Measured Vaccine Deployment Marching Forward as County Chips Away at Backlog

The Flathead City-County Health Department’s distribution of the COVID-19 vaccine has been more tortoise than hare but the local health officer believes his department is on track to immunize the community as efficiently and effectively as possible, even as eager residents struggle to book appointments and available doses sit unused.

Logistical complications have hampered the county’s ability to ramp up vaccination efforts quickly and data compiled by the Montana Department of Public Health and Human Services (DPHHS) confirms that Flathead lags behind similar-sized counties across the state. As of Feb. 4, Flathead had administered 88.2 vaccine doses per 1,000 eligible residents, far behind Missoula (129.4), Lewis and Clark (144.7), Cascade (128.6), Yellowstone (146.1) and Butte-Silver Bow (177.7) counties. Only Gallatin County (81.2) reported a total similar to Flathead.

Health Officer Joe Russell blamed the disparity, in part, to the number of people in Tier 1A — primarily healthcare professionals — in other counties that allowed those areas to pull ahead, and expressed confidence that Flathead County would catch up over time. And at a clinic at the Flathead County Fairgrounds Expo Center on Feb. 4, held primarily for those in Tier 1B, Russell and his team showed off the thoughtful planning and public-private cooperation that he believes has the county set up to distribute the vaccine more efficiently in the coming weeks.

Tom Bertelsen and his mother, 90-year-old Shirley Bertelsen, arrived at the Expo Center Thursday morning, less than 24 hours after Tom received a call that the pair had received one of the precious vaccine appointments scheduled at five-minute increments. Inside, the Bertelsens signed in and confirmed their identities, were given a card with a date for their follow-up second shot, received the first dose from one of eight vaccinators on duty, and watched 15 minutes tick away on an egg timer in case of a rare allergic reaction.

The clinic’s operation spans from wall-to-wall inside the16,800-square-foot building with safe social distancing in mind, and volunteers routinely sanitize chairs, pens, clipboards and anything else that could be contaminated. To minimize the chance of an errant vaccine or recipient, every needle and vial is diligently labeled, forms are color-coded, and workers wear different colored vests to correspond with their responsibilities and expertise. Those at work at the clinic Thursday included a contingent of health department employees and contractors, retired and active medical professionals, staff from Kalispell Regional Healthcare, and volunteers with no medical training who assisted in non-medical ways.

“It’s a big relief for me and it’s a big relief for (my mother),” Tom Bertelsen said as he settled into a chair in the observation area after receiving his shot. “It’s a happy day.”

But for the thousands of people still waiting on a vaccine appointment, their happy day has not yet arrived, and it may not be coming for several weeks. Russell wrote in a press release on Feb. 2 that vaccinating all of Tier 1B would take “several months” and the backlog of appointment requests was around 8,000 as of late January. Flathead County is not unique in its inability to keep up with demand — both in Montana and around the country — but certain challenges here have compounded the delays.

At a health department call center, the phone rings about 1,000 times a day with only three or four employees tasked to answer those calls, collect vital information, book appointments when available and answer a flood of voicemails. The small staff is unable to match the volume of calls coming in, Russell said, and the county is currently receiving more doses from the state than it is able to administer. The Kalispell clinic had about 1,500 doses available the week of Feb. 1 but was unable to put that number of shots in arms, although Russell said none of those doses are being wasted.

“We have to create our own solutions and a lot of solutions are human resource,” Russell said. “We have the (scheduling) hardware now and we have to continue to staff up.”

Russell said the department is working with a temp agency to make additional hires for the call center but that even onboarding those hires takes time, with county computer training mandated before staff can get to work. And inside the clinics themselves, the county has all but maxed out the available personnel and space needed to pull off the event, making operating a second vaccination site impossible.

The other factor contributing to the slow pace of vaccinations is a more deliberate one. By the end of the month, the county will be circling back to give second doses of the vaccine to those in the current tier, as well as administering the first dose to a new crop of people. So if the county’s current capacity is 600 or so doses per day, administering 600 first doses now would lead to a huge logjam later this month. Russell sees a semi-solution there, too, with the county expected to open up the larger Trade Center for vaccinations in March, once a series of scheduled events there have been completed. Tearing down and moving the clinic from the Expo Center to the Trade Center and back, depending on scheduling, is not something Russell said is feasible.

Once the 45,000-square-foot Trade Center becomes the clinic’s base, Russell says at least 12 vaccination stations will be operating and the clinic will be capable of giving out as many as 900 doses per day. And if the need presents itself, the department is also open to some weekend clinics, again provided supply and staff is available.

“When we move forward, we may be more like the little turtle that could,” Russell said. “I really do believe things are working a lot smoother; we’re gaining the efficiencies it’s going to take to really ramp up.”

For now, Flathead County’s vaccine clinics are scheduled to operate Tuesday through Thursday, and all shots are administered by appointment only. Those in Tier 1B — anyone age 70 and over, Native Americans and other people of color, and those with select severe medical conditions — can request an appointment at flatheadhealth.org/covid-19-vaccine or by calling (406) 751-8119. Callers are asked to leave a message with their name, phone number and date of birth. Calls will be returned in the order they are received and callers are asked to leave only one voicemail.

As of Feb. 4, 7,394 vaccine doses had been administered in Flathead County and 2,350 people were fully immunized, according to DPHHS.

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