A day after Clark County Public Health released data showing the state's vaccine allocation to the county hasn't been proportional to other counties, Washington's secretary of health admitted the state needs to better help local health jurisdictions that have received smaller allocations from the state.
Washington Secretary of Health Dr. Umair Shah made those comments during a congressional hearing Wednesday, after he was questioned by Rep. Jaime Herrera Beutler, a Republican from Battle Ground.
Public Health's data, provided to The Columbian Tuesday night, shows that a study of 15 Washington counties, looking at the five counties with the highest, lowest and median population sizes, revealed that Clark County ranks 14th out of 15 in the allocation of first doses per 1,000 residents and first-dose allocation as a percentage of the total county population.
Herrera Beutler said what has happened to Clark County is "completely unacceptable," and challenged the state Department of Health to fix the disparity.
"The current metrics Public Health is using are not creating equity, but instead are causing Clark County to have this weird lottery-style system for all these people who are eligible," Herrera Beutler said.
"We've heard repeatedly that this is a supply issue, but given this revelation, I think it points to a systemic issue in how the state chooses to allocate the vaccine," Herrera Beutler told Shah. "I need to know what your department is doing to rectify this error and why Clark is being shorted vaccines."
Shah said the state is considering multiple metrics culled from local providers to determine vaccine allocation. He said a county's vaccine-eligible population and the county's throughput — ability to vaccinate — have been two important decision metrics.
Vaccine shortages have plagued the country's rollout, and contributed to long waits for vaccination.
Shah acknowledged the allocation system has not been perfect, especially in the transition from vaccinating health care workers to vaccinating those 65 and older and those 50 and older who live in multigenerational homes.
"When you take all that together, it is absolutely imperfect when it comes to jurisdictions," Shah said. "What we are doing now, is we are going back to the ones that have the gap, if you will, and trying to figure out what we can do."
Shah, who recently took the secretary of health position after working for Harris County Public Health in Houston, Texas, said he understands the importance of keeping local jurisdictions in the loop and that he wants to "continue to do a better job of working with the local health jurisdictions."
The state Department of Health also told The Columbian in a Wednesday email that, over the weekend, it offered more vaccine to local jurisdictions that were experiencing a gap in vaccine allocation and reached out to those counties again on Wednesday. The statement said the gap is mostly due to "second dose reallocations in recent weeks."
"This is a complex issue with many moving parts," the statement reads. "The good news is, our allocations from the federal government are increasing, and our vaccination rates across the state are, as well. More than 90 percent of the 1.5 million doses delivered to Washington have been administered, which helps protect us all by building community immunity."
County takes action
The Clark County Board of Health also decided to take action Wednesday morning by agreeing to send a letter to Gov. Jay Inslee and other state leaders, asking for clarification on vaccine allocation in hopes of remedying the situation.
Clark County Councilor Gary Medvigy first proposed the letter at Wednesday's Board of Health meeting.
"We need to get this message out," Medvigy said Wednesday. "We always, as a county, wanted to be a model of distribution and always in the position where we had more capacity to vaccinate than we had vaccines. We didn't want the state to say, 'Hey you're not getting them out. We're not going to give you more vaccines.' So we've done all that. We have our infrastructure in place and we have the capacity up."
Clark County Public Health Officer Dr. Alan Melnick told the Board of Health that public frustration has grown because Clark County is near the bottom of Washington counties for vaccine administration on a per 100,000 population basis.
"The providers have the capacity to give the vaccine, and they'd be giving it if they had the vaccine to give," Melnick said. "Our issue right now is vaccine allocation and how many doses we are getting."
According to the data, the state has allocated 45,950 first doses of vaccine to Clark County over the last 11 weeks. That means Clark County has received 94.1 doses per 1,000 people — doses for 9.4 percent of Clark County's population.
The next largest county, Spokane County, has received 30,325 more first doses than Clark County, even though Spokane County has only 35,000 more residents. Spokane County has received 145.9 doses per 1,000 people, or doses for 14.6 percent of its population.
According to the U.S. Census Bureau, 16 percent of Clark County's population is 65 and older, and 16.6 percent of Spokane County's population falls in that category.
Clark County has administered 44,941 doses of the vaccine, and 16,928 residents are fully vaccinated, receiving both doses. According to state Department of Health data, 8.26 percent of Clark County's population has received one dose of the vaccine and 3.47 percent has received both doses.
In Spokane County, those numbers are 13.48 percent and 5.28 percent, respectively.
Clark County Council Chair Eileen Quiring O'Brien said she's frustrated by the allocation disparities, referencing a chart with data shown at Wednesday's meeting.
"If (the state is) using metrics to distribute the vaccines, looking at this chart, it does not look fair," Quiring O'Brien said. "This is not our fault. Our public health department has an incident management team that is ready to administer vaccines. We have health care partners who are ready, willing and able to distribute vaccines. We don't have the product to give. I just think it needs to be stated that it's not the county who is doing this, as far as limiting supply or not acting in an efficient way."