Across the state, thousands of senior citizens, their children, and tech-savvy grandkids have spent hours stressing while trying to grab scarce, or even nonexistent, COVID-19 vaccination appointments. Many have been sent unprepared into a massive web of networks and portals of local health departments, pharmacies, grocery stores, and hospitals trying to find a shot that could save their life, especially if they suffer from a pre-existing medical condition.

As of Monday night, the state reported about 1.3 million vaccinations, about 5% of what is needed to vaccinate the entire state (each person requires two doses of the Pfizer or Moderna vaccines.) The state is reporting almost twice as many does on hand, 2.1 million.

It has left people around the state wondering why the rollout is so slow, where the additional vaccine is, and why it is taking so long to vaccinate those in high-risk populations.

The Illinoize spoke with nearly a dozen public health officials from around the state, trying to get a grasp on what’s holding up vaccinations. Our conversations included some of the state’s smallest and largest counties.

The first, and largest, issue appears to be supply.

One southern Illinois public health official says while the county has been allotted about 700 doses per week, the county has averaged nearly 1,200 appointment requests.

“There is a certain level of frustration in the community that demand has been much higher than supply so that has led to lots of people expressing that frustration,” the local official said. “They’re spending a lot of time online and on the phone trying to get appointments and answers. We’re trying to answer those calls.”

The official says at the initial step into Phase 1B of vaccination, phone lines in the local office were “jammed” for two weeks. That county stopped keeping a waiting list last week due to overwhelming demand.

Public health officials in one of the small counties we spoke to in central Illinois says they’re trying a hybrid method for scheduling appointments. Their local hospital sends a sign-up link to younger people, while public health staff calls senior citizens to schedule appointments.

The local official says their doses have been low for demand, but they’re glad to receive them. We’re told not every county has continued to receive doses every week.

As of Monday, 32 local public departments reported having no vaccine on hand.

In one of the state’s larger counties, Lake County, Public Health Department Executive Director Mark Pfister says his department has been required to keep close to 5,000 doses in a freezer each week to meet demand for mass vaccination sites and clinics with school districts to vaccinate teachers.

Officials from another central Illinois county say they’re using all of their vaccine each week but keep a wait list that people can come in on short notice in case of cancellation so none of their supply goes to waste.

A suburban official says they’re doing their best to meet the demand.

“We’re doing the absolute best we can with the demand we have,” the official said.
What we’ve done so far is phenomenal.”

That doesn’t mean local officials are comfortable with the amount of vaccine they’re getting.

“It’s a simple matter of not [having] enough vaccine to meet this demand,” the official said.

In Lake County, Public Health Executive Director Mark Pfister says to reach 80% vaccination in that county, the department would have to vaccinate 43,000 people each week for six months. So far, the county has received a total of about 50,000 doses.

“In our society, we’re used to clicking on it and you get the package the next day,” Pfister said. “Patience is not a virtue anymore. No matter how mad they are, it doesn’t change the fact we don’t have 43,000 doses and we don’t have enough vaccinators to vaccinate 43,000 people per week for six months.”

For his part, Governor JB Pritzker offered few specifics when asked about the rollout at an appearance Friday in Machesney Park, just outside of Rockford.

“Remember, there isn’t enough vaccine being delivered to us by the vaccine manufacturers right now,” Pritzker said. “In Illinois they’re not delivering it, in other states anywhere in the country, they’re not delivering enough.”

All of the local officials we spoke with understand production takes time, especially of a new product that didn’t exist just a couple of months ago.

“The public isn’t aware of the magnitude of this effort,” a suburban official said. “Don’t forget, we ran out of toilet paper.”

Many counties have voiced their frustration with state officials for what they call “difficult” communication from the Illinois Department of Public Health in lead time for vaccination deliveries.

Most say timelines from the state have varied, but, in general, they get word from the state on Wednesdays about how many vaccine doses each county will receive on Monday. They say that doesn’t allow adequate time to schedule appointments.  

“In order for us to properly plan, we need to know how many doses we might receive [not only] this week but next week and in future weeks,” a southern Illinois official tells us. “It does make us uncomfortable when we’re scheduling appointment times for vaccines we may not have in that point in time.”

Many counties have reduced their available appointment blocks to a week or less as they fear being unable to meet demand or canceling appointments on vulnerable seniors.

“[The late notice] not only makes planning challenging, but it makes scheduling challenging too,” a suburban official said. “We’re only scheduling out for what we know we can allocate.”

Some officials have been told by IDPH that late notification to counties is because of federal government is late notifying the state about the number of doses being allocated to each state. One local official says they’re hopeful the federal government can meet a new three-week benchmark for allocation notification promised by the new Biden administration.

“It will be a few weeks before all those who are eligible will get it,” Pritzker said Friday. “I’m proud of the work that’s been done so far. We always want to move faster. We’ll continue to work to get more doses in people’s arms.”

Some county officials also say there aren’t enough locations approved to distribute the vaccine.

Lake County’s Pfister says there are only 62 approved vaccination sites in a county of 700,000, and seven of those sites are Public Health Department owned facilities.

Pfister says the state has taken 6 to 8 weeks to approve new distribution providers under the I-CARE program (Illinois Comprehensive Automated Immunization Registry). Though he says the lead time has dropped in recent weeks.

In many smaller, rural counties, only the local public health department and possibly a hospital are the only providers authorized to give the vaccine.

“When we do get large amounts and we need to do a mass vaccination clinic, how will we be able to provide that,” asked a small county official with a staff under 10.

May counties will likely have to seek volunteers, but training required by the state could slow the number of people able to help.

While the state received $90 million from the recent federal COVID relief bill for vaccinations, distributions to counties are being made by population. Even then, most counties say they won’t receive enough to cover costs of mass vaccination sites.

“Our costs may be triple that or more,” guessed one local official.

The Pritzker administration has called up the National Guard to help at vaccination sites in Cook, Winnebago, and St. Clair counties, Lake County had its request denied. Many local departments said their staffs are shrinking and their employees have been working 7 days a week for over 300 days.

No matter what, producing, distributing, and administering the vaccine will take time.

“We need to be patient,” Pritzker said.

Local officials agreed.

“We’re asking for the public to be patient. Data is good but we have a lot of stressed and burned-out people who are coming to work every day. We have a job to do and we’re gonna do it,” one local official said.

Patrick Pfingsten

@pfingsten1 patrick@theillinoize.com