US Community Health Centers Say They Have Given More Vaccines Than Government Data Show

By Rebecca Spalding

February 04, 2021

(Reuters) - Some U.S. community health centers say they are doling out COVID-19 shots far faster than government data suggests, likely accounting for some of a gap between how states and the federal government describe the availability of vaccine doses.

The federal government said only about 60% of nearly 56 million doses of vaccines from Pfizer Inc or Moderna Inc that have shipped have been used. Yet states such as New York have said that their supplies are stretched thin.

Community health centers, which often serve people of color and those with low incomes, are an important piece of the Biden Administration's plan for equitable COVID-19 vaccine distribution, which also includes pharmacies, mass vaccination sites, and hospitals.

Experts said data reporting issues at community health centers and other small providers likely represent some of the disparity, which has also been attributed to the slower-than-expected rollout pace at hospitals and nursing homes.

St. John's Well Child and Family Center was allocated thousands of COVID-19 vaccines for their south Los Angeles community health centers. But weeks into their vaccination campaign, California state officials threatened to cut future deliveries for not administering doses fast enough.

The state's data suggested the center had only given out 700 doses. St. John's records showed it had administered shots into ten times that many arms.

"They think we're sitting on thousands and thousands of doses," St. John's Chief Executive Jim Mangia said in an interview.

He has since begun working with officials and put 12 staffers on data entry - an expensive proposition for a center losing more than $100 on every shot due to mushrooming administrative costs, he said.

Four community health centers in New York and North Carolina said their experience has been was similar. Staff members spend hours each week entering data to meet state requirements, while juggling running vaccine clinics. Given the priority of protecting people from a deadly disease, keeping up with data entry sometimes fails.

The four centers said state reporting requirements were labor intensive and often involved manual data entry. Three said government registries have indicated they had doses on shelves at times when their supply had run out.

Six states including California, Pennsylvania, and Maryland told Reuters they had identified data reporting lags from some vaccinators. The states said they were working on measures to make their data more accurate.

New U.S. Centers for Disease Control and Prevention Director Rochelle Walensky said at a January White House media briefing that national data reflects a delay between when shots are given and when they are reported to states. She said the agency was working to better understand that delay.

MANY RULES TO FOLLOW

Beth Blauer, an executive director at Johns Hopkins University who has been tracking COVID-19 vaccines, said data is not being released in a way that can explain the "persistent deltas" between doses shipped and those used.

Blauer said an estimated 10% or less of doses distributed have gone to smaller providers, including community health centers. Their data reporting issues could account for only a small part of the gap, she said.

Rebecca Coyle, executive director at American Immunization Registry Association - a group for public health officials who track vaccination data - said it was no surprise community health centers and other small providers, like mom-and-pop pharmacies, would have greater data reporting challenges than large, well-resourced hospitals.

"It's taking time to get folks up to speed in terms of what is required," she said.

Roberta Kelly, chief nursing officer of Sun River Health, a community health center network in New York City, Long Island, and New York's Hudson Valley, said she and other staff spend hours each week manually entering missing data to both the state's and city's vaccine registries.

The databases are both cumbersome to use and distinct, meaning much of the same information must be entered twice for shots given at their city locations, Kelly said, adding: "It's like two different countries."

A Sun River center in the New York City borough of Staten Island was highlighted at a Jan. 18 news conference by Governor Andrew Cuomo as one of the lowest-performing vaccinators in the city.

Kelly was puzzled by that conclusion. Doses are gone within days even when data suggests otherwise, she said.

Recently for instance, the city's registry showed they had 250 doses available when in fact those doses had been given out days before.

"The system's just not caught up with what's actually happening on the ground," Kelly said. "We're following the rules and there are many of them."

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