A drop in vaccine demand means ‘things evolve’

Vaccination sites are closing, others revamping hours as Murphy says state is responding to changes
Credit: (Edwin J. Torres/ Governor’s Office; CC BY-NC 2.0)
April 23, 2021: Health Commissioner Judy Persichilli, center, and Gov. Phil Murphy, right, visit a COVID-19 vaccination site at a ShopRite store.

With COVID-19 vaccine supplies holding steady and demand for the shots declining, New Jersey’s immunization program is shifting gears, with walk-in appointments now regularly available at mega-sites around the state and some larger county operations shutting down or temporarily suspending inoculations.

Gov. Phil Murphy declined to detail state plans for any additional vaccination site closures on Wednesday. But he made clear the evolution is part of the state’s plan to transfer focus from its larger, regional immunization operations to smaller, community-based programs that allow people to get shots in doctors’ offices, local drugstores or at home with help from a visiting caregiver. The state is also targeting younger people, he said, by partnering with colleges and offering the “Shot and a Beer” program announced Monday, which enables those who got a first dose in May to enjoy a free beer at participating breweries.

“When you’re in a war, things evolve,” Murphy said at his pandemic briefing Wednesday, comparing the state’s response to a military battle for the second time this week. “We always knew,” he said, “that we would get to the place where the supply-and-demand imbalance would swing the other way and it would require us to shift strategy and to be very offensive in getting into communities.”

State officials did not detail how the changing demand has impacted their statewide vaccine-distribution strategy but stressed that doses are not going to waste. The vaccines require careful temperature-controlled storage and have strict expiration dates and state officials employ a complex formula — based on local COVID-19 rates, demographics and immunization-site capacity — to determine how many doses to provide to each operation every week.

Of the nearly 8.97 million doses delivered to New Jersey to date, the state has been unable to use just 8,570 — or barely 0.1% — not counting approximately 700 that spoiled in transit, according to Donna Leusner, Department of Health communications director. This is lower than the national loss rate of 0.13% and far below the initial federal wastage goal of under 2%, she said.

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Murphy said more than 3.3 million New Jerseyans have now been fully vaccinated, when those immunized out of state are included, meaning the state is 72% of the way to reaching its initial goal of inoculating 4.7 million people by July.

Older New Jerseyans lead the way

Participation is highest among those over age 65, according to state data. Just over half of those age 30 to 49 have had their first shot and slightly more than one-third of individuals between 16 and 29 have received one dose. The most common vaccines require two shots, spaced several weeks apart.

Reaching people who have yet to be vaccinated — and convincing them to get the shot — is now the priority, Murphy said. On Monday he outlined a two-pronged strategy, dubbed Operation Jersey Summer, which calls for additional outreach and public education plus logistical changes to make it easier for people to access immunization sites. The campaign is particularly focused on underserved communities with high numbers of Black and brown residents, who have been disproportionately impacted by the pandemic, and other populations in which vaccine rates are lagging.

“These are steps at the right time and the right place that we always knew we would take,” Murphy said Wednesday. New Jersey’s shift to the new “hub-and-spoke” model — in which larger sites transfer doses to more local operations — echoes  the national strategy President Joe Biden outlined earlier week, which encourages states to make walk-in appointments available and take other steps to ease vaccine access, the governor noted.

‘Get into all the crevices and corners of the state’

“This is basically going to get very localized,” Murphy said. While some of the bigger vaccination sites will still exist, the state has started to deploy other strategies, like partnering with churches and community centers and deploying a trio of specially outfitted buses to serve as mobile vaccination clinics. The goal, he said, “is to get into all the crevices and corners of the state. That was our intention all along.”

Credit: (NJDOH)
The health department is using mobile vaccination clinics to reach people.

New Jersey’s vaccination program launched in mid-December at a handful of large hospitals — limited to health care professionals and few others. It quickly expanded to include other people at high risk for infection or death and eventually grew to include hundreds of sites operated by health care providers, local and county governments, and state officials. Anyone over age 16 is now eligible.

But enormous demand was compounded by inconsistencies in the supply chain, leaving people scrambling for limited appointments and sparking widespread public frustration. Eventually the system stabilized and New Jersey was administering more than 120,000 shots daily at several points in early April, according to state data. That level of interest didn’t last, however, and by the beginning of May daily vaccination numbers had fallen to below 50,000.

The health department is now working to counter this slide with the new community-based initiatives and public outreach envisioned in Operation Jersey Summer. The campaign involves novel partnerships, like an alliance with churches called “Grateful for the Shot,” and has trained 900 volunteers to serve as vaccination ambassadors in communities where immunization rates are lagging. The state has also tasked operators at its vaccine call center with reminding people to get their second dose on schedule, officials said last week.

This evolution doesn’t mean all six of the state-run vaccination mega-sites, or other large county operations, will shutter permanently, Murphy said. He hopes the evolving vaccine rollout will prevent New Jersey from facing another widespread viral surge but said the state will still need a system to respond to local outbreaks and keep people protected with booster shots, which experts anticipate will be required in the future.

“We’re hoping it doesn’t rear its head again,” Murphy said of the virus that has now infected more than 1 million New Jerseyans, including nearly 25,000 who have died. But the state will leave aspects of its vaccine distribution infrastructure in place, he said, likely a mix of some larger sites and many smaller, local options. “It could be every October when you get your flu shot you also get a COVID booster,” he said, either at a mega-site or your local pharmacy.

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