In letter to state, Linn Public Health criticizes allocation of 1-dose COVID vaccines

CEDAR RAPIDS - The state's decision to allocate one-shot COVID-19 vaccines to colleges and employers is 'heartbreaking” to local public health officials who have been 'requesting, even begging, for several weeks” to receive the doses to administer to vulnerable populations, Linn County Public Health wrote this week in an emotional plea.

In a letter Wednesday, Linn County Public Health asked the Governor's Office to allocate the Johnson & Johnson vaccine to local public health agencies and let them decide what's best for their jurisdictions.

'It is becoming increasingly clear that the Governor's Office does not trust local public health to identify and serve individuals in our community who are most vulnerable,” wrote Tricia Kitzmann, community health division manager, in the letter.

She continued, 'I am struggling to understand why will the Governor's Office not listen to those that know their communities best and work with us to identify the best strategies to vaccinate our community, both manufacturing, businesses, higher education, and the most vulnerable and susceptible to barriers to accessing vaccine and experience social determinates of health.

Kitzmann's letter was sent to leaders at the Iowa Department of Public Health, including Director Kelly Garcia. The letter first was reported on by KCRG-TV.

Kitzmann said in an interview with The Gazette that since the beginning of the pandemic, local public health officials have dealt with disjointed communication from state officials and a lack of transparency from the Governor's Office.

Because of that lack of transparency, Kitzmann said, it's hard for local officials to know how state input has impacted vaccine distribution - namely, whether communities are getting their fair share of doses.

'There's a lot of complicated things that go with that,” she said. 'I don't know how the community is being impacted, because I don't know how those decisions are being made.”

The state public health department pushed back on that characterization.

'IDPH works on a daily basis with local public health, vaccine providers and community organizations to balance the needs of all the state's vulnerable populations,” department spokeswoman Sarah Ekstrand said in a statement.

Each of the state's counties will receive at least 100 Johnson & Johnson doses next week, she added.

Since sending that email Wednesday morning, Kitzmann told The Gazette the department has received word it will receive an additional 500 doses of the Johnson & Johnson vaccine, bringing next week's total allocation to 1,200 doses. These additional doses, which will be directed to vulnerable residents who might have difficulty getting to the two appointments required by the other vaccines, had been declined by other counties and returned to the state for redistribution.

This week, Gov. Kim Reynolds announced a large allocation of Johnson & Johnson doses will be sent to colleges and universities, and Kirkwood Community College is in consideration to receive those shots.

The simplicity of the vaccine and the fast approaching end to the semester are the reasons it was offered to colleges, Ekstrand said.

'Vaccinating students before they return home reduces the risk of them spreading the virus to family members, and ensures they have been vaccinated before returning to campus in the fall,” Ekstrand wrote.

In addition, Hy-Vee is receiving 3,200 doses of the one-shot vaccine specifically for Collins Aerospace employees, according to Kitzman.

Ekstrand said resources needed from local providers to implement two-dose clinics are 'considerably increased,” meaning some employers have opted for the convenience of a one-dose clinic.

Linn County Public Health questioned the Governor's Office in the letter about why was opting to allocate the Johnson & Johnson doses to vaccinate a 'very high functioning and health literate professional populations.”

While public health officials are always thrilled to have more shots in arms, Kitzman said in an interview with The Gazette, it's still important to ensure equity. Those populations are often well-resourced, technologically savvy and capable of attending two-dose clinics.

The state's decision was frustrating, Kitzmann said. 'It just felt wrong,” she said.

Public health officials have said the one-shot dose is ideal for vulnerable populations, which they've identified as including those who face barriers to health care or are homelessness, and immigrant, minority and low-income families.

'Our plan has always been to use Johnson & Johnson vaccines for the populations who might be more at risk for scheduling or adhering to a second appointment,” Ekstrand said in the statement. 'Many of the employers who have received Johnson & Johnson to date employ the populations referenced.”

Local public health officials say they understand the pockets of the population that are most vulnerable, and have established relationships with leaders in those communities to help reach those individuals.

'My job is to be that safety net, to ensure those populations are reached and not overlooked,” Kitzmann said to The Gazette. 'Someone in Des Moines simply cannot do that.”

Linn County Public Health had been working with local agencies and organizations in recent weeks to find solutions for vaccinating residents who face barriers. With the additional allocation expected next week, Kitzmann said officials will expand the targeted clinics planned to reach those experiencing homelessness, refugees and immigrants and Latino residents. It's also a priority to reach inmates inside the Linn County Jail, Kitzmann said.

Comments: (319) 398-8469; michaela.ramm@thegazette.com