In non-pandemic times, Beverly Lilly enjoys socializing with friends over card games, walks, and coffee. But for the past 10 months, the 82-year-old Arvada resident has been isolated alone at home. “It’s like being a teenager and being punished for something—being grounded,” she says.
On Wednesday, January 13, Lilly took a step toward regaining her freedom: At the Centura Health Church Ranch Neighborhood Health Center in Westminster, the born-and-raised Coloradan shed her mint green sweater and appeared to smile under her mask as a healthcare worker plunged a Moderna vaccine into her right arm.
“It’s security and insurance,” Lilly says of the inoculation. “Once I get the second shot, then I know that I’m covered.”
Lilly is one of more than 287,000 Coloradans (and counting) who have received at least one dose of a COVID-19 vaccine since the first batch arrived in Colorado in mid-December, according to data from the Colorado Department of Public Health and Environment (CDPHE). Over 5.5 percent of Coloradans have been vaccinated at least once, Governor Jared Polis said in a press conference on Tuesday, and our progress ranks us among the best in the country. According to data from the Centers for Disease Control and Prevention, Colorado has the ninth highest rate of total doses administered per 100,000 residents, and the eighth highest rate of people per 100,000 who have already received their second dose. In other words, we’re doing a pretty good job of getting shots into arms.
What explains Colorado’s success in what has been an underwhelming and heavily criticized national rollout?
For starters, it helps that we have one of the best public health systems in the country. A 2019 U.S. World and News Report ranking deemed Colorado number eight in the nation in the category of public health. “We’ve got a strong public health system that functions pretty heroically, even in difficult circumstances with limited resources,” says Glen Mays, PhD, MPH, chair of the Department of Health Systems, Management, and Policy at the Colorado School of Public Health. (Mays is not involved in Colorado’s vaccine distribution, but is a public health researcher whose area of study includes health system responses to large scale public health emergencies and disasters.) Moreover, our state has several big and “very capable” health systems that are being leveraged for the rollout, like the University of Colorado’s health system and Kaiser Permanente, says Mays. “Not every state has those big integrated systems with specialized expertise,” he says.
Another possible key to Colorado’s progress is that per state protocol, health care providers must use every vaccine dose they receive within three days. If they can’t use shots that quickly, the supply is then transferred to another site that can. “That’s part of the secret to our success,” Polis said in a press conference last week.
And yet another contributing factor, according to Polis, is the state’s strategy of expanding distribution to the next wave in its phased plan before the previous wave is fully concluded. Two weeks ago, the state opened up vaccination to Coloradans 70 and up in group 1B, while many frontline healthcare workers in group 1A were still getting vaccinated. Though the approach caused some confusion, “you don’t want to slow down,” Polis said when explaining the rationale.
Overall, Mays believes Colorado is doing a good job of making decisions about the vaccine distribution based on limited information and limited supply from the federal government. Right now, the state only knows three to four days in advance how many vaccines it will receive. This short notice makes it difficult for providers to plan ahead, says Cara Welch, senior director of communications for the Colorado Hospital Association, which represents over 100 hospitals and health systems.
Polis hopes communication will improve with the new presidential administration. “I let the Biden transition team know that we hope we can get to a point where we have two weeks notice, or at least 10 days notice, so that every dose can be used even quicker and that appointments won’t have to be canceled because there’s no vaccine,” he said in Tuesday’s press conference.
That followed his announcement last week that the Trump administration “lied” about the number of doses states were set to receive. “We were led to believe just a few days ago the federal government was going to release their stockpile of second doses,” Polis said, explaining that would have amounted to about 210,000 doses delivered to Colorado as a one-time shipment, which would have allowed about half of all Coloradans 70 and up to get vaccinated in the next week. “And that was unfortunately not true.”
Polis said the state expects to receive about 78,000 doses each week for the next two weeks, and about 90,000 to 100,000 doses per week for the first three weeks of February. With those quantities, he said he believes the state can achieve its goal of inoculating 70 percent of Coloradans age 70 and up—there are 562,000 Coloradans in this age range—by the end of February. As of Friday, nearly 40,000 Coloradans aged 70 and up had gotten their first dose of the vaccine, and another 110,000 to 120,000 will get their first vaccination this week, Polis said.
Brigadier General Scott Sherman, director of Colorado’s Vaccine Distribution Taskforce, believes the state could improve its inoculation rate “if we could just get more vaccine.” According to Sherman, pharmacies and healthcare providers have said they could increase vaccinations if the supply were upped. Sherman says the goal is to vaccinate between 200,000 to 250,000 Coloradans a week, which is about the rate at which the state vaccinates people in a typical flu season.
For now though, limited supply from the federal government means many Coloradans 70 and up have not yet been able to receive their first dose. “Appointments are filling up very quickly,” says Welch of the Colorado Hospital Association. Last week, Coloradan Bill Kibe, 75, said his wife was able to get her first vaccination at the Centura Health Church Ranch Neighborhood Health Center, but that he had not yet been able to book an appointment. “We’ve been isolated since March,” said Kibe, a type-two diabetic. “I would just like to get the vaccine so we get behind this.”
As vaccine distribution slowly but surely continues, Mays is very concerned about equity issues—both in Colorado and across the country. He worries about vaccine access for rural communities as well as historically marginalized and underserved populations. In yesterday’s press conference, Polis highlighted several state initiatives aimed at ensuring equitable access, including a partnership with Valley-Wide Health in Alamosa that vaccinated more than 200 people aged 70 and up, as well as a program through Salud Family Health Center in Aurora that vaccinated hundreds of uninsured Coloradans over 70. These efforts are a start, but not a sweeping solution. “Likely there are hidden inequities that we can’t see very well yet with limited data,” says May, “but we need to identify them as quickly as possible and start addressing them.”
For Coloradans frustrated about the pace of the rollout, Welch urges patience. “It’s just a matter of the timing,” she says, adding that in the meantime, it’s important to keep up public health precautions, like mask-wearing, physical distancing, and hand-washing. Polis expressed confidence in the Biden administration’s goal of administering 100 million doses of the vaccine in 100 days, which would translate to about one-third of all Coloradans getting the shot by the end of April, he said. And Mays is “cautiously optimistic” that the vaccine will be widely available to all Coloradans who want it by this summer—so long as no unforeseen events disrupt the production and supply chain. The possible FDA approval of the Johnson & Johnson and AstraZeneca vaccines, both of which are in stage three clinical trials, also adds hope.
“Vaccines are our path back to the Colorado that we know and love,” Polis said on Tuesday. Indeed, once 82-year-old Lilly receives her second dose of the vaccine next month, she anticipates “having the freedom to jump in the car and go where I want and get together with friends.”
“I’m looking forward to getting back to my previous life,” she says.