North Carolinians ages 65 to 74 are now eligible to get a COVID-19 vaccination, the N.C. Department of Health and Human Services said Thursday.
The move follows a recommendation this week by Alex Azar, secretary of U.S. Department of Health and Human Services, to expand the age range beyond ages 75 and older in the Phase 1B subgroup.
The federal guidance also includes individuals with chronic health conditions.
Joshua Swift, the county’s health director, cautioned that as vaccination schedules are adjusted to accommodate those ages 65 to 74, ”we are not currently accepting appointments at this time.”
Appointments currently are meant for health-care workers and individuals ages 75 and older.
The Forsyth health department temporarily shut down its call-center phone line on Jan. 7. It is reaching out to individuals on its 50,000 call backlog and vaccinating between 500 and 550 individuals per day.
“It is top of mind to change as quickly as possible to go from vaccinating those ages 75 and older to those 65 and older,” Swift said.
A ripple effect from adopting the recommendation is that N.C. DHHS is phasing out its four-phase vaccination allocation strategy.
N.C. DHHS said the announcement means that "vaccine providers who are ready may vaccinate adults 65 years and older and health care workers, which will be followed by frontline essential workers, then adults with high risk of exposure and increased risk of serious illness, then everyone.”
Frontline workers would include teachers, law enforcement, first responders and child-care workers among the employment categories.
Some states have vaccinated their elderly population groups before some essential-worker sectors.
“If you are 65 and older, or all of our health-care workers, it is your time” to get a shot, said Dr. Mandy Cohen, the state’s health secretary. “Providers can move on if they are ready.
“However, we need to remember that not every provider has appointments available right now for those ages 65 and older.”
‘Simplicity and speed’
On Tuesday, several state Republican senators urged Cohen to emphasize flexibility in terms of vaccine allocation.
Cohen said Thursday that what DHHS took out of the U.S. DHHS and legislative recommendations is to put a focus “on simplicity and speed.”
However, Cohen cautioned that even though DHHS plans to reallocate doses from lower-demand communities to mass-vaccination sites, the allocation timeline won’t change much for most North Carolinians.
That means individuals who will now be in the “everyone” category still should not expect to be vaccinated until late March at the earliest.
“We’re still awaiting word on how the federal release will work — will they release just second doses or doses they were holding back related to shipping or manufacturing concerns,” Cohen said.
“We want our providers to know that the second dose will be there so they don’t hold back on giving first doses.”
An example of applying flexibility is rolling out the mass-vaccination site strategy, which involves shifting weekly vaccine supplies from providers with current excess supply to mostly urban areas.
Over the next month, Forsyth County is expected to have separate mass-vaccination sites operated by Atrium Health Inc. through affiliate Wake Forest Baptist Medical Center, Forsyth Medical Center and the county Department of Public Health.
Swift said its mass-vaccination site could increase its daily vaccination volume from a range of 500 to 550, to between 1,000 and 1,500.
Dr. Christopher Ohl, an infectious disease expert with Wake Forest Baptist, said he is comfortable with individuals getting their second dose within two to three weeks after the 21-day waiting period for the Pfizer vaccine and 28-day waiting period for the Moderna vaccine.
Ohl said that although the 95% vaccine efficiency doesn’t come until both doses are administered, the first dose is at about 85% efficiency.
Expert: Please be patient
The expansion could — at least in the short term — add to the bottleneck that has produced long waits to get COVID-19 vaccination appointments for the limited supply of Pfizer and Moderna doses.
Ohl said extending vaccinations to ages 65 to 74 will be a challenge considering the appointment process for ages 75 and older "has been complicated and a moving target."
"That sounds great, and as far as I'm concerned, the more people who get vaccinated the better," Ohl said.
However, Ohl cautioned that complying with the new federal guidelines with current vaccine supplies "still means a lot of people who won't be able to get it for a while."
"Just saying that 'it's OK for you to get vaccinated' doesn't mean there's a vaccine out there for you.
"Appointments are going to scarce for a while,” Ohl said. “So, people are going to have to be patient."
Timeliness is key
Azar said Tuesday that by late January, U.S. DHHS will begin rationing state vaccine allotments in part based on the number of residents ages 65 and older, as well as states' percentage of distributing previous vaccine allotments.
"If you are not using vaccines that you have the right to, then we should be rebalancing to states that are using that vaccine," Azar said.
A New York Times report, last updated Friday, has North Carolina ranked 41st with just 2% of its population having at least one Pfizer or Moderna vaccine dose, or 211,512 out of 10.5 million residents.
A Bloomberg News report ranked North Carolina 42nd in terms of percentage of doses (27.8%) used, although the state was 12th in total doses administered.
DHHS reported during Tuesday's legislative committee meeting that the total was up to 257,165 doses. The breakdown is 219,173 through community sites and 37,922 at long-term care facilities through CVS Health and Walgreens.
Cohen said Thursday the vaccination total is up to 326,198 statewide.
A reporting glitch Tuesday contributed to higher COVID-19 daily totals being reported Thursday by N.C. DHHS.
The department said some laboratory data files were not processed Tuesday.
DHHS lists COVID-19 cases and deaths on the day they are confirmed by medical providers and public health officials, so individuals may have been infected or died days before their cases are counted.
DHHS reported Thursday there were 9,853 new COVID-19 cases. The statewide total is at 650,926 since mid-March.
It is the fourth highest daily total for the pandemic, all of which have been reported since Jan. 7. The daily high is 11,581 reported on Jan. 8.
There were 327 new cases reported for Forsyth County. Forsyth set a record for new cases Saturday with 430. The total is at 24,103 since mid-March.
There were an additional 80 COVID-19 related deaths reported Wednesday for an overall total of 7,825. A record 142 deaths were reported Sunday.
DHHS reported an additional COVID-19 death in Forsyth for an overall total of 237.
The statewide COVID-19 hospitalization count was at a record 3,990 as of 11:30 a.m. Thursday, up 39 from Wednesday. The previous record high of 3,960 was reported Jan. 7-8.
The 17-county Triad region had 1,033 hospitalized COVID-19 patients as of Thursday's report, up 15 from Wednesday's report. The daily high is 1,078 reported Jan. 8.
The Charlotte region had more COVID-19 hospitalizations, at 1,044, than any other region on Thursday.
The Triad region had the highest hospitalization numbers for 12 consecutive weeks before Tuesday.
DHHS reported Thursday that Forsyth had a positive test rate of 14.6% out of about 1,300 tests conducted Tuesday. The county had a record 14.8% positivity rate out of about 1,150 tests conducted Sunday.
Statewide, there was an 11.1% positive rate out of 46,008 tests conducted Tuesday. The record positive rate is 17.5% of the 25,882 tests conducted Jan. 4.