As of Friday, roughly 960,000 Illinois residence have received at least one shot of the COVID-19 Vaccine— and about 270,000 of them have received both shots. But the state’s pace has ranked in the bottom third of the country for residents vaccinated when adjusted for population sizes.
Gov. J.B. Pritzker’s administration has pointed to different metrics to argue the state is doing relatively well at vaccinating people. Illinois officials have blamed rollout frustrations on scarce supplies and poor planning by the Trump administration. “To accelerate immunizations, we need our federal partners to align their efforts with ours, to help solve practical operational issues,” the state’s health director, Dr. Ngozi Ezike, testified at a virtual congressional hearing Tuesday.
At that same congressional hearing, a West Virginia Republican noted Illinois had used up less than 60% of vaccine it had received, compared with his home state, which had used up more than 80% by then. Let the fingerpointing continue.
“Look, Operation Warp Speed created the vaccine. It’s the job of the states to put it in people’s arms. And it seems that (some) states can’t even get that right,” said U.S. Rep. David B. McKinley.
You May Also Like
There are some facts that add to the state’s position in the country’s rollout.
- Illinois officials were late to try to hire outside experts to manage the rollout, then abandoned that effort to assemble their own team just weeks before the first doses showed up.
- The state opened up shots to roughly a fourth of all residents, who qualified because of their ages or professions, then let a largely decentralized system figure out who’d be targeted and how fast to administer shots.
- There are no agreed-upon rules for what counts as successful. The state and Chicago each get shots to distribute, and they measure things differently.
- Some local health departments have been allowed to build up sizable inventories while others did their best to inject shots in arms as quickly as they arrived.
Gov J.B. Pritzker gives a news briefing Jan. 27, 2021, at the drive-thru COVID-19 vaccination site set up inside of the Lake County Fairgrounds. (Stacey Wescott / Chicago Tribune)
While some medical providers have begun reaching out to patients, many illinois Covid-19 vaccine seekers are often forced to make longshot cold calls to lists of places they’ve heard might have shots, or stalk websites that flash openings so briefly that those searching for them compare the hunt to the kill-or-be-killed plot of “The Hunger Games” books and movies.
Unfortunately, the state entered the pandemic with an already strained public health bureaucracy and already drained state budget. Researchers said that gave Illinois little room to adjust to a massive logistical headache by the federal government. But at the same time, they say, there’s no excuse for failing to fix resulting problems.
“Every day that a dose of vaccine is not in somebody’s arm is a day that person is exposed to COVID,” said Hani Mahmassani, who directs Northwestern University’s Transportation Center and has been commissioned by the National Science Foundation to help study logistical woes from the rollout.
Just how bad is Illinois?
On a tour of a Champaign vaccination site Wednesday, Pritzker praised the state’s mass vaccination effort. “We’re actually doing quite well,” he said. “We’re reaching new heights. I just announced a record today. We had I think three record days or four record days last week.”
To be clear, the number of daily doses are generally increasing, recently topping 70,000 per day in the state. However, that’s only one way to look at the data. States were always expecting to get better as the process moved on, but when comparing Illinois’ figures with other states, its performance appears laskluster.
As of Friday, out of 50 states and the District of Columbia, Illinois ranked 45th in the rate of shots each state has injected, when adjusted for population.
The Pritzker administration counters that the state so far has gotten less vaccine, per resident, than most others. And that’s true. The state ranks 34th, per capita, in doses provided by the federal government. (Illinois congressmen recently asked federal officials why. There was no immediate response.)
That still wouldn’t explain another ranking — 41st — for the percent of vaccine received that’s been injected into residents. In essence, even if Illinois has gotten a smaller share of vaccine than it deserves, it’s injected a smaller percentage of its share than most states. Illinois officials say such figures don’t reflect an accurate score card for judging bigger states facing more complexities in delivery across urban and rural areas. Illinois is in fact, the sixth-most populated state.
Even with focusing on the six largest states, Illinois ranks second-worst at the rate of getting doses into arms. The difference in rate isn’t huge, but If Illinois, at 57%, had kept pace with Texas, at 66%, it would have meant nearly another 180,000 shots delivered into Illinoisans by now.
What else caused the low vaccine delivery?
The national problems have been well documented, with the Trump administration pushing much of the distribution challenges to the states without much money or guidance.
Those who study vaccine logistics say that every state was stuck trying to build out its own system, with already overworked staffers using glitchy software to manage a complicated rollout of delicate, frozen vials of vaccines. In Illinois, there’s one more caveat: Chicago handles its own doses, directly from the federal government. The rest of the state, including the suburbs, is overseen by the state health department. Among other things, it means additional coordination because people living in the suburbs might work in the city, or vice versa, and get doses at either place. However, States were warned about logistical challenges well before the first vaccines were shipped out before Christmas.
Some places were predicted to have real problems, like West Virginia, with a far older, more remote population. Yet, that state became a national model in vaccine delivery, which enlisted its National Guard to game-plan distribution as early as November.
That same month, in Illinois, the state health department hadn’t even settled on who would run its operation. The department put out a request for proposals, a process often described by its initials, RFP. In questions accompanying the RFP, the state said it was seeking an outside firm for “high level planning, strategy, managing and oversight” of the effort.
Ultimately, the state abandoned the idea of seeking an outside firm to manage the project, and instead grouped four newly hired staffers with an agency deputy director and consultants already working with the department.
Early challenges
When those first doses arrived in mid-December, state and local health officials quickly handed them out to hospitals across the state to begin the process of vaccinating their workers. They were set to be the first ripples in waves that would wash over other health care workers in group 1a, then ultimately the other waves, starting with the 1b group of seniors and front-line essential workers.
But there was early debate about how loosely to define who qualified for shots, mixed with surprise that sizable numbers of hospital workers were hesitant to be among the first to have them injected. Willing doctors and nurses who didn’t work for hospitals were often left to scramble for shots, such as Dr. Inbar Kirson, whose Northbrook practice includes COVID testing.
She said five health departments told her she’d wait a month or more. Then she caught a Dec. 30 social media post of a friend, a funeral director, who’d gotten his shot at an Orland Park Jewel-Osco. He gave her the web link to make an appointment. She trekked 2½ hours down and back the next day for her first shot. Others in health care are still waiting.
Unlike with other parts of the vaccination program, the federal government set up a special partnership with pharmacies, mainly Walgreens and CVS, to directly visit long-term facilities in each state. But there were notable delays, particularly in Illinois, with the pharmacies and the state blaming each other. Some of the batches of shots sat unused.
By Jan. 8, however, when CDC first published state-by-state data, Illinois’ rankings appeared in the middle tier of states: 30th in the rate of doses administered, per resident, and 25th in the percent of its shots that had been delivered into arms. Then other states got better, faster, than Illinois.
It’s unclear exactly just why Illinois couldn’t keep pace. But officials offer some possibilities.
- Bittner, the Pritzker spokeswoman, suggested one reason was because the state waited a week later to expand vaccinations to the 1b group, and states that had done it sooner were able to boost their numbers quicker.
- Another suspected reason: the continued troubles in the long-term care vaccination process, which affected Illinois more than most states.
- Illinois doesn’t expect its first shots to get into all willing arms in long-term care until Feb. 15. But the state did announce Wednesday that it will take surplus shots in the federal program and use them for others.
- As the city and state roll out vaccinations to more clinics, those clinics are doing shots fast enough but struggling to record them quickly enough in the state’s dataset.
“In some cases, there’s an issue of providers not using their vaccines,” Arwardy said. “But still, in terms of some of that tech reporting, it’s not fully there.”
From the Feds to Illinois - Supply chain
That leaves one more, obvious possibility: It’s simply taking providers longer to put shots into arms in Illinois than elsewhere. Understanding that requires a look at the supply chain to determine the holdups. A supply chain, like most cases, that is largely hidden from public view.
Logistics experts say the goal should be for providers to use up all their vaccine within the week of receiving it and, in places with built-up surplus, to eat into that too at the same time. That is the city’s goal, too, but recognizing the challenges of the work, Chicago sets a minimum goal of 85%. Even that can be a struggle.
A state spokeswoman did not respond to a question about why the state wouldn’t provide the detailed information of the supply chain. But on Monday the state did release some data that looks at the problem a different way, by snapshots of inventory at the county level. By comparing that with the average number of shots injected in each place in a day, the figures can show how many days’ supplies are on hand.
Taking out long-term care shots, the data shows a statewide average of about a six-day supply, based on how quickly shots are being injected. But there are wide variations, particularly with concerns there won’t be enough second shots coming to cover those given first doses.
The state said that it approved shipments of all second doses on time and warned it may hold back more shipments to the county if the pace isn’t picked up. The state health department has already done that once with doses originally earmarked for Cook County but sent instead to faster-paced Adams and Champaign counties. Sadly, the state has yet to impose more precise rules on how quickly doses should be given.
Disparity
In the nation’s fast-evolving responses to vaccination, there remains a lot of unknowns that could affect whether Illinois’ slower rollout carries a significant cost to residents or is merely a footnote in the pandemic.
The Biden administration has promised to send even more doses to states, with better federal coordination, while also stepping up direct shipments to pharmacies. The state itself is standing up more mass vaccination sites with the National Guard, and other vaccines are expected to be approved to boost supplies even more. At the same time, health officials say it’s a race to vaccinate the most vulnerable before new, more contagious mutations of the virus take hold.
For now, Illinois is left with lagging rankings among states and a wide disparity in who and where the shot have been given. It can vary from roughly 1 in 5 residents on Illinois’ western edge to 1 in 35 on its southern tip. In between are the big population centers — Chicago, suburban Cook and DuPage counties — at roughly 1 in 15 residents, and Lake and Will counties, at roughly 1 in 19..
The decentralized process means teachers in and around Deerfield, the corporate home to Walgreens, got access to a special program by the pharmacy, but Chicago Public Schools couldn’t get all of its teachers vaccinated for at least a month, a delay that’s fueled weeks of bitter contract talks over resuming in-person classes.
One suburban school superintendent stated it’s created a world where success is fueled by “inside connections,” calling it “everything wrong about this rollout.”
There’s also divide between those comfortable lining up online appointments and those not. One grassroots group of health care workers, Illinois Medical Professionals Action Collaborative Team, called for a statewide sign-up and lottery system to help assign slots for shots while ensuring they’re distributed equitably.
For now, the hunt for the vaccine continues for people like the Leopardos.
They’ve been “ultra-quarantining” for the pandemic, said their daughter, Liz Driscoll. That means ordering groceries online, attending church and book clubs remotely, and struggling to clean their northwest suburban duplex on their own.
Driscoll said she lives in Ohio, where she’s watched an “orderly” process there that slowly opened first to the oldest ages, then tiered down week by week.
“It feels like my parents are in the Hunger Games against 3 million people, many of whom are younger, less at risk and more computer savvy than they are,” she said.
