The St. Louis region will host at least eight mass vaccination events in the next two weeks where residents can get their first COVID-19 vaccine dose. The large-scale sites are among the most efficient methods to distribute shots, doctors say, with many sites vaccinating thousands of people a day.
But infectious disease specialists say that while the events in stadiums and parking lots can serve huge numbers of people, they may not accommodate many of those most at risk of becoming sick from the coronavirus — people who work retail jobs, poor people and those with chronic health issues.
“I think that the case for mass vaccination sites is that we have to vaccinate at an unprecedented scale,” said Dr. Eric Goralnick, medical director of emergency preparedness at Brigham and Women's Hospital in Boston. “And then there's challenges, in particular with different populations.”
People who go to the large sites often have to drive or take public transit, said Goralnick, who has studied emergency preparedness nationwide.
That can deter people who have trouble walking or who have a disability. Many sites are only open during the day and require people to make an appointment in advance. That doesn’t serve many people who work hourly day jobs and who can’t take time off.
“It certainly doesn't facilitate people who don't have cars or don't have an ability to get to one of these clinics, it doesn't help them,” said Dr. Timothy Wiemken, an infectious disease professor at St. Louis University. “I think it’s just essentially maintaining the wedge that’s already there.”
The state has concentrated on delivering doses in St. Louis after months of pursuing a population-based vaccine distribution plan. Statewide, about 30% of Missourians have received at least one dose of vaccine, compared to about 19% in St. Louis.
The Federal Emergency Management Agency will open a two-month community vaccination site at the Dome at America’s Center in downtown St. Louis starting Wednesday. Officials expect to vaccinate close to 170,000 people at the FEMA site before the end of May.
State- and federally run large-scale vaccination sites in the St. Louis region have been successful, said Dr. Randall Williams, director of Missouri’s Department of Health and Senior Services. However, mass vaccination sites don’t work for everyone, he said.
Some people are intimidated by the sometimes-long lines and military personnel at the events.
“It fascinates me that some people really love the idea of getting into their car and going to a mass vaccination site, where it takes them 20 minutes,” Williams said. “On the other hand, there are other people where that is kind of off-putting to them, they want to go to somebody they know, they want to go to their doctor, or their pharmacist, or where they go for other things.”
Williams was surprised when few people used public transportation to get to a vaccination site at Arrowhead Stadium in Kansas City earlier in the spring, despite his department’s efforts to put the site close to transit stops.
“They weren’t coming in on the buses, they were all driving their cars,” he said.
To help make it easier for people to be vaccinated, state health officials plan to stop relying so much on mass vaccination sites. Currently, about 20% of the state’s weekly allocation goes to the large-scale events. In the coming months, more will go to clinics, retail pharmacies and other smaller sites, Williams said.
Williams also expects the demand for doses at the mass vaccination sites, including the two-month FEMA site in downtown St. Louis, to subside over the next month.
“We have to be prepared,” he said. “Come the third or fourth week of April, we’re going to have to work much harder at improving people’s hesitancy.”
That includes making getting shots as easy as possible, at places where people already are: clinics, churches and shops and workplaces where people don’t need to register in advance, said Goralnick, the emergency preparedness expert from Boston.
“There’s retail, pharmacy, primary care clinics, health care systems, pop-up clinics, whatever, maybe mobile sites,” he said. “There's a lot of different tactics we need to employ.”
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