccine has been approved only for those 18 and older, but the state’s news release March 26 did not include that information, an oversight health officials in DeKalb said could confuse those vying to get vaccinated.

Another method of vaccine distribution changed that day: The state began to roll out a self-scheduler, giving Illinoisans a chance to sign up for a vaccine appointment online through the state or county websites.

Whiteside County Health Department was using the IDPH website, not its own, spokesman Cory Law said.

And in Carroll County, accustomed to getting a couple hundred vaccinations a week, the health department now expected 800 more doses for the emergency clinic, which was to be held March 31, a week after the state’s announcement.

That’s a lot more coordination for a health department the size of Carroll County, health officials said.

“We received very little advance notice,” said Dawn Holland, who coordinates Carroll County’s vaccine clinics.

Holland said that once the date was confirmed for the March 31 emergency clinics, her team reached out to Jim Klinefelter, the county’s emergency services and disaster agencies director.

“He was able to coordinate a group of volunteers, phones and computers to help us make over 600 phone calls,” Holland said. “We worked like crazy Friday and Saturday [to notify everyone on their waiting lists].”

The two most populous counties, Lee and Whiteside, were allotted only 600 vaccines. Ogle got 1,200 doses.

In response to questions from Shaw Media in the wake of the March 26 news release, Ogle County Health Department Administrator Kyle Auman said in an email that the health department “has been inundated by new COVID-19 cases, appointment phone calls and working to plan several different vaccination events for the upcoming weeks.”

Auman said his team was “working feverishly” to meet the many demands placed on the department.

“We have been fielding several troubling and concerning phone calls related to scheduling appointments for upcoming events,” Auman said in his email. “Therefore, we will not be releasing the site location until the state is finished programing the appointments scheduling software, which should be completed very soon.”

He said his team in Ogle County was two days into planning an event where they were expected to administer 1,200 doses in a single day “while maintaining other community vaccination clinics and supporting other vaccination partners locally.”

“I do not know how the 1,200 doses were assigned to Ogle County, that was the number given to us by [the IDPH],” Auman said in his email. “The link in IDPH’s press release is not the link that will be used to register for an appointment for April 1, we are still waiting on the state to create that link. We will provide additional information as it becomes available.”

That link became available March 29.

As of March 30, all four counties’ mass vaccination clinics were booked solid.

Doses on the rise

“This is a ballet, and communication is a huge part of ballet because people train for all the different moves that a dancer has to make. That’s choreographed, and so that’s where the communication is so important.”

—  Mark Pfister, executive director for the Lake County Health Department

It’s not all gloom and doom, however, said Michael Isaacson, assistant director of community health at the Kane County Health Department.

He said Kane health officials have been in close contact with the state and working well with the IDPH.

“There are a lot of moving parts, and when taken into account of the investigations of [COVID-19] cases, to administering doses and the ordering, delivery and administration, I’d say we’re working closely with them,” Isaacson said. “There are a lot of moving pieces, and everybody is communicating the best they can. This is the largest public health response in my lifetime, and I don’t have complaints about how anything is being managed and communicated. Things change rapidly, and I appreciate how much complexity there is in all of this.”

In the past few weeks, vaccine shipments from the IDPH to local health departments across northern Illinois have increased.

In McHenry County, when asked what the state could do differently when it comes to communicating changes, Adamson said that, given the fluid nature of the situation, she was not sure there was any more they could do.

However, she said she has noticed that in recent announcements, the state has added in some language acknowledging that the timeline of the progression through vaccine distribution phases won’t look the same in every county. The state also has been incorporating more information about how vaccine supply and availability still is a major issue in many counties, which Adamson said she is thankful for.

In Lake County, Pfister said vaccine rollout is dependent upon federal partners communicating with the state, which in turn communicates with local health officials. And in counties such as Lake, where the health department is responsible for distributing vaccine supply to 92 other community entities, every message counts.

“This is a ballet, and communication is a huge part of ballet because people train for all the different moves that a dancer has to make,” Pfister said. “That’s choreographed, and so that’s where the communication is so important.”


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