Most Chatham residents get vaccinated outside the county, health dept. finds

By VICTORIA JOHNSON & HANNAH MCCLELLAN

When North Carolina first began rolling out vaccinations, Chatham resident Linda Smith thought it would be easy to get an appointment.

She quickly found out otherwise.

Smith, 70, signed up with four vaccine providers across three nearby counties, including Chatham. After weeks went by with hardly any response, she began looking farther east — and finally found an appointment with a clinic in Tarboro, a two-hour drive from her home in the northwest Chatham.

“My preference would be to go as close to home as possible, and if I had started feeling like the vaccine was readily available, and (that) I’d get called pretty quickly, sure,” she said. “But I started hearing people get vaccines, and I was hearing nothing. So I was like, ‘I don’t know how far down the waiting list I am … If I can get it someplace else, it’s worth driving.’

Many other Chatham residents thought so, too. So far, about two-thirds of all vaccinated Chatham County residents received their first vaccine shots outside county lines, according to Chatham County Public Health Director Mike Zelek.

“When I first saw that, I was taken aback a little bit,” he said last Thursday, but added that the figure makes sense.

North Carolina vaccine providers have been vaccinating frontline health care workers, long-term nursing residents and staff as well as adults ages 65 and older — making up Groups 1 and 2, as dictated by the state health department. Many Chatham health care workers, Zelek said, likely received their shots where they work, which often isn’t in Chatham County.

“If somebody, a Chatham resident, works for UNC Health in Chapel Hill or Duke or VA (Veterans Hospital), they’ll be vaccinated out of the county,” Zelek said. “We know that three quarters of our working adults leave the county to work, and so, I don’t know what that percentage is for healthcare workers, but if it’s along those same lines, it wouldn’t be surprising that those numbers would line up.”

A lower percentage of seniors have been vaccinated outside Chatham than health care workers, he added, though many may receive health care outside Chatham right “across the border” in Chapel Hill.

“We’ve been encouraging residents to pursue all options for vaccines available, knowing we have a limited supply,” Zelek said, adding, “So we’ve been encouraging and putting out contact information through other local options even outside of the county so folks can get vaccinated as quickly as possible.”

‘Just be patient’

Smith followed the CCPHD’s advice and explored outside options — but it didn’t bear fruit as quickly as she would have liked.

She first signed up with her personal doctor’s office, a family medicine practice in Carrboro. Soon after, she registered with Duke Health and the Chatham County and Orange County health departments; each put her on their waiting lists.

She tried looking for appointments with UNC Health, too, but she could never find any available slots — even 10 minutes after friends told her some had opened on UNC Health’s website. Smith’s sister, who lives in eastern North Carolina, first suggested she look for appointments with Vidant Health in that part of the state.

Now, over three weeks after getting her first shot, she said she still hasn’t heard a word from the CCPHD, other than: “Just be patient. We’re trying to get people vaccinated.”

“I think the key is to be patient, but for somebody my age, this is a life and death thing, potentially,” Smith said. “I don’t know that I would die from it, but I might be horribly debilitated, and I’m not right now. So being at the age of 70, you really start to worry about, ‘OK, what’s the quality of my life going to be from here on out, and do I really want to risk it?’ So I want to get vaccinated as soon as possible.”

Chatham’s biggest providers include the CCPHD, Chatham Hospital (UNC Health) and Piedmont Health Services. Up until recently, all three had received an “even split” of doses of vaccine, according to Zelek; combined, they had been receiving about 1,200 doses per week — much fewer than the number of Chatham residents eligible to get vaccinated. Starting this week those doses will increase. Piedmont Health now will receive doses directly from the federal government.

Per Zelek’s estimate, more than 20,000 Chatham residents are eligible in Groups 1 and 2. Adults 65 and older make up about a quarter of Chatham’s population — around 19,000 people — while Chatham health care workers number between 2,000 to 4,000 people.

Earlier this month, Gov. Roy Cooper announced that school staff and childcare workers would be eligible for the vaccine starting Wednesday, Feb. 24. After previously saying this start date was unlikely to be a reality in Chatham, the CCPHD announced Friday it would begin vaccinations for school and childcare workers 50 years and older on Friday. Nearly 1,000 individuals in Group 3 signed up for the vaccine, Zelek previously told the News & Record, and about 400 of those individuals are 50 or older. The department said the majority of its allocation would continue going to Groups 1 and 2.

As of Tuesday, just over 14,000 Chatham residents have received their first doses of vaccine, according to the state’s vaccinations dashboard. Thousands of eligible individuals remain unvaccinated.

‘Vaccine tourists’

But Chatham residents aren’t the only ones leaving their counties to get vaccinations elsewhere. Just 53% of first doses administered in Chatham across all Chatham-based vaccine providers have gone to county residents, according to Zelek.

The CCPHD’s figures are a bit higher; they’ve administered about 80% of their first doses to Chatham residents. Nearly 90% of its Group 2 vaccinations have gone to residents (65 and older).

“All providers will have some recipients from other counties since federal and state guidance requires allowing non-county residents to receive the vaccine,” Zelek told the News & Record. “Larger healthcare systems likely have higher percentages of out-of-county residents given that they have sites in multiple counties and scheduling is centralized.”

Non-county residents could include people from other states, but Zelek estimated few out-of-state residents have been vaccinated in Chatham.

“We target our efforts locally,” he added.

Media outlets across North Carolina, including WUNC, have reported that “vaccine tourists,” or people seeking vaccinations in other states, have been coming into North Carolina from Virginia. A Jan. 26 story from CBSN in Pittsburgh reported that a woman from Pennsylvania had been considering driving eight hours to North Carolina to get her shot.

While getting her first dose over three weeks ago in Tarboro, Smith remembered her nurse mentioned she’d had a patient drive down to Tarboro from as far away as Virginia.

At first, states couldn’t curb “vaccine tourism” since they receive their doses from the federal government under a federal program.

In interim provider guidance last updated Jan. 27, the North Carolina Dept. of Health and Human Services told vaccine providers that the state shouldn’t prevent non-residents from getting vaccinated.

“The Centers for Disease Control and Prevention has instructed states that this is a federal vaccine bought with federal funding,” the guidance read. “Hence, jurisdictions should not put restrictions on administering vaccinations to non-residents, if those persons meet the current eligibility criteria. This applies to both county and state residency.”

But on Feb. 9, per NCDHHS spokesperson SarahLewis Peel, the CDC updated those guidelines, which now permit states and providers to “allow limitations to vaccine based on public-health grounds” and goals.

In practice, the updated guidance encourages North Carolina to prioritize its own residents or “people who spend significant time in North Carolina and are able to spread the virus in North Carolina.” That includes people who work or receive health care in the state.

“However, to promote the public health goals for North Carolina, it is permissible to not offer vaccine to temporary travelers who do not reside, work, or spend significant time in North Carolina,” the guidance reads. “This could include persons briefly passing or traveling through North Carolina or coming to North Carolina for the main purpose of receiving a COVID-19 vaccine and then returning to another state.”

In other words, “vaccine tourists” could now be turned away under state policy.

In Chatham, some residents have expressed frustration on social media about the wait required to get a vaccine in the county, and that non-residents have been vaccinated before them.

Zelek acknowledged that the vaccination process can be lengthy and frustrating, adding that the department will work hard to provide vaccine doses “as quickly and equitably as possible.” In the meantime, he pointed residents to other vaccine options in Chatham and surrounding counties.

“What matters to us is that Chatham residents get vaccinated — who does the vaccination is less important to us, we just want them to get vaccinated,” he said. “We’ll do everything that we can as the health department to make that happen as allocation comes our way, and in partnership with the other providers in the county.”