On Thursday, Sentara defended its stance of prioritizing patients 75 and older who use its doctors as primary care providers over patients 75 and older who don’t in the distribution of COVID-19 vaccines, citing limited resources.
“It really comes down to our limited resource. The area Sentara Medical Group, which is providing the outpatient vaccinations, [most recently] received 800 doses of vaccine with no guarantee of receiving any more. So we had to come up with some sort of criteria,” Bruce Clemons, executive director for primary care for Sentara Blue Ridge, said in a phone interview.
On Wednesday, Sentara announced it would continue to prioritize vaccination of Sentara Medical Group patients 75 and older over others 75 and older.
Clemons said the hospital’s position is not discriminatory because Sentara treats people from all backgrounds and income levels.
“You could have a lot of patients who are underserved patients who are actually Sentara patients. We do have quite a few, so in that respect I don’t feel like that criteria is necessarily on its own being discriminatory,” Clemons said.
For a second day, neither the office of Gov. Ralph Northam nor Virginia Department of Health officials provided an explanation for why health care providers are allowed to prioritize their own eligible patients over nonpatients. The VDH’s Central Shenandoah Health District also did not respond to emailed questions regarding Sentara’s prioritization of patients.
Delays in the vaccine supply line have held up inoculations across the country. Virginia had been hovering around the bottom 10 states in terms of doses per 100,000 people but has improved to 26th, The Associated Press reported Wednesday. The commonwealth has received 1.16 million vaccine doses as of Thursday, and 55% of those have been administered, according to data from the Virginia Department of Health.
“My message to hospitals is this: There’s no excuse for first doses to be sitting there unused. Get them out and get them into arms now,” Northam said at a Wednesday press conference.
Other area health care providers that have received vaccines have taken different approaches than Sentara, such Valley Health, which gave vaccines to those eligible whether they are primary care patients or not, according to representatives.
“The vaccine was paid for by the federal government and is a public good. We are thrilled to have that opportunity to give that good to the public,” said Jeff Feit, vice president for population health at the Winchester-based network.
Lisa Bricker, executive director of HCHC, formerly the Harrisonburg Community Health Center, also said the nonprofit is not prioritizing its patients over other eligible members of the public, even with its small provision of doses.
“We are vaccinating anyone [eligible] in the community,” she said.
When health care providers received their doses, they agreed to follow Virginia’s prioritization guidelines as best as possible, but the state did not prohibit providers from prioritizing their own patients, according to a VDH spokesperson.
“Sentara Healthcare, as well as all 12 Sentara hospitals, are approved vaccine administrators through provider agreements with the [Centers for Disease Control and Prevention] and state departments of health. We work in partnership with state health departments in Virginia and North Carolina to receive vaccine supply through the national distribution model and administer the vaccine to those who fall in the appropriate phased groups in the communities we serve,” according to a Thursday evening statement from Sentara.
Sentara also announced Wednesday it is vaccinating all its staff, including those who are not front-line medical workers. Because they “are critical to the ongoing operations of health system facilities,” all staff meet the 1a criteria, Sentara said in a Thursday email.
On Wednesday, Northam announced changes to Virginia’s vaccine distribution plan, with new vaccine shipments now going directly to health districts.
Feit said the decision makes sense as the state continues to progress in vaccinating those in 1a, which includes health care workers and residents of long-term care facilities.
Tammie Smith, a VDH spokesperson, explained the logic behind sending vaccines to health care providers initially.
“First vaccine doses went to health systems because they employed many of the front-line health care workers who were 1a priority and because the vaccine required special ultra-cold storage capability. The other priority group was residents and staff of long-term care facilities, who received vaccinations from CVS and Walgreens through a federal partnership,” she said.
Sentara’s criteria is also limited by age as residents over 65 are eligible for vaccines, but Sentara is only giving them to patients 75 and older. Clemons said this decision was also made because of the lack of vaccines.
In the Harrisonburg area, Sentara has 12,000 patients 75 and older and 26,000 patients 65 and older. Thus, the 800 vaccines Sentara most recently received didn’t go far, according to Clemons.
Four out of five COVID-19 deaths have been reported in Americans 65 or older. Mass vaccination clinics have been held in Page County and Staunton, with the only requirements being patients meet the 1a or 1b criteria.
Clemons said the health department organized those mass vaccinations, but has not done so in Harrisonburg. He said the question of why none have been held in Harrisonburg is better directed to the health district, not Sentara.
Representatives of the Central Shenandoah Health District did not answer afternoon emails and calls as to why no such clinics have been held here.
Feit, however, said Valley Health has conducted mass vaccination clinics on its own in Winchester and Warren County, though it is in frequent contact with Lord Fairfax Health District staff, who operate their own mass vaccination clinics.
Even though vaccines will now go directly to the health district, it does not change how Valley Health is working to inoculate patients, he said.
“That doesn’t change anything for us,” Feit said. “The collaboration stands.”