Emails show Linn County Health begging to have more say in vaccine allocations, say Governor’s office is ignoring health equity

Published: Apr. 1, 2021 at 8:55 PM CDT
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CEDAR RAPIDS, Iowa (KCRG) - In an email KCRG-TV9′s I9 investigative team received through a public records request, Linn County Public Health begs and pleads with the Governor’s Office to give local public health departments more say in how vaccines are allocated to make decisions regarding the one-dose Johnson and Johnson vaccine.

The email, which is three pages directed to officials at the Iowa Department of Public Health and the Governor’s Office, strongly critizes the state’s handling of the Johnson and Johnson COVID-19 Vaccine. Iowa gave 3,200 doses of the Johnson and Johnson vaccine to Hy-Vee to give to employees at Collins Aerospace in Cedar Rapids. While, Linn County Public Health wants those doses to go to harder to reach populations, like people who are homeless.

On Wednesday, Governor Kim Reynolds announced it would work with Colleges and Universities to give them Johnson and Johnson doses.

Tricia Kitzmann, who is the community health division manager, for Linn County Public Health said in the email that it is clear the Governor’s Office does not trust local public health offices.

“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,” she 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, businesses, higher education, and the most vulnerable and susceptible to barriers to accessing vaccine and experience social determinates of health.”

Kitzmann, who also sent a copy to Linn County Public Health Director Pramod Dwivedi, said her department worked with leaders in vulnerable populations who said it is vital to offer the one-dose series to several of these populations due to the loss in follow-up, fear of government, trauma, access barriers and/or transient nature of the population.

She said workers at Collins Aerospace and college students are equally able to receive two doses themselves.

“Why is the Governor’s Office choosing to allocate the Johnson and Johnson COVID-19 vaccine to Hy-Vee to vaccinate very high functioning and health literate professional populations?,” Kitzmann asked. “Collins Aerospace is a valued business in our community. However, a large majority of these employees has been working remotely since the beginning of the pandemic and most do not have barriers accessing healthcare, transportation or mistrust the government. In fact, there is a CVS Pharmacy on the Collins Aerospace campus that is prepared, willing, and eager to vaccinate this population. This particular CVS Pharmacy began vaccinating Collins Aerospace employees with allocations from Linn County Public Health.”

She said she believes the only single-dose vaccine available in the United States, which is the Johnson and Johnson vaccine, should go to people who are homeless or that live in transitional housing that are difficult to reach. Kitzmann also advocated for inmates and those living in correctional facilities because they live in close proximity to each other and there have been several outbreaks in this population. She also said staff members who work with these populations are at high risk.

Kitzmann then begged the Governor’s Office to give local public health agencies more power in the allocation of vaccines.

“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.”

In the email, Kitzmann also pointed out the Governor’s focus on health disparities between who is getting the vaccine based on race she made last Wednesday. Then, the Governor focused the small percentages of vaccines going to Black and Hispanic Iowans, which was respectfully at 1.07% and 1.67%.

She said the decisions from the state reinforce those numbers

“By not listening to the voices of those most vulnerable and doing what we can to meet their needs, we are reinforcing messages that those with privilege, such as those with secure employment, reliable transportation, access to technology, and stable housing, come before them. We are reinforcing the message that they cannot rely on or trust our Government or those with power to protect and serve their community,” Kitzmann said.

Although not as vocal many other local public health agencies have been advocating for a similar strategy as Linn County health leaders. Sam Jarvis, who is the Community Health Division Manager for Johnson County Public Health, said Johson and Johnson’s Vaccine is an ideal vaccination to provide to folks who are harder to reach or have issues with scheduling or transportation.

“The barriers are literally cut in half. There are persons who are experiencing homelessness, jail/prison populations who are going to transfer, patients or persons who rarely seek care, persons who are homebound, and other similar scenarios where it would be difficult to schedule the second dose appointment that this would be extremely beneficial for,” he said.

Since this email, the state will allocate doses to Linn, Johnson and other counties for the first time. Earlier doses went directly to food production and manufacturing plants.

Pat Garrett, who is a spokesperson for the Governor’s Office, said the state is simply trying to fully vaccinate as many people as possible.

“We are trying to vaccinate as many people as possible and work through priority groups while simultaneously dealing with limited supply,” he said. “Iowa has one of the best vaccine administration rates in the country.”

Sarah Ekstrand, who is a spokesperson for the IDPH, said her department works with local public health agencies and the Governor’s Office on determining vaccine allocations. She said the logistical simplicity of the Johnson and Johnson vaccine and safety was why colleges and universities were prioritized.

“Vaccinating students before they return home reduces the risk of them spreading the virus to family members, and ensures they have been vaccinated before returning to campus in the fall,” Ekstrand said. “Because the end of the semester is fast approaching for many colleges and universities, completing student vaccination with one dose is the best option.”

She said the reason Johnson & Johnson is being utilized for a portion of Iowa’s larger employers is that a two-dose vaccine takes away more resources from public health. But, said it’s plan has always been to use the Johnson and Johnson vaccine on those who are more at risk.

“Resources from county health and other providers to implement two clinics are considerably increased when administering a two-dose vaccine, but some employers and local public health departments have opted for that approach,” Ekstrand said. “Our plan has always been to use Johnson & Johnson populations for the populations who might be more at risk for scheduling or adhering to a second appointment. Many of the employers who have received Johnson & Johnson to date employ these populations you reference. Each of the 99 counties has received at least 100 doses of Johnson & Johnson in next week’s allocation, and can be utilized to vaccinate harder to reach populations.”

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