A carefully constructed county plan to corral the influx of residents seeking a coronavirus vaccination was upended Tuesday when the Pennsylvania Department of Health again revised its vaccine distribution plan.

The primary change Tuesday was the reclassification of all individuals 65+ and those 16-64 with certain preexisting conditions as “1A”, or the first wave of vaccinations.

Preexisting conditions include cancer, heart conditions, and being immunocompromised, as well as pregnancy, obesity, and smoking. Based on these changes, a hypothetical 21 year old smoker would now get vaccinated prior to a 55 year old otherwise healthy teacher or postal worker.

Previously, 1A had been limited to front line health care workers. Long-term care facilities were also part of initial vaccinations, although the state is directly coordinating those vaccinations through pharmacy partnerships.

Lebanon County Director of Emergency Services Bob Dowd said in an interview that prior to the state’s reclassifications on Tuesday, just about 100 individuals were left in a county-maintained list of 1A individuals who were still needing vaccinations. That’s out of about 500 signups overall.

Now those numbers are set to balloon, with little to no coordination or support from the state government on how to manage the deluge. Dowd estimates that 30,000 individuals in Lebanon County may now be eligible for 1A status, but nowhere near that level of vaccine is expected to be available in the near or medium term.

Compounding the problem is that no state clearinghouse exists for vaccination data in a way that counties or health care providers can access – who has received, who needs one, what conditions or employment status might qualify one for accelerated immunization, etc.

Internally though, DOH does track vaccinations for Pennsylvanians in a similar manner as it does coronavirus cases, providing the figures to the public and local officials at the county level only. According to state data, 3,655 county residents are partially covered with a single dose as of today and 754 are fully covered with two doses.

Stuck behind the influx of new 1A candidates, the essential workers in 1B – about 3,500 had signed up as of earlier this week, out of maybe 15,000 expected to be eligible overall – are primarily from the education sector, with agricultural and governmental employees also being significant portions of the list. While some of these individuals may now qualify under 1A status, those who do not are expected to see wait times for a vaccine increase by 4-8 weeks or longer.

With relatively static distribution and no signs of imminent increased allotments, the state changes prompted the county to abandon a plan it had previously pursued to help county residents and healthcare providers navigate this situation and connect individuals with vaccine doses as quickly as possible.

Read More: Lebanon County launches online portal for essential worker vaccination signup

Between the gargantuan increase in volume and the dearth of guidance from the state on how to actually validate and prioritize between the various 1A factions, the county is now moving to a model where it points residents to providers but does not actually manage a signup list or vaccination queue. Dowd acknowledged that he does not want to be in a position where an individual is on a county list but may be able to get vaccinated faster by approaching a provider directly.

Dowd said that people are frantic and scrambling to call everywhere until they get an appointment and that the department has already received a huge spike in phone calls and emails. In the confusion, Dowd said, inequities can easily occur given the inconsistent or totally absent guidelines from the state as to how providers should ensure they are giving shots to those who actually qualify for them.

WellSpan Health would not share specific numbers but said that it opened registration forms last night; vaccination signups which will be contingent on supply.

“We are proud to be a trusted partner in our communities and be able to administer the vaccine but we ask everyone for patience as the current supply will take some time to catch up to the demand,” said WellSpan spokesperson Ryan Coyle in an email. “We opened schedules last night but that hinges on us getting ongoing, adequate vaccine supply from the state.”

“We may have to adjust schedules depending on that supply.”

Dowd said that the county is looking into a large scale vaccination site that could be jointly run with a health care provider. He is also actively working to bring additional health care providers and pharmacies online to provide vaccinations to the public.

In the meantime, your best bet is to watch for DES website update on local providers or use the state’s map to see local vaccination providers. WellSpan also has some vaccine information specific to its system available here.

LebTown is continuing to cover this story and will bring you further updates as they occur.

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