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All 64 Colorado counties, including Chaffee County Public Health (CCPH) got thrown a curve ball by Colorado Governor Jared Polis last week, when he changed up the planned process for distributing the COVID-19 vaccine. The change is necessitating some major strategic changes for rural counties such as Chaffee.

“We anticipated additions, but not an overnight transition,” said Chaffee County Public Health Director Andrea Carlstrom. “Overnight we have to work on including the age 70-plus people as well as critical and essential workers in Phase I and completely redoing our plan of action.”

Translated, Polis’s announcement last week meant two things:

  • The shift of 70-plus age residents into Phase 1A of the COVID-19 vaccine rollout means that counties such as Chaffee, with disproportionately large populations of retired people (25 percent of Chaffee’s population is age 65-plus)  immediately had to make dramatic adjustments to their distribution strategy.
  • The shift means that rather than this population being vaccinated by this rural county’s small health care providers and pharmacies as had been planned (such as Buena Vista and Salida Pharmacies and grocery pharmacies), the vaccination of this entire population must now be done by the already over-taxed public health department instead of the health support structure.

Chaffee County Public Health has begun to use the Chaffee County Fairgrounds for COVID-19 vaccinations. Back in March, the Colorado Department of Health personnel conducted drive-through testing at the fairgrounds, assisted by National Guard members.

Chaffee County has a population of around 20,000. In the three weeks since vaccines have been available, Carlstrom says that Chaffee County has vaccinated around 750 people with the Moderna vaccine that has been designated for use by public health departments (HRRMC is using around 600 doses of the Pfizer vaccine for its staff, as planned), for a 6.75 percent vaccination rate.

“We anticipate that we at Public Health can vaccinate about 200 people in a three-hour period. We began this on Dec. 28 with the first Moderna clinic – that’s what we have access to.”

Carlstrom said the clinics at the county fair grounds had gone well so far. The first clinics included critical workers, and frontline health care groups not associated with the Heart of the Rockies Regional Medical Center (HRRMC), but critical to our community, including home health and hospice and Emergency Medical Services.

“It was working successfully until the Governor’s announcement that Phase I would include the 70+ group, essential workers, frontline journalists and state government. The aspect of the 70+ age group is a challenge,” explained Carlstrom. “Not only is 25 percent of our county ages 65+, he didn’t consult with communities like ours with older demographics, that are rural, and have limited resources.”

She added that CCPH had “lots of good providers signed up for Phase 2, but now the only providers  [for this large group] are public health and the hospitals – now [those providers] are out in the cold and the responsibility falls on public health.”

“We had a good plan – but with this announcement happening right before the holiday, we were besieged with calls – everyone wanting to know when their turn is,” she sighed. “We got through yesterday, including first responders, such as law enforcement and fire, we continued with the dental community, and some ad hoc folks, we were aware of, filling in the spots where some department staff were hesitant about taking a vaccine.”

Carlstrom said that with the governor’s announcement, her department got more than 70 voicemails from the community, loading up their voicemail system. All were from people age 70 and older, wanting to get on a list. “We took down those names and numbers so when we hit a lull, we would start calling folks, if spots came open in Phase I; basically it was we have an open spot, if you can get here in 30 minutes we can give you your first dose. But at the end of the clinic we all agreed, we have to find another way to build capacity.”

With that in mind, she explained that the county is taking this week to build an online scheduler to help streamline the interest and get people plugged in to appropriate spots. For those with internet access, this is going to be the best way to set an appointment. (Those that don’t have Internet access will need to work with their caregivers and service providers and call for appointments.) Starting next week CCPH will offer vaccination clinics at the fairgrounds on Mondays and Tuesdays from 1:00 to 4:00 p.m.

Carlstrom said they have been able to see several people every 15 minutes until now, but that as this shifts to the general public rather than disciplined first responders, this will be a tougher demographic to manage. She said that CCPH is beginning with two clinics at the Chaffee Fairgrounds, and is exploring options for a Saturday clinic. She added that CCPH will set up a custom approach for school districts for vaccinating teaching and support staff.

Regarding quantities, Carlstrom said that so far, the county is getting a steady supply of the Moderna vaccine, although there are no guarantees of a specific number. “Between us and the hospital, we’re getting about 600 or so doses of vaccine a week.” She isn’t sure which vaccine, or how much, may be flowing to the Buena Vista Correctional Complex.

Asked about Columbine Manor, Carlstrom said that early on, that Columbine Manor opted into a federal program that is tied to Walgreens or CVS for vaccinations. “On paper that sound great, but in reality in rural Colorado, we can’t wait for these pharmacies that don’t even exist here. So we started vaccinating Columbine staff at the last clinic and the next will be the rest of the staff and residents.”

“We’re really making it happen – it’s unfortunate that we had this curveball, but we have fantastic county and municipal leadership,” she adds. “I couldn’t do what I do without the strong camaraderie and the network in our county. That clearly sets us apart from what other communities and other public health departments are dealing with.”

Featured image. During the first COVID-19 vaccine clinic Monday, Dec. 28, 2020 at Chaffee County Fairgrounds (done in a snowstorm), Chaffee County Emergency Medical Services (EMS) staffer Andrew, was a part of the collaborative team that monitored for adverse reactions post-vaccination. In the frigid and snowy weather, Andrew with EMS monitored for adverse reactions, which he said “are highly unlikely.” None of the individuals vaccinated at CCPH’s first vaccine clinic experienced adverse effects.