The state’s having difficulty administering the doses it has to top priority groups. As for the general population, the head of the Maryland Hospital Association says, “Just be patient.”

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This story was updated.

Maryland’s having a tough time administering its early doses of the COVID-19 vaccine, and Gov. Larry Hogan acknowledges it.

“While none of us are thrilled with the pace of this rollout over the first few weeks,” Hogan said at a Tuesday evening news conference, “I can assure you it is improving every day.” In response, he announced a series of steps to try to improve the vaccine distribution.

The state’s top priority is to offer the vaccines initially to health care workers, first responders, and residents and staff at long-term care facilities. But as of Tuesday, only a little more than 79,000 doses of the more than 274,000 vaccines the state has already received have been administered, according to state health department data.

State and local officials say delays in the supply chain and making the distribution of vaccines more predictable are behind the slow start. And that raises concerns about the long-term plan to vaccinate millions in the state against the virus.

Mike Ricci, a spokesperson for Hogan, tweeted Tuesday that “supply [of the vaccine] is the limiting factor.” Ricci attached a graphic showing how vaccines move from the manufacturer to distributors and then transported to healthcare providers.

Hogan said slow and uneven data reporting from vaccine providers is part of the problem.

To bolster the rollout, he announced the Maryland National Guard would be activated starting Wednesday to provide support teams to vaccine providers. The state health department has also identified 700 individuals who are qualified to assist with vaccine distribution. And Hogan announced an executive order which requires all health care providers to report inoculations within 24 hours of injection.

To make sure providers are getting the vaccines into arms, the department is releasing a directive stating that any providers that has not used 75% of their allotted initial doses may have their future allocations reduced until they can prove their ability to meet capacity requirements.

“Our message to those responsible for vaccinations is clear,” Hogan said. “Either use the doses that you have been allocated, or they will be redirected to another facility or provider where they will be used immediately.”

County health officials say that they’re having difficulty planning for the vaccine when they don’t know how many doses they’ll get from week to week.

Dr. Nilesh Kalyanaraman, director of Anne Arundel County’s Health Department, says the county received a little more than 5,000 doses this week. Last week, it received half of that.

“We’re pulling existing staffing to do vaccinations. We haven’t really received the money to do vaccination efforts,” Kalyanaraman says.

He adds that Anne Arundel is aware that in the next three to four weeks the health department will have to double its capacity just to accommodate people who need to receive a second dose.

Montgomery County’s Health Department reports that the county has received 4,200 doses and vaccinated more than 3,700 people so far. Dr. James Bridgers, deputy director of the county health department, says it’s working with private physicians’ offices and the county’s six hospitals to make sure the vaccine gets into the right peoples’ arms.

“If we get more vaccines, we’re able to scale up [our operation],” Bridgers says.

But, Rupali Limaye, a vaccine expert with the International Vaccine Access Center at Johns Hopkins University’s Bloomberg School of Public Health, says state and local health departments are overwhelmed and under funded. “It’s a lot for health departments to be taking on and thinking about how we increase demand and acceptance,” she says.

Maryland and other states also face an access issue. Limaye says health departments have to effectively communicate to eligible groups that they are able to get the vaccine and where it is being distributed.

“And then being able to make sure that the supply is there,” Limaye says. “I don’t want to call it a [logistical] nightmare, but it’s a logistical challenge. … There’s room for improvement in how we conduct outreach with community members.”

The Christmas and New Year’s holidays also slowed distribution of the vaccine to frontline health care workers.  Bob Atlas, president of the Maryland Hospital Association, says hospitals have used about 35% of the approximately 160,000 vaccines they have received.

“The rate that was experienced in the first couple of weeks is not indicative of the rate that will happen now that we’re through the holidays and the flow of vaccine supplies is better understood,” Atlas says.

Atlas also says some health care workers— like some members of the public— don’t want to get vaccinated quite yet. “No hospital is mandating their employees to get vaccinated,” Atlas says.

For eligible people who decline the vaccine, Limaye says the state can’t wait for them and should proceed to others who are eligible. 

Hogan late announced that the state would do just that, beginning what he called “a Southwest Airline model, a rolling vaccine distribution model.”

“No doses should be sitting in freezers going unused … while others are in need of more,” Hogan said. “We’re no longer going to be waiting for all the members of a particular priority group to be completed before we move on to being that next [priority] group. … Either use the doses you have been allocated or they will be redirected to another facility or provider.”

Individuals wondering if they’re eligible for the vaccine can either ask their primary care physician or go to the Maryland Department of Health’s website for more information.

In the meantime, health experts are asking for patience from people in the general public wondering when the state will be in phase three of the vaccine rollout

As for when the general population can get the vaccine, “I don’t want to give a quantifiable or definitive target date,” Bridgers says, “because it changes. Just be patient.”

This story was updated with additional information from Gov. Larry Hogan.

Filed Under: Anne Arundel Count, covid-19, Johns Hopkins Bloomberg School of Public Health, Maryland, Maryland Department of Health, montgomery county, pandemic, vaccine,