Since Texas began distribution of the Pfizer and Moderna vaccines in mid-December, Travis County providers have received 126,550 doses of the vaccine, accounting for a fraction of its 1,016,090 residents over age 16—the youngest age at which someone can currently be vaccinated, according to the Texas Department of State Health Services.
With an estimated 72,623 health care workers in the county as well as 8,271 long-term care facility residents and 337,286 people with qualifying medical conditions, supply still falls short to cover individuals currently qualified to receive a vaccine.
As allotments to the area grow week by week, Dr. Mark Escott, Austin-Travis County interim health authority, has continued to preach patience and has called it a “miracle” that effective vaccines are already in circulation.
Finding a dose
Vaccines continue to be distributed to both private providers, such as hospitals and pharmacies, and public ones, including Austin Public Health, each week. More than 350 providers are registered through the Texas Department of State Health Services, although not all of them receive allocations every week.
In January, the DSHS classified APH as one of a limited number of regional vaccination hubs, which are being chosen for their capacity to vaccinate 1,000 people or more in a single day. Since then, APH has received two shipments of 12,000 vaccines doses, with the most recent arriving this week, which have primarily been offered to members of distribution Phase 1B: people over age 65 or who have a qualifying underlying health condition.
“Priority right now is individuals that are 65 years of age and older, including our communities of color,” APH Director Stephanie Hayden-Howard said at a Jan. 12 news conference. “It is going to be so important that if we have elderly family members in our family—that we sign them up and put them ahead of the line.”
According to the DSHS, there are around 126,607 Travis County residents aged 65 or older. With vaccine limited, many people in this group have still been unable to book an appointment through the portal, despite receiving messages informing them they are qualified to do so. APH representatives said they will continue to update the portal with additional appointment slots as further vaccine shipments arrive.
Although APH has expressed an intention to eventually coordinate with other public and private providers through its portal, there is currently no centralized access point to find which local providers have vaccines available. Hayden-Howard has recommended people with insurance try to go through other providers so that APH can serve as a "safety net provider" for people without insurance. A number of other providers have their own registration systems set up, including Baylor Scott & White Health and UT Health Austin, as well as some smaller pharmacies, such as Tarrytown Pharmacy.
Exceptions to Phases 1A and 1B
APH has vaccinated a small numbers of people outside of Phase 1A and 1B in several instances. In one case, staff at an APH site administered leftover vaccine to people who had waited in line without an appointment. Hayden-Howard said this was to avoid wasting any leftover doses in vials; since the Pfizer and Moderna vaccines require cold or ultra-cold storage, their shelf life is limited once the product has thawed. While Hayden-Howard said residents should not expect this to happen again, Escott said it could if vaccine administrators were to need to find a quick solution for expiring doses.
“Vaccine is not wasted if it is in the arm of a Texan,” Escott said Jan. 13 in response to questions about the incident.
Escott also said Jan. 19 that APH would set aside a limited number of doses for local judges and key governmental staff in order to protect continuity of government. He has advocated for the state to set aside vaccines for state legislators as well as they work in Austin through the 87th Texas legislative session.
“I’m talking about hundreds of people who are going to be in contact for six months. That represents a risk for a superspreader event,” Escott said. “Essential government services must continue, and COVID-19 remains a threat to those essential government services.”
Vaccines are unlikely to be extended to the general population—or even prioritized essential workers—until allocations for APH and other local providers increase.
County commissioners have expressed hope that President Joe Biden’s plan to distribute 100 million vaccine doses within 100 days will be effective in increasing supply. However, Escott said the circumstance most likely to help is the emergency authorization of a third vaccine, one manufactured by pharmaceutical company AstraZeneca—a cheaper-to-produce option than the Pfizer and Moderna offerings currently available. Escott said he expects that authorization to occur near the end of January.