Teton County has a new problem with vaccines, albeit a much more desirable one.
After finding out at the end of February that it would receive about 5,600 doses of vaccines in March, the Teton County Health Department learned it would actually get more than 7,000 doses of the Pfizer vaccine this month, along with 300 doses of the newly approved Johnson & Johnson shot.
The surplus doses are coming in an extra box of Pfizer vaccines this week. For a county that as of Monday had administered 7,630 doses total (first and second) in the first two and half months of vaccine distribution, giving out more than 7,000 first doses this month will be a huge undertaking.
“Here’s the dilemma: I think at about 6,000, between us and the hospital, we can get it all out,” Teton County Director of Health Jodie Pond said. “It’s that extra box that we got — it’s going to be a difficult situation to get it out there.”
Mass vaccine clinics through the Teton County Health Department will now run six days a week, Pond said, with a daily capacity of about 400 shots. St. John’s Health can do around 150 a day, but Medical Director of COVID-19 Response Dr. Paul Beaupre said that should increase to around 200.
Were the partners administering only first shots from the 7,320 slated for Teton County this month, they’d easily have the capacity. However, because the Pfizer and Moderna vaccines are two-shot regimens, some mass vaccination clinics are for second doses only.
The increase at the St. John’s clinic will be helpful, but it won’t completely fill the gap. Pond is debating how to use the extra doses. Clinics are taking place at the Presbyterian Church of Jackson Hole, which can’t support much more than about 500 shots each day, though that figure would be a 100 shot a day increase.
Capacity at the church is limited by its waiting area. People have to wait 15 minutes after they get their shots in case they have an allergic reaction, and past 500 shots a day social distancing would become difficult in the church’s auditorium.
Needing to figure out how to administer 1,000 extra doses is a problem Pond is OK with. Though they are only one piece of the response, vaccinations have helped the community stem the tide of an outbreak that spiked quickly in January.
“We are getting people vaccinated, and we do have some natural immunity in the community, so cases are low,” Pond said.
Continued decreases in cases are part of the reason the Health Department moved the community danger level to the yellow, low-risk phase last week for the first time since the risk scale was created last summer. The department bases the risk level on a variety of things, including case counts, hospital capacity, protective equipment stores and others.
It rates them as improved, stable, concerning or critical. When more metrics are in the improved or stable range, the risk level is lower.
Currently, all metrics are rated as stable or improved, except for community spread, which is still critical. At present 44% of cases have no known origin, though Pond has an idea where they are coming from.
“I think it’s the variant,” she said. “I think we have probably more cases than we know, and because it’s more contagious you don’t know where you got it.”
That concerns her and other health care officials. Declines in cases have plateaued around the country, according to a database maintained by The New York Times, and some places are seeing increases again, including parts of eastern Idaho like Idaho Falls.
Some of the variants have proven to be somewhat contagious to vaccinated people, though everyone who is inoculated — no matter the shot — is essentially protected from severe infection. With restrictions easing around the state and continued tourism, Pond sees potential for that trend to reach Jackson.
“There’s no reason not to believe, like in other surges in the past, that we are only a few weeks behind the rest of the country,” she said.
Health officials say a combination of community caution and vaccinations is the key to getting ahead of the variants and keeping the risk level at yellow. Pond encouraged “not throwing caution to the wind” even as restrictions ease.
For Beaupre the Johnson & Johnson vaccine represents a huge shift. Pfizer and Moderna’s shots are incredibly effective against the original strain of SARS-CoV-2, but they are fragile and require special treatment and freezing.
Johnson & Johnson’s shot is produced like a flu shot or other viral vaccines, and it merely needs refrigeration.
“The good news about Johnson & Johnson is we don’t necessarily have to keep this under control of public health,” Beaupre said. “It can go directly to doctors’ offices, pharmacies.”
It may be a while before that happens, Pond said, because officials want to get to the general population before handing the reins to clinics and pharmacies. Vaccinating priority groups takes a lot of administrative time to ensure the priority groups are followed and people aren’t lining up for vaccines, which Beaupre called “a bad idea during COVID.”
Pharmacies and clinics can join the process once people are able to just make an appointment. When that happens, Beaupre said, he wants to discourage people from “vaccine shopping,” because all the available vaccines provide strong protection against severe cases and death.
“If you’re offered a vaccine, say, ‘Yes,’” he said. “The bottom line is it doesn’t matter what vaccine it is; we’re all really fortunate that all the vaccines are equally good.”
When the Health Department and St. John’s will reach the general population is unclear, though the windfall of doses might mean they can start groups in 1c this month.
Pond and Beaupre hope to start the general population by May or so, though supply and capacity will be the limiting factors. With variants spreading widely both in the Intermountain West and the nation, they’d like to be as close to herd immunity as possible before the waves of summer tourists descend on Jackson.
“We’re in an arms race here,” Beaupre said. “We’re trying to get this community vaccinated before the summer.”