As Nation Speeds to Vaccinate All, Maryland’s Path Shows Challenges Ahead

UPPER MARLBORO, Md. – The path to quickly vaccinate the country’s 250 million adults will be built from pharmacy chains, hospitals and hawking stadiums where uniformed soldiers help to vaccinate thousands of people a day.

But it will also depend on the Recreation Center at First Baptist Church of Glenardon Here with small storefront service organizations and vaccine-stocked vans that filter the neighborhood for the uninsured.

Maryland makes a subtle description of the issues that hastened to open enough vaccination sites to face President Biden’s goal To make every adult eligible for Kovid-19 shots by May 1, it has faced almost all the geographic, demographic and human behavioral challenges that come with public health work of this scale: poor urban neighborhoods where many Lack access to routine care; The rich washington proved it Vacuuming shots for other zip codes; Separate rural areas; And a sign-up system, which has so contaminated citizenship that vaccine victims have fallen to many part-time jobs.

“We are going to push, but we also have to pull up,” said Dennis Schrader, Maryland’s acting health secretary, who described the plan to increase capacity not only at mega-sites and pharmacies. Pull people in with smaller, more targeted efforts.

Nearly every state in the nation now finds its residents in a dangerous race amid a suicidal wave of cases of fueling vaccines and partly by the emergence of new variants of coronovirus. As states raced to expand eligibility for the shot, many are also loosening the rules on food, gathering and masks.

It will strive on a wider scale for the wider interests of the states to bring the states closer to herd immunity. Efforts are being made to find out who is getting vaccinated, and where, all will become important so that health officials can quickly identify who is being left behind and shift their strategies and resources accordingly.

Many states This week alone, vaccination has been opened to all adults, including more than a dozen. To further this process, Mr. Biden announced New promotional campaign On Thursday, communities where the vaccine content is high have been targeted.

“This is really going to be the beginning of much monitoring and analysis to ensure that this was both a rapid and appropriate rollout of the vaccination campaign in human history,” Allison M. Butenheim, an associate professor, said the University of Pennsylvania School of Nursing.

Here in Maryland, the punch-demand for the vaccine is huge: only people 65 and older, certain types of essential employees, and some other narrow categories were eligible By the end of march, Excluding Two thirds of the population Still insecure.

On Tuesday, the Republican, Gerry Larry Hogan, opened the vaccination to everyone who is 16 years old and has some medical conditions; As of April 27, all 16 and older people will be eligible regardless of medical condition.

But while Mr. Hogan has faced stiff criticism from local leaders about the state’s moderate pace of movement, some now worry that it is growing too fast. Mr. Hogan has already been criticized for not being enough to reach Black and Latino residents, who make up more than 40 percent of the state’s population, but Only 28 percent Among those who got at least one shot.

Hogan administration plans to open four More Mass Vaccination Sites By the end of April, a total of 12 were brought in, and it has shots from 320 pharmacies; A federally operated site Will open Next week at a suburban metro station. Mr Hogan aims to manage 100,000 shots per day by May, which is now above the average of 57,000 a day.

The kingdom has started Connecting primary care doctors Attempts to have 400 practice of conducting shots by May. It is working with local health departments and community partners, particularly churches, to open “pop-up” vaccination sites aimed at populations that may be geographically or socially isolated, or government And may distrust large institutions.

Pastor John Jenkins at the First Baptist Church of Glenardon understood his role that his church could bring down a main bridge in Prince George’s County – Majority black area This is a high Kovid infection rate, but a low vaccine rate – a snacking line of cars leading up to the mass vaccination site at Six Flags Amusement Park.

“The people in those cars didn’t look like the people of the county,” said Pastor Jenkins. “People in this community could not get appointments.”

With the help of his church’s long-term partner, the University of Maryland Capital Region Health, he quickly built pop-up vaccine sites with his army of church volunteers. State officials, who were providing contract workers, came to see their huge indoor recreation center and quickly agreed to greatly expand on their initial dreams of several hundreds of shots a week.

The site, which acts like a medical center, planned to vaccinate a few hundred people a day, but quickly reached close to 1,000 with residents like Dennis Evans, who said he compared the stadium to the street I feel “more comfortable” in my church. . The church will soon move up the ramp to provide daily shots. Pastor Jenkins said, “I am grateful for the real resources here.”

Targeting small populations may also take special effort. A group of Latino residents in Baltimore, who were given 25 slots at a state convention center, were often unable to access the site, and those who went there could find none who spoke Spanish. The Opranza Center in Baltimore, a unit of Baltimore’s Catholic charitable organizations, was contacted by the National Guard in February with Johns Hopkins at Sacred Heart of Jesus Church to establish a clinic for that group.

“The thing that really mattered to us was that they were not uniform,” said Catherine Phillips, the center’s medical director. (Many of those attending the church are undivided immigrants.)

The site uses a hotline to help residents make appointments and offer shots at their church on Friday nights, when more area residents who otherwise could not leave work can reach there.

Another focus of criticism in Maryland, like many other states, has been the system of scheduling vaccine appointments. Instead of a single online portal where people can view available placements across the state, each provider has its own online appointment system, meaning that people often have to look through multiple sites to find slots. The state has recently created a Single online platform Where residents can place a condition for appointment at any of its major vaccination sites, but the Acting Health Secretary, Mr. Shredder, said hospital systems and pharmacy chains operating on most sites “want to use their system.”

Dr., a Vice Dean of the Johns Hopkins Bloomberg School of Public Health in Baltimore and a former Health Secretary of Maryland. Josh Scharfstein said he expected the approach to prove more and more problematic and more and more people would seek out appointments.

“This chaotic system where people have to visit 15 websites, it actually discriminates against people who don’t have computers or can’t spend all day doing so,” Dr. Scharfstein said.

Mr biden Recently said His administration will help make it easier to find vaccine appointments, creating a union-backed website showing people around them where shots are being given and a toll-free hotline to help people get vaccinated. As of May 1, they also promised to deploy “vaccine teams” to states that need help improving their vaccine appointment portals.

To date, Maryland is sending about 30 percent of its weekly vaccine allocation to its collective sites, 30 percent to local health departments, which share with community groups and other small providers, and the rest with hospital systems, pharmacies, and independent doctors’ offices . .

Going forward, Mr. Shredder said the state would rely heavily on local health departments and community health centers that provide primary care to low-income and uninsured people at 126 locations around the state and directly from the federal government Receiving their allocation. Among other things, they can compare their patient’s lists to the state’s vaccine registry to find out if a shot is still needed.

In Baltimore, where 21 percent of residents live below the poverty level, local hospitals, pharmacies, and a nursing school have partnered with the city’s Health Department, which teams up on public housing for the elderly at least six times a week. More than 2,300 people are vaccinated for delivery. till now. City Health Commissioner Drs. Letitia Dzirasa said the city would soon expand the program to other high-risk populations.

Dr. “For a month, it is a bit scary to think that it will be completely open,” said Dirasasa.

Still, she and other local officials around the state said they expected no shortage of vaccinators or sites where people could come in for shots. In Washington County, where the large rural boundaries are Pennsylvania, Virginia, and West Virginia, the fundamental s. Joshi, president and chief executive of Meritus Health, the local hospital system, said that between the county health department, the local aging commission and its own, a workforce of about 3,000, he talks about the number of vaccinated balloons as employees Was not worried.

Dr. “People like us won’t believe you,” Joshi said, adding, “He once walked into an outlet mall in Hagestown with a severed-rate Merino wool sweater and Orange Julius outpost.” The mass vaccination site is set to open. , Now part medical center. “People from finance and outpatient rehab care are running our immunization sites. we are recruiting. We are ready to go. It is not a cost issue or a people issue for us, it is just a vaccine issue. “

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