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Health & Wellness

Q&A On Texas' Vaccine Rollout: No New Hubs, More Vaccines And How The Allocation Process Works

A nurse injects the vaccine into an elderly patient.
Keren Carrión
/
KERA News
A nurse administers a COVID vaccine to Cunduan Zhang, 90, who said he was glad to finally get vaccinated, at Fair Park in Dallas, on Jan. 11, 2021.

The number of vaccine doses sent across the state of Texas next week will increase from 300,000 to 380,000. And the Texas Department of State Health Services (DSHS) has been told to expect that level of vaccines over the next few weeks. But DSHS is moving forward cautiously.

Imelda Garcia, the associate commissioner at the Department of State Health Services, said she doesn't know that the increase in doses will be 'sustainable.' And because of that, the state's not planning to add any more 'mass vaccination sites' to its list of providers.

"While the federal partners have told us that this is going to be a recurring thing," Garcia explained, "We really need to see it in writing."

Garcia said Texas needs to "actually get our numbers before we make additional commitments to our providers about recurring amounts."

Texas recently shifted its vaccine distribution strategy from one that sent hundreds of doses to hundreds of providers to one that's more focused on getting mass amounts of vaccines to 'hubs' that could serve lots of people in one place.

Texas DSHS is reporting that more than 2 million doses of the COVID-19 vaccine have been administered across the state. Approximately 1.7 million people have received at least one dose. There are also about 370,000 individuals who have been fully vaccinated.

On a call with reporters on Jan. 28, Garcia also said the state will get a one-time boost of about 125,000 vaccines. Those will mostly go to suburban areas that haven’t received vaccines in proportion to their population size.

Garcia also shared information about how vaccines are allocated across the state and shed light on the process Texas DSHS uses to select places for their 'mass vaccination sites.'

Read some of the highlights below:

How Does The Allocation Process Work?

Every Monday, Texas DSHS meets with a 17-person committee called the Expert Vaccine Allocation Panel (EVAP) for about three hours. During their meeting, DSHS presents an estimated number of vaccine doses to the Panel that they believe will be granted to the state by the CDC for the following week. Then, the two parties discuss distribution strategies and mull over which providers will receive vaccines and how many they’ll get.

Once the EVAP has weighed in on the strategy and direction of distribution, DSHS drafts and refines a plan for the week. But DSHS cannot begin to finalize the plan until “late-Tuesday afternoon,” because that’s when they find out how many actual doses of the vaccine they’ll be getting from the CDC.

After learning how many doses the CDC is sending to Texas, they rework the previously drafted plan for vaccine allocations and distribution to accurately reflect the number of doses they plan to receive. This is done in partnership with a small group of members from the EVAP. Then the plan is sent to DSHS Commissioner John Hellerstedt for his approval.

Once the plan has been approved by Hellerstedt, the allocations are plugged into a system that allows providers to accept delivery. Providers get approximately 24 hours to accept.

After that, DSHS must submit their plan to the Federal Ordering System as quickly as possible in order for providers in Texas to receive shipments of vaccines by Monday or Tuesday. Then the process begins all over again.

How Do Texas DSHS And The EVAP Decide Where To Send Vaccines And The Amount Of Vaccines?

This has been an evolving strategy. But since expanding the number of folks “eligible” for vaccination from just frontline workers and folks in long-term living facilities to include senior citizens and the chronically ill, DSHS has used population estimates to help them choose which places get the most amount of vaccines.

What About 'Hubs' Though?

Since Jan. 18, DSHS has shifted their COVID-19 vaccination distribution strategy from going straight to as many providers as possible to focusing on ‘mass vaccination sites’ orhubs. This decision was made because DSHS says it was the best way to get large populations vaccinated quickly.

DSHS also says these sites are beneficial because the people looking for vaccines now ‘have a place that they know will definitively be getting it.’ They say this strategy keeps Texans from having to call dozens of providers every single week in order to score a vaccination. Additionally, DSHS says the providers operating ‘mass vaccination sites’ benefit from the strategy because they can plan ahead to optimize the administering of vaccinations with one-day, drive-through events.

Can You Provide Information On Where DSHS Has Decided To Place ‘Hubs’?

As stated previously, ‘hubs’ or ‘mass vaccination sites’ were chosen using population estimates. That’s why so many large cities seem to have the ‘hubs.’ Providers in big cities like San Antonio, Fort Worth and Dallas need to be able to administer 2,000 shots a day during the week to be a hub. But in rural communities, providers only need to be able to dole out 200 to 400 vaccinations per day to be a hub.

Are More 'Hubs' Coming?

DSHS says they do not plan to add any more ‘mass vaccination sites’ at this time. Though they will be revisiting the conversation next week.

When Will Smaller Private Providers Like Pharmacies And Doctors’ Offices Begin Receiving Vaccines?

The Department of State Health Services says they have already been providing vaccines to a small number of pharmacies and doctors’ offices. But the majority of the doses are going to the ‘hubs.’ Still, as the supply of vaccines increases, so will the allocation of doses going to smaller providers.

When Will Texas Announce Who’s In The Next Phase Of Eligibility?

Texas DSHS and the EVAP are still discussing who will be in the Phase 1C group and when that group will be eligibleto be vaccinated. The decision to make more people eligible will be dictated by vaccine supply.

Is There A Consensus On Who Will Be Included In Phase 1C?

Texas DSHS and the EVAP expect to be discussing this for several weeks. They plan to rely upon data though. They want to see what is happening in Texas when the vaccine supply is higher. If a population — like teachers or customer service workers —is highly affected by the virus, they may be next up. But they want the vaccine to be used strategically to save the most amount of lives. With a new presidential administration in office, they also want to wait and see if new federal regulations for administering the shot will affect their current plans.

How Concerned Is The State About Rural Communities? Don’t The ‘Hubs’ Put Those Communities Further Back In Line?

Texas DSHS says they are continuing to keep rural communities in mind and that they plan to open ‘mass vaccination sites’ in rural areas. But a new pilot program will vaccinate residents for COVID-19 in five rural counties this week. The pilot program will be staffed by Texas National Guard members and will focus on getting vaccines to homebound Texans who are 65 years of age and older.

Got a tip? Email Hady Mawajdeh at hady@KERA.org or Bret Jaspers at bjaspers@kera.org. You can follow Bret on Twitter @bretjaspers and you can follow Hady on Twitter @hadysauce.

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