A yawning regional disparity in vaccine availability in Maine worsened this week after the state’s allocations left mass vaccination sites serving northern York County and Portland’s western suburbs operating at 50 to 80 percent of their capacities.

Meanwhile, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, spent two minutes of Tuesday’s media briefing urging Mainers 70 and older to schedule vaccinations at Cross Insurance Center in Bangor, where Northern Light Health has been vaccinating more than 1,000 people a day, repeating the phone number to call. The clinic had to scramble to fill appointment slots that opened up after the discovery of a software error.

MaineHealth’s Scarborough Downs vaccination site, however, was running at only 80 percent capacity for lack of vaccine, despite serving the most populous swath of nearby York County, which has by far the largest number of unvaccinated over-70 Mainers in the state: an estimated 16,500 as of Monday based on census and demographic data, compared to 8,900 in Penobscot County, where the Cross Insurance Center is located.

Shah and MaineHealth have starkly conflicting accounts of why this is happening – and why Northern Light and other Penobscot County providers received 8,720 vaccine doses this week while York County providers got 1,600 and Scarborough Downs made do with 4,000 to serve both Cumberland and York counties.

Cumberland County, with Scarborough Downs on its southern edge, got 9,120 doses, about the same number as Penobscot, even though it has twice the population and hosts the medical centers and vaccination sites that serve much of Sagadahoc and northern York counties.

Shah said the issue has been a lack of additional capacity at Scarborough and other mass vaccination sites in the state that received smaller allocations than the number of unvaccinated people over 70 in their service areas would imply.

“I’ve been really clear with my priorities: If you’re running a high-throughput site like the Cross Center or Scarborough Downs or Intermed and you need more vaccine, we will find it,” Shah said in an interview Wednesday. “This is not me being stingy or having some special love for Penobscot County. If they have people who are willing to get shots in arms, I will get them vaccine.”

Shah said he has been reaching out to all the mass vaccination site providers and encouraging them to expand capacity rapidly, as large sites have the fastest and most efficient methods to achieve effective herd immunity in a population. Northern Light has risen to the challenge, he said, expanding its capacity from 900 shots a day when it opened Feb. 2 to about 2,000 currently, and has accordingly received large allocations.

“I have offered that to other sites,” Shah said. “If (MaineHealth) needs more vaccine, I will get them more. Tell me what you can do and I will get it.”

This explanation doesn’t add up for MaineHealth’s chief medical officer, Dr. Joan Boomsma, who said the health system has been seeking larger vaccine allocations for Scarborough Downs and its other providers. The Scarborough Downs site is ready to deliver 5,000 first vaccine shots a week, she said, but has been receiving only enough vaccine from the Maine CDC to do about 4,000 first doses a week.

“MaineHealth has the capacity to vaccinate considerably more qualified Mainers for COVID-19 if more vaccine were made available,” Boomsma said in a written response to questions.

As a whole, MaineHealth – the state’s largest health care network and the dominant provider in Cumberland, York, Franklin, Oxford, Lincoln and Knox counties – received 8,250 first doses from the Maine CDC this week. “We could easily administer 12,000 first doses next week and even more the following week,” Boomsma added.

She said MaineHealth informed the leadership team at the Department of Health and Human Services via email on Feb. 15 that it had “identified the needed staffing and set up the necessary infrastructure to administer up to 25,000 total (first and second) vaccine doses a week.”

She also said MaineHealth’s Westbrook vaccination site is operating at half of its 2,000 first-dose weekly capacity, also for lack of supply, and that systemwide the network is providing vaccines at only 35 to 40 percent of capacity.

MaineHealth’s waiting list for first doses stands at about 30,000 eligible Mainers over age 70, Boomsma said, some of whom have been on the list since Jan. 26. More than half of them – about 18,000 – live in Cumberland and York counties.

“It is clear we have a significant opportunity to vaccinate Maine residents over 70 in the southern part of the state, provided we have the vaccine to do so,” Boomsma’s statement concluded.

In response to MaineHealth’s assertions, Shah stood his ground, saying MaineHealth had not yet reported using all the doses it was allocated for the week and that the hospital network had not “communicated a specific request for more doses.”

“We continue to strive to work with MaineHealth and other systems to vaccinate as many Maine residents as quickly and fairly as possible, and we look forward to a day when MaineHealth demonstrates that it can get more shots into people’s arms in compliance with Maine’s vaccination plan,” Shah said in an emailed statement sent Thursday evening.

Shah and Gov. Janet Mills sharply criticized MaineHealth after Press Herald columnist Bill Nemitz revealed the network had vaccinated thousands of its remote workers who don’t interact with patients as well as 10 out-of-state consultants hired to help block a unionization effort by Maine Medical Center nurses. Shah said on Feb. 9 that hospitals that violated vaccination eligibility guidelines would have vaccines taken away from them.

Supply constraints are also at work at MaineGeneral’s new mass vaccination site at the Augusta Civic Center, which opened Feb.17. It serves Kennebec County, which started the week with an estimated 9,939 eligible 70-and-older residents who had not yet received their first dose, or 58 percent of that age group, one of the worst figures in the state.

This week, the Maine CDC allocated the county’s providers 2,100 doses, 1,440 of which are being used at the Augusta Civic Center site, according to MaineGeneral spokeswoman Joy McKenna.

“We are capable of increasing our weekly vaccinations to reach the rate of vaccinating up to 1,000 people a day,” McKenna said via email. “We have been increasing our vaccine order, adjusting our scheduling and our staffing to meet this goal.”

The hospital does face a chicken-and-egg problem: It wouldn’t allocate large numbers of staff to expand capacity at the site unless it knew it would receive a large increase in vaccine. “If we were to get 1,000 additional doses tomorrow, it would take us a week to get staff scheduled and schedule patients for the vaccination clinic,” she said.

As of Wednesday afternoon, she said, it had about 5,000 people 70 or older on its waiting list. “As we know how many vaccines we will receive for the next week, we reach out to get them scheduled.”

At Central Maine Healthcare, the parent entity of Central Maine Medical Center, which is Androscoggin County’s principal vaccination site, supply is also the main constraint. “Our capacity is based on vaccine availability,” said CMHC’s chief medical officer, Dr. John Alexander. “As that ramps up, so does our capacity.”

He said CMHC would also need advanced notice to dramatically increase capacity, as it would have to divert qualified personnel from other work.

At York Hospital, a 48-bed community hospital serving southern York County, capacity does appear to be a limiting factor. Hospital spokesperson Jean Kolak said the vaccination site at St. Christopher’s Church in York had an effective capacity of 400 to 500 doses a day but is still working its way toward being open five days a week and had been receiving as many doses as it could handle from Maine CDC.

The hospital’s backlog of eligible vaccine seekers stands at 4,950, she said.

Northern Light announced Wednesday that the Cross Insurance Center clinic in Bangor will expand from three to four days a week. Spokeswoman Suzanne Spruce said the network still has considerable demand and that the slots that had opened up this week are due to a scheduling software issue with the system that holds slots in reserve for people needing their second vaccine dose.

“When that was caught and corrected, a number of appointments for first doses opened for today and tomorrow,” Spruce said via email. “We saw an increase in volume of people registering online and via phone later in the day and appreciate Dr. Shah’s help getting the message out.”

Some regions in eastern and northern Maine – including near Bangor – have probably reached the threshold of “early adopters” 70 and older who were actively seeking to be vaccinated, Spruce said. “We now have many folks who are eagerly awaiting their turn – especially that 65-and-over grouping,” she said.

The Maine CDC may expand vaccine eligibility to include 65- to 69-year-olds as early as next week. “If there are open slots then that is a good signal to us that we can open up the categories to start filling these spots,” Shah said at Tuesday’s briefing.

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