Dr. Dan Varga, the chief physician executive at Hackensack Meridian Health, said he’s stunned to see statistics that say New Jersey has only administered 30-40% of the vaccine it has received. He said HMH has administered more than twice that number.
“We’ve been very successful at HMH at getting shots in arms,” he said. “We’re running at about 85-plus-percent use of our available vaccine. So, if we get it, we’re getting it in arms. The rate-limiting step for us — and I’m sure it is for all the other health systems and other vaccinators — is the availability of the vaccine. We can bring up sites and we can schedule vaccinees — as long as we got vaccine.”
The talk about having enough facilities — or enough people to give the shots — is not heard around HMH, Varga said.
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“Tomorrow, if (President-elect) Joe Biden said, ‘I’m giving you 100 million doses of vaccine, and I’m sending it out on Monday,’ we’d open access all over the place, ASAP,” he said. “And we’d churn vaccine until we couldn’t churn vaccine anymore.
“We’ve got plenty of people to give the shots. We’ve got the logistics down for scheduling. We’ve got the logistics down for documentation and reporting to the state.”
Varga said he would just need to know one thing: Details about the second shot.
“If the distribution plan changes, we want to make sure that there’s absolute clarity of how the second dose is being handled,” he said. “In other words, if I’m getting 500,000 doses tomorrow, I need to know if 500,000 more are coming — or if I need to hang on to half of that shipment for the second dose. That’s the only thing I need to know before I ramp things up.
“Just tell us how we’re supposed to handle the second shot, and we’ll do it.”
With all the talk about vaccine distribution, we went to Varga to hear how it’s going in one of the state’s two large systems. Here are his thoughts, edited for space and clarity.
ROI-NJ: Where is HMH administering vaccines — and where could it be?
Dan Varga: We are in 10 acute care hospitals, but we can expand into 18 physician practices and three urgent care centers if we need to. And we’re going to be working with the state on the Meadowlands mega site.
We have sites we can open, and we have ways to staff all those — but we really don’t want to promise access and then not have vaccine to deliver. So, the more of the vaccine comes, the more sites we’ll open.
ROI: The physician practice offices make sense. After all, you’re already seeing patients. How would that work?
DV: Agreed. We do about 35,000 visits a week in our physician practices. And, I guarantee you, most of those people are over 16 and they have a condition, otherwise they’re not coming to the doctor. I could easily go through 35,000 just in our physician offices each week, without any strain.
ROI: Let’s talk logistics. HMH has been asked to distribute both the Pfizer and the Moderna vaccine. Is that a problem?
DV: Not at all. It actually give us more flexibility. Moderna does not require the extra cold storage, so — as we open more sites — I’ll be able to bring Moderna to those sites while keeping Pfizer at the sites that have the extra-cold facility.
ROI: People have asked why the state is not doing 24-hour vaccination. Could you?
DV: It’s just a matter of having the vaccines. I have to tell you, I really don’t know the explanation for why sites say New Jersey’s used only 40% of its 650,000 doses. I’ve used almost 90% and the only reason I haven’t used 100% is I don’t have any more vaccine scheduled to arrive until Tuesday, and I’m vaccinating all day Friday, all day Saturday and all day Monday before the next shipment of vaccine comes in.
The first couple of weeks, we weren’t quite at that just-in-time scenario, but we’re really getting close. Which means, if the delivery doesn’t come on Tuesday, we’ve got a lot of people scheduled with no vaccine to give them.
ROI: So, adding vaccines from Johnson & Johnson, which may be coming in February, will not be an issue?
DV: J&J would be a great addition. Here’s one of the things that J&J will allow us to do, since it’s a one-shot vaccine. All health care facilities encounter people that they know they are going to see once, but they’re not sure they’re coming back — like someone in your emergency department. If we’ve got a one-shot vaccine, we’re taking care of them right then and there. You can start doing things like that, because you don’t have the need to coordinate the logistics of the second shot.
ROI: Last question, and it’s the question of the day. People with conditions such as diabetes, or people who are smokers, have moved up the priority list. You’re giving the vaccine. How will you know if they have the condition that they say they do?
DV: The easiest way to do that would be to say you need to walk into the vaccination center with the equivalent of a prescription from your doctor that says you have whatever the condition is. The state is strongly urging that we don’t do that, and we don’t want to do that.
But, one of the reasons we want to open more of our physician practice groups is that we want to treat those people there. We know these people. We already treat them. We know how to care for them. So, in that sense, it works out well.