On Thursday, Colorado Lt. Gov Dianne Primavera did what hundreds of thousands of Coloradans her age are wishing they could also do.
“I’m in the wave that’s getting the COVID vaccine,” Primavera, who is 70 and a cancer survivor, said in a video posted to Facebook as she sat next to a health worker preparing to put a needle into her arm. “I’m excited to be here and I want to encourage everyone who is 70 to sign up, get vaccinated and let’s see an end to this pandemic.”
Almost immediately, the comments on the post began filling up with stories of frustration from across the state, illustrating the turbulent way the coronavirus vaccine has rolled out..
“Pueblo we don’t even have a list for me to get on!” one commenter wrote. “I’m 70+ and nothing from our health department!!”
“I am also a cancer survivor and over 70 but on a wait list,” another wrote.
Months ago, Polis, medical experts and state public health officials mapped out an orderly plan prioritizing when different groups of Coloradans can get the vaccine. But as that plan – now twice revised – has been put to use, the on-the-ground reality so far has been much less orderly.
Communities are winding their way through their own vaccination lines at dramatically different paces. Seniors in Summit and Eagle counties – among the wealthiest communities in the state and the healthiest in the nation – have already begun receiving shots, while hospitals and health departments in the Denver metro area largely don’t yet have any vaccine to spare.
Cherry Creek School District developed a partnership with Centura Health to access vaccines for its staff members beginning at the turn of the year, while other districts were left scrambling to come up with their own plans.
But the emerging disparities are also unpredictable and don’t necessarily match with an easy understanding of haves and have-nots. Among the first older Coloradans to receive the vaccine were seniors in the small, economically disadvantaged southern Colorado towns of San Luis and Center, after the state helped the communities stage drive-thru vaccination clinics.
“These are exactly the kind of events we are looking to replicate across the state,” Polis said gleefully during a Wednesday news conference. “We want to go where the need is.”
Rural hospitals have been able to move faster at vaccinating their employees than large urban hospital systems. And some small hospitals, like the one in Hugo, have been able to secure enough vaccine to also inoculate people living in attached long-term care facilities, rather than waiting for a federal program that state officials have complained is moving too slowly in providing vaccinations to nursing homes.
Even as individual communities are left guessing about exactly how and when they’ll be able to inoculate their own populations, state leaders have expressed confidence that Colorado’s rollout will not lead to the same kind of persistent inequities that have made the pandemic so punishing for communities of color and the poor. Instead, they argue, everyone within the state’s priority groups will have the chance to be vaccinated with their group. It just may take a few weeks or months to get to them.
“I think really the disparity is one of timing,” said Julie Lonborg, a senior vice president at the Colorado Hospital Association. “In the end, everyone will get vaccinated who wants to. It’s going to be a timing disparity, instead of a disparity of one group getting the vaccine and one group not.”
Conflicting goals: Speed and orderColorado has been preparing for months to distribute coronavirus vaccines, but key variables remained uncertain throughout that long process.
For one, the state was never sure how much vaccine it was going to get and when. And neither the state nor federal governments settled on a priority scheme until after vaccine doses were already on their way.
Polis amended the state’s prioritization plan on Dec. 9, just days before the first doses arrived. The Polis administration amended the plan again on Dec. 30 to change who would be next in line for vaccination in Phase 1b of the state’s plan, after thousands of doses had already been given and some communities were fast approaching that phase. The second set of changes came after a federal committee issued new guidance on prioritization in mid-December – recommendations came after states had already assembled their own plans.
In a news conference on Dec. 30, Polis declared, “Any Coloradan 70 and up can now legally receive the vaccine.”
But the changes caught hospitals, pharmacies and local public health agencies, which will do the grunt work of administering the vaccine, off guard. Some hospitals still haven’t finished vaccinating all of their workers and aren’t expected to do so until next week. Several local health agencies released statements saying they were still working through their plans for vaccinating older Coloradans.
That confusion persisted into this week. On Tuesday, in response to questions from The Sun, Boulder County Public Health spokesperson Chana Goussetis said her agency had received verbal guidance from the Colorado Department of Public Health and Environment to treat Phase 1b like two sub-subphases. The guidance highlighted the location of a previously unexplained dotted line in a chart the state had distributed showing who is eligible to be vaccinated in the phase. CDPHE confirmed this later in the day, when it announced that first responders and those 70 and older should be vaccinated first, ahead of other groups also in Phase 1b, such as teachers.
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As they were deluged by calls from older residents wanting to know how they could get vaccinated, local health agencies pleaded for patience.
“We want to reiterate that we are still on Phase 1a and early Phase 1b of residents who qualified for the previously approved tiers,” Cali Zimmerman, the Denver Department of Public Health and Environment’s emergency management coordinator, wrote in an email. “With limited vaccine supply, we are working as quickly as possible to facilitate vaccine distribution to all qualifying residents.”
Meanwhile, concerns began to grow both locally and nationally that vaccine distribution wasn’t happening fast enough. As of this week, Colorado has received 243,000 doses of vaccine. Through Thursday, the state had reported vaccinating 138,607 people – a rate that Polis says puts Colorado among the top states in the nation but that still leaves a lot of doses so far unused.
But Colorado health leaders say these two goals – vaccinating people in the order they deserve to be vaccinated and vaccinating people quickly – are in conflict. And that means Coloradans are going to have to be somewhat flexible.
“This was all done with the intent that we are not going to waste a dose of vaccine,” Lonborg, of the hospital association, said. “If we’ve got it, we’re going to find a way to vaccinate somebody who needs to be vaccinated. That’s maybe a little more confusing than we had hoped for, but I think that’s what’s going to happen.”
Other leaders encouraged people to see the big picture. Colorado is receiving about 70,000 doses of vaccine a week. There are nearly 550,000 Coloradans age 70 and older who are eligible for vaccination in Phase 1b, along with 125,000 health care workers and first responders who are also in the phase’s highest-priority level. It’s a pretty serious bottleneck.
“I don’t have to tell you that people are anxious to return to some semblance of a normal life,” said Bob Murphy, the Colorado state director for AARP, which represents older Americans.
Doctor’s offices, hospitals, pharmacies and health departments are all overwhelmed right now with people calling for information. He’s heard a lot of frustration. He urged the federal government to provide more resources and vaccine manufacturers to move as fast as they safely can. But, as for the state’s response?
“I think, all things considered, it’s going reasonably well,” Murphy said.
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