‘We’re all in the same boat’: Urban, rural health officials strive to deliver vaccines equitably

Supply shortage still main hurdle across state

MADISON, Wis. – The pandemic has a way of making things feel far away, including loved ones, neighbors and a return to normalcy.

“We want to get out there and we want to vaccinate people,” said Jeff Jelinek, Sauk County COVID-19 incident commander. “I mean, this is what we’ve been working on since March, just to get to this point.”

The rural parts of our state may seem especially out of reach.

“I think the biggest thing for us is resources. We do not have the amount of resources big, urban populations have,” Jelinek said. “The great thing is, we do have a lot of great partners.”

Jelinek said in Sauk County, they have the benefit of established connections. The health department has been keeping close ties with hospitals including SSM Health St. Clare Hospital in Baraboo, going the distance to overcome any hurdles.

“We really are striving to make sure we deliver this vaccine as equitably as possible and we’re able to reach everyone in our county,” said Treemanisha Stewart, Sauk County’s new public health officer.

With the help of the Wisconsin National Guard, mobile vaccination teams have set out to offer health departments vaccination resources where they’re needed across the state, including in Sauk County.

“There is a large rural population, and some of them have to travel great distances to get to local health care providers to get the vaccine,” said Dave Kitkowski, emergency preparedness specialist and safety manager at St. Clare Hospital.

But other than that, Kitkowski said there isn’t much of a difference between getting vaccinated in a rural area vs. an urban area within the SSM network, which has more than a dozen vaccination sites across Wisconsin.

“The process is a bit different for us, but in the eyes of a person coming in for a vaccine, it looks the same,” said Mo Kharbat, SSM regional vice president of pharmacy services.

Kharbat said while Dane County has more people and health care workers, that’s mostly balanced by more vaccinators.

“I think there’s pros and cons to being in a rural area vs. an urban area,” said Tess Ellens, COVID vaccine deputy with Public Health Madison & Dane County. “Everyone’s just doing their best to make sure we’re getting vaccine out as soon as possible. For us that means scaling up at Alliant Energy Center to make sure we can get big fast. For other places, that might not be the case.”

On Saturday, Upland Hills Health in Dodgeville held its first vaccination clinic for patients who qualify in Phase 1B.

“It was very joyous,” Vice President of Ancillary Services Krisann Karls. “It’s one of the highlights, I would say, of my career.”

At Upland Hills, Karls said they use the Moderna vaccine, which doesn’t require as cold of storage as Pfizer’s vaccine, making it preferable for rural areas.

“We are not seeing any specific challenges being in a rural setting,” she said. “We have been receiving our vaccine in a timely manner.”

Karls said the hospital’s barrier is one all health officials share: a lack of supply as they set out to vaccinate health care workers, first responders, people 65 and older and others currently eligible.

“We haven’t been getting enough Pfizer and Moderna vaccines as a state, not just as a health system,” Kharbat said. “We request enough doses for our vaccine clinics across the Wisconsin region. However, we have been allocated only a third of what we request for the past two weeks in a row. If we receive more doses, we will certainly be able to vaccinate more people.”

Jelinek said the Sauk County Health Department received a quarter of what they requested last week. Typically, Karls said Upland Hills gets anywhere between 25 to 40% of its requested vaccine.

It’s an issue Wisconsin Department of Health Services officials addressed in a briefing Tuesday.

“We have a terribly difficult situation with nearly 300,000 doses requested and only 27% we could provide,” said DHS Deputy Secretary Julie Willems Van Dijk. “We’re going to have to alter back and forth between places in the weeks to come as we continue to have a relatively small supply for the number of requests we are getting.”

Willems Van Dijk noted they made changes to their formula determining where the doses go “to assure we were equitably distributing the vaccine across our state.”

“We’re all in the same boat in this, whether in urban or rural settings,” Karls said, noting Upland Hills is working closely with partners, as well. “We’re all collaborating together to make sure we can get vaccines out as quickly as we can.”

That collaboration brings a return to normalcy closer.

“I think the biggest thing would be patience,” Jelinek said. “Not just the public having patience. We need to have patience as well.”

Kitkowski stressed it’s still as important to keep up precautions such as physical distancing and mask-wearing during the vaccination process.

“Things we’re already doing making sure we’re keeping ourselves and our neighbors as safe as possible,” Kitkowski said.

He said internet access can be a challenge for some patients living in rural areas. St. Clare Hospital has a phone line eligible patients can call at 608-250-1222. Upland Hills patients can call 608-930-7224.