For starters, the COVID-19 vaccine doses intended for Ness County in west-central Kansas landed somewhere else.
“That was my first clue we had a problem,” said Carolyn Gabel, the county’s public health administrator.
Then someone from Dodge City called. Those vials bound for Ness City? They hadn’t been kept as cold as needed. They were no good anymore and needed replacing.
Eventually, she had to drive to the next county to the west, pick up a different set of doses, put them in her cooler and dash back across 30-plus miles to her office.
“Instead of having the vaccine before Christmas like we should have had,” Gabel said, “we didn’t get it until after Christmas.”
In some parts of the state, things have gone a little smoother.
But the rollout of a potentially pandemic-ending vaccine in Kansas — a state still seeing some of the highest infection rates in the country — looks at best uneven. And that’s put the state in last place, at least in terms of reporting, for the rate that it’s vaccinated its residents against the killer virus.
Larger population centers in Kansas don’t have the lost-package problems of Ness County, but many have had trouble getting the vaccine in their freezers transformed into shots in the arms of health care workers.
Public health officials across Kansas say they’ve found themselves regularly unsure — often lacking clear instructions from Topeka or Washington — on how best to get the most people vaccinated in the quickest way.
Gabel got four vials of the Moderna vaccine. It was enough for about 40 doses. But other than receiving the vaccine with some needles and syringes, she wasn’t really told anything.
She had to figure out what paperwork to use, what patients were required to know and how to file reports with the state and federal government by herself.
“There was just a lot more prep work to this than what we had any idea about,” she said.
Other smaller counties had issues, too. The Coffey and Osage county health departments disputed the state’s claim on Monday that all 105 counties had received vaccines. Neither had.
By Tuesday afternoon, shortly after raising the issue, the Coffey County Health Department reported it had received 80 doses earmarked specifically for health care workers.
In larger counties, the rollout has gone a bit smoother, but imperfectly.
In the Wichita area, the Sedgwick County Health Department got about 10,000 doses. At the start of this week, it still had about 7,000 shots waiting for the right people to roll up their sleeves.
The county opened a vaccine clinic at Intrust Bank Arena on Dec. 29. It could vaccinate 50 people every 15 minutes. If only they’d show up.
On the first day the clinic was open, the county vaccinated 920 health care workers. After figuring out some minor issues, the clinic eventually managed to reach more than 1,300 in a day.
“If all of our appointments were full, we could almost give all of our vaccine out by the end of Saturday,” Sedgwick County health director Adrienne Byrne said. “So, it’s all a matter of health care-associated workers signing up.”
If open slots go unfilled, the county will be sitting on about 4,000 doses of the vaccine at the end of the week, even though it’s capable of administering them.
When Byrne asked the Kansas Department of Health and Environment if she could fill open spots next week with people considered to be in Phase 1b — essential workers such as firefighters, postal workers and teachers — she was told no.
“So we have to follow exactly what we are approved to do,” Bryne said. “And right now, it is that very first phase.”
She said communication has been a weak spot.
“This whole vaccine rollout across the country is going to have glitches,” she said. “It’s not going to be totally pretty because of the speed at which they’re trying to get the vaccine out.”
The state has yet to give any direction on how people will be prioritized beyond Phase 1 or what smaller counties should do once they’ve vaccinated everyone in that group.
KDHE declined to comment on the process of setting up those priorities until they are final.
For many county health departments, that’s too slow.
“It would have been nice by the end of last month to have all of this settled,” said Dennis Kriesel, executive director of the Kansas Association of Local Health Departments. “We didn’t need to have the vaccines ready to go to be ready to know what groups should be prioritized.”
The state ranks last in the country for per capita vaccinations, according to the latest data from the U.S. Centers for Disease Control and Prevention. The state argues that those numbers do not reflect reality because of issues with the reporting system. But the state has not provided its own numbers and both Gabel and Bryne said they haven’t had serious issues with their reporting.
The University of Kansas Health System hospital in Kansas City, Kansas, has been vaccinating just the people that work for it. (County health departments, on the other hand, have the trickier job of giving shots to people scattered among a myriad of employers.)
Chief Medical Officer Steve Stites said the hospital already had systems in place, and it just took a few weeks to scale those up. Now, he’s working on preparing to move on to vaccinating the public.
“It’s just taking us a while to get through those logistics in order to know how much (vaccine) we’re going to have, when we’re going to have it and understanding exactly who we want to give it to,” he said.
Just vaccinating the tens of thousands of frontline medical workers in larger counties like Sedgwick, Johnson and Wyandotte counties could take a month or more.
But in places like Ness County, there’s only about 200.
Because the two hospitals in the county where most of those people work got their own doses of the vaccine, almost all of the doctors, nurses, pharmacists and ambulance workers there have already been vaccinated.
That meant Gabel, the county health administrator, had more vaccine doses than people who fit into Phase 1a. With little to no guidance from the state, she figured she’d move on to Phase 1b, rather than let the vaccine go to waste.
“That leaves me able to get, like, volunteer firefighters,” she said. “And I’m focusing on teachers next, to be honest, because they’re also deemed essential personnel.”
She’s also reached out to grocery store workers and the post office. While she can get some that fit into Phase 1b, she doesn’t have enough vaccine to get everyone that does.
In the meantime, she doesn’t have any word from state health officials about when her next batch of doses will wind its way to Ness City. She said she won’t likely know when or if she’s getting more vials until the day someone calls to tell her to come pick it up.
“We should be at the top of the pile as far as information goes,” she said. “And we’re not.”
Brian Grimmett reports on the environment, energy and natural resources for KMUW in Wichita and the Kansas News Service. You can follow him on Twitter@briangrimmettor email him at grimmett (at) kmuw (dot) org. The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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