Dickinson County declines vaccine shipment as demand drops

Tuesday, April 20, 2021

Editor's note: Iowa Gov. Kim Reynolds said during her April 21 press conference that 43 counties have now declined some or all of their vaccine allocation, and shipments are being redistributed to higher-demand areas of the state.

More than 20 percent of Iowa's 99 counties have turned down their allocations of COVID-19 vaccine from the state, according to reporting by the Iowa Capital Dispatch. Dickinson County Public Health Director Katy Burke confirmed Dickinson County was among them. The local public health office declined doses which would have been used this week, citing "a sharp decrease in demand."

"There are other counties in the state with a greater need for doses, so by declining this latest shipment, it can be reallocated to an area with a greater demand," Burke said. "We are not filling our appointment slots like we used to, so we are switching to a weekly walk-in model at the Lakes Area Senior Center. Local pharmacies continue to be another great source to receive the vaccine."

Burke said her office was offered about 300 doses of the vaccine developed by Moderna, which she said was consistent with allocations in recent months.

"Hy-Vee and Walmart received doses," Burke said. "We do not have a total of their doses received and/or administered. Dickinson County residents have also had the chance to participate in nearby mass clinics and the opportunity to visit pharmacies in neighboring counties."

Local health officials said 7,407 doses of vaccine had been administered through the public health office as of Friday — brining the total number of people to be fully vaccinated via public health to 3,253. Residents of long-term care facilities were vaccinated through a separate state program for which the public health office does not have totals. The number of vaccines administered through local pharmacies is also unknown to the public health office. Around 2,450 of the county's 2,588 confirmed cases of the respiratory virus are considered recovered, but Friday's report added another COVID related death to the county's total, which now sits at 44. Dickinson County's rolling, two-week positive test rate was listed at 9.2 percent in the most recent report — the rate was at 9.2 percent as of March 12 and heralded a rise to 16 percent by April 2.

Burke said Dickinson County Public Health may not qualify for additional doses in the coming weeks because of the local reduction in doses being used.

"We successfully completed hundreds of vaccine series last week, but had significantly reduced interest in first doses," she said. "If and when we accept and are offered doses is heavily determined by our community’s demonstrated interest in getting the vaccine."

Burke also noted no counties will be receiving shipments of the single-dose vaccine developed by Johnson and Johnson during the current pause on its use. Officials with the Center for Disease Control, as well as the Iowa Department of Public Health, called for health providers to pause the use of the single-dose vaccine after patients developed blood clotting in six of the 6.8 million cases the vaccine was used.

"Currently, the odds of this reaction happening are literally one in one million," Iowa Gov. Kim Reynolds said during last week's press conference.

Dr. Pat Winokur, executive dean of the medicine at the University of Iowa — which aided in some COVID-19 vaccine trials — said the clotting disorder seems to be associated with low platelet counts — components in the blood which help form clots — and has so far occurred in women ages 18-48. She said similar cases involving a vaccine developed by AstraZeneca have been reported in the European Union. No such cases have been associated with the Moderna or Pfizer vaccines, according to Winokur. She noted the Moderna and Pfizer vaccines use MRNA platforms, which are a different type of vaccine than the adenovirus platforms used by Johnson and Johnson and AstraZeneca, according to Winokur.

"I think the fact that we did pause is important," Winokur said. "It's what we want the system to do. Many of you are probably concerned that we rolled these vaccines out too quickly. I can assure you we did not skip any steps in the creation of these vaccines. Remember, each of these vaccines was tested in 30,000 to 40,000 people. That's ten-fold higher than we typically include in our drug trials."

Winokur said symptoms of the rare blood clotting are different and more severe than the mild pain and fatigue sometimes experienced by most who receive any of the COVID-19 vaccines. The IDPH recommended Iowans who experience severe headache, leg pain abdominal pain or shortness of breath within a month of receiving the Johnson and Johnson vaccine should seek immediate medical attention. Winokur said a specific test can be done to determine if an unusual antibody is attacking a patient's platelets.

"If anyone is identified with this disorder, we have experts that can help walk through how to treat this disorder," Winokur said.

Reynolds, who received the Johnson and Johnson vaccine herself on March 3, encouraged all Iowans to be vaccinated when they are eligible.

"It's really the most important that thing we can do to get life back to normal and keep yourself and your fellow Iowans healthy," Reynolds said.

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