County Vaccination, Moderna Vaccine

Jen Krum, a registered nurse and owner of Qualicare, volunteers her time to vaccinate other health care workers with the Moderna COVID-19 vaccine on Wednesday, Jan. 6, 2020, at the Gallatin County Fairgrounds.

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Gallatin County is gearing up to expand vaccinations from frontline health care workers to adults over 80, as well as Native Americans and other people of color.

Those groups will likely begin receiving doses the week of Jan. 24, said Health Officer Matt Kelley.

The Gallatin City-County Health Department plans to work with local health care providers to notify those who are eligible and to help them sign up for an immunization time slot.

It will likely take weeks to vaccinate those over 80, Native Americans and other people of color if the county continues to receive about 500 doses from the state each week, Kelley said.

“We want to make sure that people don’t feel left out of that process, but we also need them to understand that not everybody will be able to get it in the first week,” he said.

The move to expand vaccinations comes after Gov. Greg Gianforte announced this week that counties will soon be able to shift from vaccinating frontline health care workers — labeled phase 1A — to simultaneously vaccinating adults over 70, people of color and those 16-69 with specific underlying health care conditions, called phase 1B.

Phase 1B comprises about 250,000 Montanans, so Gallatin County is dividing it into smaller groups because of the limited vaccine supply.

Once the county is confident it has offered the vaccine to residents over 80, Native Americans and other people of color, it will also offer doses to those older than 75, Kelley said.

Once these groups are vaccinated, the county will provide the vaccine to those over 70.

Depending on supply, those between 16 and 69 with specific underlying health conditions that place them at elevated risk for COVID-19 complications will also eventually be offered the vaccine.

The decision on how to break phase 1B into smaller groups came from a county vaccine task force, which includes about 18 people from health care organizations, local governments and businesses.

“These are really difficult decisions. The task force that came together really thought about this a lot,” Kelley said. “…For the most part, the people who have been dying from this disease are the oldest among us. … We also know that American Indian populations and people of color have been disproportionately affected by the pandemic.”

To reach those who are now eligible, the Gallatin City-County Health Department will likely contact local health care providers and ask them to identify patients who meet the current eligibility criteria, such as being older than 80. Those eligible will then receive a notice telling them they can sign up for a time to receive the vaccine, said Patrick Lonergan, the county’s chief of emergency management.

“We’re going from frontline health care workers, where they are generally employees of well-known organizations to a population that is largely known by health care providers, so we’re using health care providers to access them,” he said.

Bozeman Health is working with the county vaccine task force to share patient demographic information with the health department to identify those who are eligible in the next round of vaccinations, said spokesperson Lauren Brendel.

As vaccinations continue to roll out, some will be administered at the Gallatin County Fairgrounds.

Bozeman Health is also planning for its clinics and hospitals to distribute the vaccine, Brendel said.

As supply grows, it is likely that additional locations, such as pharmacies, will receive approval from the state Department of Public Health and Human Services to offer immunizations.

Some other counties are also preparing to expand vaccinations beyond frontline health care workers, said Gen. Matt Quinn, who is leading the governor’s coronavirus response.

However, before counties expand eligibility, the state wants to ensure that frontline health care workers across Montana have received the vaccine because they are most at risk.

“(We don’t want) a county going headlong into 1B while we have another county still struggling to get through the frontline health care workers,” Quinn said.

To provide equitable access to the vaccine, counties must submit weekly requests to the state for the specific number of doses they would like for the following week, Quinn said. The state then looks at data including the number of doses the federal government plans to send, the number of people each county has vaccinated and the number of unused doses counties have in order to determine how many to distribute to each county.

When the federal shipment arrives, the state generally adjusts each county’s allocations based on the number of doses actually sent.

Quinn said the distribution system has worked well so far, with no vaccine going to waste.

The U.S. Centers for Disease Control and Prevention reports that Montana has received about 98,500 doses, about half of which have been administered.

Even as counties prepare to expand vaccinations, they are still working to provide access to frontline health care workers who may not have been vaccinated over the last month.

“There’s no hard line between 1A and 1B,” Quinn said. “We will always be moving in between 1A and 1B.”

As new groups are vaccinated, Gallatin County is preparing to provide second doses to health care workers.

Residents of long-term care facilities are also continuing to receive doses through national pharmaceutical chains, including CVS and Walgreens. Those vaccinations are scheduled to be completed in late February or early March, Quinn said.

To date, Gallatin County has received a total of 5,275 doses, all of which have been distributed to frontline health care workers by Community Health Partners, Montana State University, Bozeman Health and the Gallatin City-County Health Department.

In the coming weeks, the county is working to provide regular updates on the number of vaccines it has distributed. The state is preparing to add information on vaccine distribution to its dashboard, likely beginning next week, Quinn said.

The Gallatin City-County Health Department also plans to provide information about how to access the vaccine on its website, through its call center and on social media as it becomes available.

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Perrin Stein can be reached at pstein@dailychronicle.com or at 582-2648.