By Isabel Ashley
As flu season begins and vaccine clinics roll out for children across the county, there is still limited accessibility to COVID-19 vaccines on San Juan Island. Although updated COVID-19 vaccines from Pfizer-BioNTech and Moderna were approved and released in mid-september, there are a few reasons why these vaccines have yet to be made available to a majority of residents on the island. Representatives from SJC Health and Community Services, Peace Health and Friday Harbor Drug elaborated on the reasons for these challenges and provided information on who should get the vaccine and where.
On May 11, when the public health emergency declaration ended, the COVID-19 response began its shift from a public health effort to a privatized model, leading to the commercialization of the COVID-19 vaccine the following September. Meaning, the vaccine is no longer provided free of charge by the Federal government to vaccine providers. Private vaccine providers such as pharmacies and primary care facilities are now responsible for purchasing the vaccine and seeking reimbursement through insurance companies. The privatization of the COVID-19 vaccine has had a profound effect on the ability to receive and distribute the vaccine for different vaccine providers, especially for out-of-network providers like San Juan County Health and Community Services.
Although the county has held COVID-19 vaccination clinics before, they are unable to bill insurance as an out-of-network provider and therefore would be expected to pay out of pocket for the vaccine, costing roughly $120 per dose. The department’s original plan was to execute mass vaccination clinics in the fall utilizing grant funds. Unfortunately, they learned that they were not permitted to use their funding from the Washington State Department of Health to purchase the vaccine, halting their vaccination clinics indefinitely.
“Right now, COVID is really different than before,” said Dr. Frank James, Health Officer for SJC Health and Community Services. “Throughout the pandemic, we’ve been the safest county in the state. We’ve done really well, and people kind of get used to that. Even though the emergency is over, they still have an expectation for the county to do something.”
After persistent negotiation efforts, the department recently learned that this policy might change, allowing them to purchase around 4,500 doses if the appeal is successful. According to SJC Health and Community Services, “This would be a massive investment by the Health Department and could not be done in future years.”
While the department continues to explore options for providing the COVID-19 vaccine to vulnerable individuals living within San Juan County, they do receive free doses of the vaccine for children six months to 18 years old and uninsured adults through the Vaccines for Children Program and the Adult Vaccine Program, respectively.
PeaceHealth Peace Island Medical Center in Friday Harbor is currently not offering the COVID-19 vaccine, according to Jack Estrada, chief administrative officer at PeaceHealth Peace Island. While some other PeaceHealth locations are providing the vaccine to pediatric patients, that need is being met locally through San Juan County.
“As supplies have allowed, we have provided the previous vaccines to both children and adults [in the past],” said Estrada. “The primary driver behind the decision not to offer the latest updated vaccine this fall was its availability at pharmacies in most communities.”
However, Estrada added, PeaceHealth understands the unique challenges with vaccine availability on San Juan Island. “We hope to soon be able to offer a limited number of doses to our highest-risk adult patients on the island,” Estrada said. “Those patients would be contacted individually.”
He added that PeaceHealth is continuously monitoring availability and access in all its local communities and may opt for a different approach to the COVID vaccine in the future. For the most up-to-date information and guidance from PeaceHealth, visit their COVID-19 website at https://www.peacehealth.org/coronavirus
One such pharmacy that is experiencing challenges with COVID-19 vaccine availability is Friday Harbor Drug. The pharmacy has placed an order for the Pfizer and Novavax vaccines; they hope to receive the Pfizer vaccine by the end of the month and Novavax in a few weeks. While part of the delay has been caused by the need to order specific brands for storage requirements and efficacy, the main reason for the setback is the cost.
According to Joshua Matlock, Pharmacy Manager at Friday Harbor Drug, pharmacies do not get reimbursed for 30 to 90 days. With the Pfizer and Novavax vaccine costing around $150 and $100 per dose respectively, it is a large sum to pay upfront. Additionally, the pharmacy is currently rolling out two other vaccines, RSV and the flu, with the RSV vaccine costing $270 per dose.
“The raw cost is definitely a big part [of the delay], now that it’s not funded by the government,” said Matlock.
After test-billing, the pharmacists found that most insured patients can expect their copays to be zero. For uninsured patients, they could expect to pay around $190 for the Pfizer vaccine and $130 for Novavax. Once the pharmacy receives these vaccines, patients will be able to schedule an appointment at https://www.fridayharbordrug.com/vaccination-appointment. Appointments will likely occur over a set number of days due to the efficacy of opened multi-dose vials. As of Nov. 1, Lopez Pharmacy and Ray’s Pharmacy on Orcas do have the COVID-19 vaccine.
So, who should receive the vaccine? According to Dr. James, immunocompromised individuals and those over the age of 60 should highly consider getting the COVID-19 vaccine, being that they are more vulnerable to hospitalization and adverse effects. They also comprise a large part of this community; over 35 percent of San Juan County residents are over the age of 60, as opposed to the average in Washington state of 17.1 percent.
“Preventing outbreaks is really to protect [these at-risk groups], and that should really be our biggest priority,” said Dr. James.
Dr. James still recommends others to receive the vaccine, but he views the decision to be vaccinated as less of a public health matter and more of an individual, private health matter for those outside of high-risk groups. Additionally, depending on factors such as having COVID-19 before or receiving previous COVID-19 vaccinations, or both, allow for a variety of protection against the disease. Those who have received a COVID-19 vaccine have significantly reduced hospitalizations and deaths; those who have contracted COVID-19 before have built antibodies to the disease; and those who have had both are doubly protected. PeaceHealth providers recommend patients to stay current with the COVID-19 vaccine in alignment with the CDC’s recommendations, which can be found at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.
For the most up-to-date information on COVID-19, you can visit the CDC website at https://www.cdc.gov/coronavirus/2019-nCoV/index.html or the Washington State Department of Health at https://doh.wa.gov/ for monitoring COVID-19 in Washington. Additionally, you are welcome to speak to one of the nurses at SJC Health and Community Services by calling 360-378-4474.