The highly anticipated rollout of coronavirus vaccines in Florida has so far been hindered by supply issues, inconsistent communication and chaotic distribution plans.
A month after the U.S. approved its first vaccine, nearly 444,000 Floridians have received at least one dose as of Friday. Millions more have faced confusion, frustration and mixed messages as the state struggles to get vaccines to the people who need them most.
Gov. Ron DeSantis has touted Florida as one of the first states to offer vaccines to people 65 and older who live independently. But some seniors have crossed county lines and contended with overloaded call centers and crashed websites in search of shots.
Meanwhile, some health care workers and residents of long-term care facilities, who the governor originally said would get priority, are still awaiting inoculation.
Florida is not alone in dealing with a messy start to its vaccine rollout. That’s little solace to those clamoring for shots that could bring the state to the end of a pandemic that’s already claimed about 23,000 lives here.
“I know they’re overwhelmed, but we’re not seeing the smooth information flowing out,” said Dr. Glenn Morris, director of the Emerging Pathogens Institute at the University of Florida. “The general public still doesn’t have a good sense of what’s happening, when vaccines will be available and how.”
Too few doses
The scarcity of doses has been a large logistical challenge for the state, Florida Division of Emergency Management Director Jared Moskowitz told the Times/Herald this week. If doses were more widely available, he said, providers wouldn’t see the same rush that has knocked out call centers and crashed appointment websites in parts of the state in recent weeks.
Florida has not been clear about how many doses it has received, nor where they have been sent.
What information the governor’s office has put out is incomplete and does not always match data from the Centers for Disease Control and Prevention. Questions from reporters for clarity have gone unanswered as the vaccination effort has clearly stalled in places.
Nearly 1.4 million doses had been shipped to Florida as of Thursday, according to CDC data. State data from Friday shows that, as of Thursday, fewer than 470,000 total shots had been administered, including second doses.
CDC data shows Florida is comparable to other large states and the national average in the percentage of its population that has been at least partially inoculated.
So far, Florida appears to have allocated ample doses to some vaccine providers and extremely limited doses to others — possibly in part due to uncertainty about shipments from the federal government.
Even with such limited supply, DeSantis moved before most other states to start offering vaccines to the general population 65 and older, going against his own blueprint for distribution. A draft plan from October said independent seniors would not gain access to vaccines until Phase 2 of distribution. Phase 2 was described as starting when there is a “large number of doses available, supply likely to meet demand.”
That was set to come after Phase 1, when health care workers, those living in long-term care facilities and some first responders were slated to get the state’s first shots. Not all of them have.
Sarah Palm, a 39-year-old home caregiver in St. Petersburg, said they’ve tried to snag an appointment in seven counties around Tampa Bay. Palm either couldn’t get one or was turned away for being younger than 65.
The best direction they found was from the Pinellas County health department’s tweet Jan. 4 that health care workers should “contact your nearest hospital to discuss vaccine options.” Palm said they emailed BayCare Health System, but no one responded. Bayfront Health St. Petersburg was out of appointments.
“I’m risking my life to provide care,” Palm said. “If we’re putting our lives on the line, we should have access.”
Christina Johanssen, a 43-year-old physician’s assistant in Palm Harbor, emailed DeSantis Dec. 29, asking when she would get a vaccine. She still hadn’t found a shot as of Friday.
“I understand your desire to vaccinate older adults,” she wrote to the governor. “I must ask, though, that you don’t forget us.”
In a recent letter, Hillsborough’s deputy county administrator Greg Horwedel told commissioners that “managing expectations” about vaccine supply is key. The county has 1.5 million residents and received 9,000 doses in its first week.
“Doesn’t go very far,” said commissioner Ken Hagan, who called the early rollout a “clown show.”
Local health departments don’t know how many vaccines they’re going to get, or when they’re going to get them, until soon before they do, said Dr. Marissa Levine, a professor of public health at the University of South Florida. “That makes it very difficult to initiate a distribution plan.”
Breakdowns in distribution
The federal government has largely left it to states to decide how to dole out doses. Florida, in turn, has relied largely on hospitals and county health departments to get vaccines into people’s arms.
Both sectors are already overburdened as coronavirus cases surge, said Jay Wolfson, a public health expert at USF. While it’s good for local entities to direct vaccination programs because they know their communities, he said, they need support.
Unlike in some states, local health departments in Florida have been left to set up phone lines and webpages for hundreds of thousands of people to register for vaccination. Some counties offered doses on a first-come, first-served basis, leading to viral images of elderly Floridians camped out in lines overnight.
Lacking clear guidance, hospitals set up their own eligibility rules about who was considered a frontline health care worker. Independent providers working outside hospitals haven’t received clear guidance on where they fall in the distribution line.
“I think without a kind of unified state plan that fits the national plan, then that’s added stress to the local health departments to try to figure out how to do it,” Levine said, adding that underfunded county health departments are already dealing with contact tracing and testing.
The state’s vaccination plan hasn’t been publicly updated since the governor shifted his priority to independent seniors, leaving Floridians with “inappropriate expectations” about what will happen and when, Wolfson added.
DeSantis is putting pressure on hospitals to do more vaccinating of the general public, saying he wanted to spark “healthy competition” between them and that those who didn’t use vaccines quickly would have them taken away.
Experts have warned against that strategy, saying hospitals are not set up for mass inoculations, especially as the state breaks records for coronavirus infections and hospitalizations climb.
Little and confusing communication
Issues with supply and distribution at the start of Florida’s vaccine rollout were not entirely surprising to those in public health.
But Florida’s struggles to clearly communicate how and when vaccines would be available has added unnecessary angst and confusion, say those on the ground.
That includes communication to the public, as well as getting key information to vaccine providers.
“Let’s be clear: The reason there’s confusion is because there’s been no real, comprehensive plan,” said Barry Burton, Pinellas County administrator. “Absence of information sows that confusion.”
DeSantis’ disjointed messaging about vaccines — delivered in hastily called news conferences around the state — has further confused Floridians.
In a surprise announcement before Christmas, he announced that vaccine doses would become available within days to Florida residents 65 and older. But he offered no information on where vaccines would be available or how people could sign up. Nor did he clarify that many county health departments would not immediately have doses for this population.
Even some within health departments had not known the announcement was coming, and they hadn’t gotten specific instructions from the state, Wolfson said.
Days later, DeSantis announced that all health departments would soon have doses to start giving to older residents but he did not say how much each county was getting.
Burton said the Pinellas health department, which reports to the state health department, didn’t know it would be receiving only 3,000 doses in the initial batch until days before the vaccines arrived. By then, expectant residents were already itching to sign up.
With roughly 250,000 residents over the age of 65 in Pinellas County, the phone lines quickly jammed and a reservation website crashed.
“It’s a coordination issue and a communication issue,” Burton said. “Before we make an announcement, let’s make sure we have the distribution channel to be able to deliver on that announcement.”
This week, DeSantis announced plans for vaccines to be distributed at Publix locations in three counties and said the state is working to offer vaccinations at coronavirus testing sites and at places of worship. But it’s unclear when and where some counties will get vaccination sites like that.
St. Petersburg Mayor Rick Kriseman said his city is ready to set up two sites, but he doesn’t know what the state expects.
“Give us a consistent message just so we know what in the world we need to be doing,” Kriseman said. “It’s been so disjointed. It’s been so inconsistent.”
On Friday, U.S. Sen. Rick Scott, a former Florida governor, sent a letter to Florida Surgeon General Scott Rivkees, asking for details on the state’s vaccine distribution plan, including information on how it’s ensuring Floridians know when and where they can get a vaccine and what resources the state has deployed into communities. Other elected officials have also raised questions, with a bipartisan delegation of U.S. representatives from Florida asking DeSantis on Friday to brief them on the state’s vaccination process.
Florida’s problems have been compounded by issues at the federal level. In a letter to Alex Azar, secretary of health and human services, the American Hospital Association asked for guidance and said “it is unclear who is responsible for answering questions.”
Still, the communication and transparency failures from Tallahassee started long before vaccines arrived. DeSantis has been criticized throughout the pandemic for issuing vague orders and having an uneven response that at times pushed responsibility to local governments.
The messaging on the vaccine rollouts has irked some of the groups the governor has prioritized for receiving doses.
On Wednesday, AARP Florida State Director Jeff Johnson released a statement calling on the state to be transparent about its distribution plans.
“Too many older people are frustrated by their inability to understand when and where they can get vaccinated,” Johnson said in the statement. “And in some communities, a long history of systemic discrimination has left trust in tatters. This is jeopardizing the effectiveness of a brilliant scientific success in developing the vaccines.”
At a Thursday news conference, DeSantis said “significantly more shots” would be administered that week across the state than the previous one. He said the holiday season may have contributed to the slow start.
The governor talked in a news release Saturday for the need to “accelerate the pace” of vaccine rollout. He said the state has averaged about 40,000 per day and is “prepared to increase that number” as Florida receives more shots from the federal government.
Cindy Prins, associate professor of epidemiology at the University of Florida, said health care workers and public health agencies are still facing a daunting task: rolling out mass vaccinations while caring for infected patients and handling testing and contact tracing while the virus rages.
“We’ve had some hiccups, but I think we’ll start to get this worked out over the next few weeks, hopefully, and get a smarter distribution happening,” Prins said.
Morris, of UF’s Emerging Pathogens Institute, is less convinced Florida’s problems will be short-lived. He said he’s concerned the state’s lack of planning will force it to keep playing “catch up” as the vaccine is made available to other populations.
There are still few answers on how vaccines will get to underserved communities and how to ensure equity among socioeconomic groups, racial and ethnic groups and with people in rural areas, Morris said.
On Thursday, Dr. Anthony Fauci, the nation’s top infectious disease expert, stressed in an interview with National Public Radio that the country, like the rest of the world, is only in the early weeks of the vaccination effort.
He told NPR’s Morning Edition that people should keep an eye on vaccine rollout in the coming weeks, adding that if the U.S. does not start catching up on its vaccination goals soon, “then we really need to make some changes about what we’re doing.”
While Florida works to get its rollout figured out, positive cases of the coronavirus are hitting record highs, and hospitals are straining to manage the numbers of patients coming through the doors. More than 1.4 million Floridians have tested positive for the virus.
Adding to the mix is the appearance in recent days of a likely more contagious strain of the virus in the Sunshine State.
Kriseman, St. Petersburg’s mayor, said people should be optimistic that there’s such demand for vaccines and that Floridians are getting inoculated. But he hopes the first few weeks of the vaccine rollout will offer lessons.
“I hope we as a state look back and say, ‘We need to learn from the mistakes we made,’ because we sure as hell made a lot of them.”
Staff writer Natalie Weber contributed to this report.
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