“It’s just a weight lifted now,” said Sergeant Detective Brittany Thompson of the Western Carolina University Police Department, as she left the clinic around 5 p.m.
She’d arrived 10 minutes before the four-hour clinic began at 4 p.m. After making her way through the line, she entered the rec center, received her dose — it didn’t hurt, she said — and sat in one of the spaced-out chairs in the gym where vaccine recipients were asked to wait for 15 minutes, allowing health department staff to watch for any adverse reactions. None occurred, said Health Department Director Shelley Carraway.
Thompson, 31, said she was excited for the opportunity to get vaccinated but that it was a more complicated decision for her than for most. She’s 18 weeks pregnant, and while experts believe that mRNA vaccines like the Moderna dose Thompson received are unlikely to pose a risk to either the mother or the baby, actual data on the topic are extremely limited at this point. After talking with her doctors and her husband, Thompson ultimately decided to get the shot.
“We’re very pro-vaccine. We missed our families,” said Thompson, whose father is currently undergoing chemotherapy. “We haven’t been able to see them a lot, so we’re just ready for stuff to get back to normal.”
Brad Rice, a volunteer with the Cashier-Glenville Fire Department, said family concerns also drove his decision to get the vaccine.
“I was a little skeptical,” he admitted. “My wife’s a nurse and she made me feel a little better about it, explaining it to me. I mean, without knowing anything, new stuff you kind of push away, but my father-in-law lives with me and he’s 86. That’s the main reason. If it wasn’t for him living there I probably wouldn’t get it for a little while and let all these older people get it first, but I’m just trying to protect him.”
As it stands, Rice, 41, arrived early and was the 15th person to get vaccinated last Friday.
Meanwhile, the long line of people waiting their turn moved slowly closer to the door. Lieutenant John Beegle of the Jackson County Sheriff’s Department and Stephanie Dinn of Jackson County 911 both said they had no second thoughts about getting their dose.
“It’s available. I’m going to get it,” said Dinn. “I was waiting for it.”
Scramble to vaccinate
In total, the health department administered 200 first doses of the Moderna vaccine during last week’s clinic, which served as a rough run of sorts for staff to get their process down for future mass vaccination clinics.
As vaccine supply allows, the county will offer drive-thru vaccination clinics 10 a.m. to 4 p.m. on Tuesdays and Thursdays at the Jackson County Department on Aging — at the first drive-thru clinic Jan. 19, 300 people were scheduled to receive a shot. Pre-registration for the clinics is required by calling 828.631.HELP or completing the form at forms.gle/NtPSjjSJSVQMPTD26.
To date, the health department has received 800 vaccine doses from the state, said Carraway, and it has administered 820 doses — Harris Regional Hospital gave the department some of its allotment in order to cover the shortfall. The health department and the hospital will soon get additional help with vaccine distribution, as Blue Ridge Community Health Care and Western Carolina University recently became providers.
Additionally, the Highlands Cashiers Health Foundation is receiving vaccine doses from Mission Health and is planning its own clinics on the plateau. The first one will take place 1 to 7 p.m. Wednesday, Jan. 27, and registration information is available at www.highlandscashiershealthfoundation.org.
Currently, Jackson County is receiving Moderna vaccines only, which require a second shot 28 days after the first. The county is working on planning events to handle second doses, said Carraway, and expects to receive its first shipment of second doses soon. An exciting note is that WCU will be receiving its own separate vaccine allocation from the state, and the University of North Carolina System is providing it with an ultra-cold freezer capable of handling the Pfizer vaccine — its storage requirements have been a challenge for rural communities.
Last week, Jackson County changed its vaccine distribution plan to align with revisions to state guidelines. The population is now divided into five priority groups for vaccination, with the first two currently eligible for vaccination. Those groups include healthcare workers with in-person patient contact, staff and residents at long-term care facilities and anyone 65 or older.
Next up will be frontline essential workers, then adults at high risk for exposure and increased risk of illness and then finally anyone else who has not yet received a vaccine. While there is no specific timeline for moving from phase to phase, Carraway said that she doesn’t expect to move on to Group 3 until early-to-mid March. There is no way to predict how many doses Jackson County will receive in any given week, but the department has been averaging 200 per week. However, changes to state rules mean that communities that are more efficient in getting vaccines administered are rewarded with increased doses, so Carraway hopes to see that allocation increase as drive-thru clinics ramp up.
Clinic staff monitor patients for 15 minutes after they receive the shot to watch for adverse reactions. Melissa McKnight/JCDPH photo
According to the N.C. Department of Health and Human Services, in Jackson County 923 people had received the first dose in the two-dose vaccine regimen as of noon Jan. 18, with 53 people in the county having taken both doses. That is a significant increase from the report for noon Jan. 13, when 559 people had received the first dose and 46 people had completed the vaccine course. However, it’s still a drop in the bucket compared to the total population — only 2.1 percent of the county’s estimated 43,938 residents has received at least one shot.
It’s a similar story in nearby counties. In Macon County, 722 people have received a first dose and 72 people have completed the course, while in Swain County only 423 people had received a first dose with four people completing the course. Haywood County’s numbers are higher, with 2,302 people receiving the first dose and 511 people completing the course as of Jan. 18.
Statewide, 344,456 people have received a first dose and 60,073 people have completed the vaccine series.
Addressing a staffing shortage
In Jackson County, staffing issues have significantly impacted the health department’s ability to monitor cases and contact tracing while also launching the vaccination effort. Currently, the health department has six nursing positions — including one supervisory nurse — but only three are filled. Recently, the department has been limping along with just two nurses on staff because one person was out for medical reasons.
The problem, County Manager Don Adams told commissioners during a Jan. 12 work session, is a competitive hiring environment and a lacking county pay policy.
“Right now when we hire a nurse, we cannot give that nurse one-to-one credit for their experience, meaning they could have been a nurse for five years at the hospital, but they would be counted as indirect experience and only given a one-to-two step increase,” he said.
Public health positions already pay less than public-sector nursing jobs, and the indirect experience policy doesn’t help. The county is simply not receiving any applications for these vacant positions — it’s been advertising one of them since November, to no avail.
In addition to improving hiring strategies for full-time nursing positions, the county is also considering part-time hires to help with the coronavirus response effort. Adams said that he’s heard from paramedics and retired nurses who would be willing to assist.
“What this does is it gives the Health Department access to medically trained individuals relatively quickly when needed in order for them to walk in and be of benefit,” he said. “It’s that type of part-time assistant we’re looking for.”
Help is on the way.
During their Jan. 19 meeting, commissioners unanimously approved two items aiming to address these issues.
The first, an amendment to the county’s pay policy, allows the county manager to give one-to-one experience credit to registered nurses and nurse practitioners seeking employment with the health department. In order to receive credit, applicants must be licensed and working full-time in the field at the time of application. Only consecutive years of licensed employment in North Carolina would count as direct experience.
Commissioners also approved a hiring policy change that will sunset when the ongoing State of Emergency is lifted. During this time, the county manager will be able to set pay rates “in accordance with market demands” and to offer salaries above Step 12 on the county’s pay scale without seeking approval from commissioners.
More immediately, members of the N.C. National Guard are slated to arrive in Jackson County next week to help with the vaccination effort. Carraway said Jan. 19 she was promised a total of six people who will assist with vaccination, data entry and other tasks. All of their time and expenses will be paid for, and they will supply their own laptops as well. They will be on site for at least a month.