Linn County health officials express frustration over state’s allocation of vaccine and lack of local control

Moderna vaccine doses in Norfolk, Virginia, Feb. 13, 2021. — Chelsea Palmer/U.S. Navy

In a three-page email to Gov. Kim Reynolds’ office and the Iowa Department of Public Health, Linn County officials questioned and criticized the state’s allocation of the one-shot Johnson & Johnson vaccine, as well as pleaded for local control to allocate the single-dose vaccine to vulnerable populations.

Tricia Kitzmann, who is Linn County Public Health’s community health division manager, sent the email to three individuals: Ken Sharp and Kelly Garcia with IDPH, as well as the governor’s health policy adviser Elizabeth Matney. LCPH director Pramod Dwivedi was copied on the email.

The email was sent on Wednesday, March 31, and obtained by KCRG through an open records request.

Kitzmann began the email saying LCPH is “always thrilled to know when more vaccine is entering our community” but expressed concern over how the vaccine is being allocated. Kitzmann said she learned that the Johnson & Johnson vaccine is being allocated to college populations and 3,200 doses were given to Hy-Vee to vaccinate Collins Aerospace employees.

The state has so far directed most of its supply of the Johnson & Johnson vaccine to employer-run vaccination programs for some workers who have been designated essential, but starting this week will also be dedicating that vaccine to a program to vaccinate college students and staff before the end of the academic year, Reynolds explained at her news conference on March 31.

“This will protect their families upon their return home and it will ensure they have been vaccinated before they come back to school for the fall semester,” the governor said.

“It is extremely heartbreaking to learn of these plans, as myself, as well as many others in the public health community, have been requesting, even begging for several weeks for access to the Johnson and Johnson vaccine to use with our vulnerable populations,” Kitzmann wrote in the email.

Kitzmann said employees at Collins Aerospace need to be vaccinated, but they “have the ability to work with pharmacies, health care providers and public health to obtain one of the approved two-dose vaccines.” She added that college populations are “equally as resourced and capable,” especially since they have reliable contact information and are technologically savvy.

LCPH has “made several pleas” to the Reynolds’ administration, Kitzmann said, adding the department had a call with Matney about using the Johnson & Johnson vaccine for the most vulnerable populations. Kitzmann said other local public health departments have also spoken with the governor’s office about the issue but did not name those other departments.

“It is becoming increasingly clear that the Governor’s Office does not trust local public health to identify and serve individuals in our community who are the most vulnerable,” Kitzmann said. “This includes persons who experience homelessness, substance abuse, mental health issues, barriers to accessing healthcare, or are from minority, refugee, immigrant or low-income families.”

“I am struggling to understand, why will the Governor’s Office not listen to those that know their communities best and work with us to identify the best strategies to vaccinate our community, both manufacturing, business, higher education and the most vulnerable and susceptible to barriers to accessing vaccine and experience social determinants of health?”

A single-dose vaccine is vital for individuals in these vulnerable populations “due to the loss in follow-up, fear of government, trauma, access barriers and/or transient nature of the population,” Kitzmann added.

Kitzmann specifically expressed concern over providing a two-dose vaccine series to people experiencing homelessness since they are difficult to reach and it would be “extremely difficult” to find the individuals for the second dose, which is why the one-dose shot is ideal for this group. She also advocated for individuals in correctional facilities, including inmates, staff and officers, to receive the single-dose vaccine due to the high-risk conditions in these buildings.

Kitzmann asked the governor’s office for more control over how vaccine is allocated and to be involved in these decisions.

“I, along with several of my local public health colleagues, am begging the Governor to allow local public health to make decisions within our communities on how to best vaccinate our populations,” she said. “The Governor’s Office does not have the depth of knowledge or expertise to control all aspects of a local public health response. Local public health professionals are trained, prepared, and ready to serve our community. Allow local public health entities to do what we do best, and work with our communities and community partners to make decisions at the local level that will positively impact our communities.”

Responding to questions about the email from KCRG, a spokesperson for the governor said, “We are trying to vaccinate as many people as possible and work through priority groups while simultaneously dealing with limited supply.”

A spokesperson for IDPH told KCRG its vaccine allocation plan calls for using the Johnson & Johnson vaccine for people at higher risk, and considers its distribution of the vaccine to employer-run programs and colleges to be part of that approach.

On Monday, the Gazette reported that LCPH expects to receive 1,200 doses of the Johnson & Johnson vaccine this week for officials to administer to vulnerable populations.

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