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ARHS Experiencing High Utilization of Vaccines But Still Short Supply Coming from the State

Appalachian Regional Healthcare System (ARHS) is experiencing overwhelming success with its daily vaccine clinics and has among the highest vaccination rates in the United States.

As of January 22, ARHS has received 2,750 first dose vaccines from the North Carolina Department of Health and Human Services (NCDHHS) and has distributed them at a 90% utilization rate. ARHS will reach a 117% utilization rate by the end of the week by using the remainder of its current supply — and because it has scheduled additional clinics for which it does not currently have vaccines.

ARHS President and CEO, Chuck Mantooth, attributed the system’s success to planning and leadership. “Our team has been planning how we would distribute the vaccine for months. After it was approved for emergency use in December, we anticipated receiving our first doses right around the Christmas holiday. We knew we would need to act quickly.”

 Challenges in the Process

While ARHS has been experiencing success in distributing the vaccine, many areas across the State have been mired with problems.

The most significant problems are related to the low supply of vaccine and the lack of visibility in receiving weekly shipments. ARHS reports that it typically receives notice of its weekly allocation on Thursdays. Then the vaccine shipment usually arrives 5 days later on Tuesday. “When we learn how much we will be getting, we begin scheduling appointments. It’s a tight turnaround to schedule hundreds of appointments in 5 days – but we’ve been able to manage it,” said Mantooth.

Another challenge ARHS has faced is related to the COVID-19 Vaccine Management System (CVMS) database, which is required by NCDHHS to record how many doses have actually been administered. The CVMS database is a web-based system which requires ARHS to enter personal information for each person receiving a vaccination. Each entry takes approximately five minutes. Over the past five weeks the CVMS system has crashed hundreds of times and has been taken offline for maintenance for days at a time.

“We have had a team of people entering data into CVMS to make sure that NCDHHS knows how many folks we are vaccinating, but it has not been easy. The system really slows our process,” Mantooth said. To make matters worse, any organization that has not entered data in a timely manner will have their weekly allocation reduced the following week. Some organizations across the state received zero vaccines last week because of the flaws in the CVMS system. “We partnered with AppHealthCare (Appalachian District Health Department) Saturday, January 16 to do 1,168 vaccinations at Watauga High School – but the CVMS database was down all weekend. The very next week AppHealthCare was notified they would not receive any vaccines, which was extremely frustrating after they worked so hard to vaccinate that many people,” Mantooth added.

Short Supply Each Week

Over the past six weeks ARHS has been receiving first dose allocations from NCDHHS which range from 400 to 800 doses per week.

On Tuesday, January 26, ARHS was notified that the entire state of North Carolina will receive 127,125 doses per week, for the next three weeks. Two days later ARHS was informed that Watauga County will receive a total of 500 vaccines next week (200 for ARHS, 200 for AppHealthCare and 100 for High Country Community Health). Neighboring Avery County will only receive 200 doses, which will be distributed by Toe River Health Department.

“Our primary service area includes Watauga, Avery and Ashe Counties where the total population is over 100,000 people. We also have seasonal residents that stayed here through the winter this year. When we’re receiving distributions of four to six hundred doses per week you quickly realize it could take a while to get everyone vaccinated,” said Rob Hudspeth, Senior Vice President for ARHS. “We’ll just keep vaccinating — exhausting our supply each week — and remaining hopeful that we’ll receive greater quantities in the near future. We just have to be patient,” Hudspeth added

ARHS Not Conducting ‘First Come, First Served’ Clinics

While other locales have implemented ‘first come, first served’ clinics, ARHS has chosen a different approach to vaccinating the community. Each week, after learning of their vaccine allocation, ARHS works quickly to schedule appointments for each and every dose.

Chuck Mantooth added, “We heard stories of people in other counties lining up in the wee hours of the morning for the opening of an 8am clinic and then by 11am – after waiting in-line for hours – they were turned away because the clinic was out of vaccine. We just didn’t want this to happen to folks in our community.”

ARHS reports that it has not had to cancel any appointments for eligible candidates yet– and the feedback they are receiving from people who go through their clinics has been overwhelmingly positive. Mantooth also acknowledges that there may be frustration in understanding how to get an appointment but ARHS and AppHealthCare have established online registrations for people who are interested in receiving a vaccine. Mantooth added, “Our first priority is to vaccinate Group 1 and Group 2 populations, as directed by the State’s Vaccine Plan. As more vaccines become available we will begin holding larger clinics to get the vaccine distributed more quickly.”

Second Dose Scheduling

With the ongoing shortage of vaccine, and the confusing nature of its distribution, some people are worried that the second part of the two-shot vaccine won’t be available when they are due to receive it.

ARHS understands these concerns — but explained that when it vaccinates people with the first dose, they are scheduled for the second dose four weeks later.

Additionally, ARHS registers each person receiving the first dose in the CVMS database — so the State knows how many second doses ARHS will need and when. Now when ARHS receives its weekly shipment the allocations are designated as “first dose” and “second dose.”

ARHS noted that second dose appointments have been ongoing for three weeks now at ARHS and, “so far the second dose supply has been readily available.”

Hudspeth emphasized that patients who received their first dose from ARHS should return to the same site on the day of their appointment to receive their second dose – unless they themselves chose an alternate second dose location.

Additionally, patients who are scheduled for a second dose will receive an automated email appointment reminder 24 hours before their second dose vaccine.

ARHS will use New Recreation Center as Vaccination Site

For the last five weeks ARHS has been doing vaccine clinics for 100 to 200 people each day in its facilities in Watauga and Avery Counties. But as ARHS begins to get larger allocations of vaccine from the state, they see a need to scale up those clinics to vaccinate thousands of people each week.

To accommodate a large-scale operation, ARHS realized a much bigger space would be necessary. So they reached out to the Watauga County Board of Commissioners and Watauga County Manager, Deron Geouque, to gauge their interest in using the new Watauga County Community Recreation Center.

On January 21, officials from Watauga County and ARHS met to conduct an evaluation and walk-through of the new Watauga County Community Recreation Center for possible use as a vaccination site.

“Their response was overwhelmingly supportive. For our walk-through, a host of county leaders showed up to talk about how we could work together in utilizing the new space,” said Hudspeth.

Upon review they determined that the new 100,000 square foot facility is ideally suited to handle logistics for large-scale vaccinations. It has ample parking and large gymnasiums to accommodate vaccine stations and post-vaccine, socially distant seating areas. It is also the only large space in Watauga County which is not being utilized for other purposes.

“We walked in and were wowed by what we saw. It was immediately apparent that the new rec center is going to be a point of pride for this community for generations. And what better way to showcase its usefulness than hosting mass vaccine clinics there? We are so thankful to the County for sharing it,” said Hudspeth

Vaccine Information and Registration Forms

North Carolina is currently in Group 2 of North Carolina’s vaccine rollout plan, which includes adults 65 years or older.  You can learn more about North Carolina’s vaccine rollout plan at https://covid19.ncdhhs.gov/vaccines.

ARHS Form – https://apprhs.org/vaccine-registration/

If High Country community members want to receive a vaccine, they can register with ARHS. If you are eligible for the vaccine in the current phase, you will be directed to schedule an appointment as they are available. Other groups will receive a notification when it is announced. Registrations will place you in the que to be contacted as more vaccines become available.

AppHealthCare Form – https://www.apphealthcare.com/covid-19-vaccinations/

Ashe, Alleghany and Watauga County residents can fill out this form regardless of which phase you fit in. If you are eligible for the vaccine in the current phase, you will be directed to schedule an appointment as they are available.

Toe River Health Formhttp://www.toeriverhealth.org/Vaccination_paperwork_packet.pdf

Avery, Mitchell and Yancey residents can complete this form and visit their website at www.toeriverhealth.org for more information on how to schedule a vaccine when supplies are made available.