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Staff photo by Troy Stolt / Hamilton County Health Department workers distribute Pfizer COVID-19 vaccines to eligible residents at the Health Department Enterprise South COVID Vaccination POD on Wednesday, March 3, 2021 in Chattanooga, Tenn.

Just over two months into community vaccination efforts, operations at Hamilton County's largest vaccination site at Enterprise South Nature Park are helping officials to vaccinate more than 1,300 new people a day.

Lisa Vincent, a site manager with the health department at Enterprise South, said the site near Collegedale can expand to handle more patients as the supply of vaccines increases and more people become eligible.

The department is running a short loop through the park to coordinate cars among the waiting line, intake area, injection site and waiting area. A larger loop through the park would allow the site to handle ever more people, Vincent said.

But local systems will be stressed further on Monday, when those with chronic conditions such as hypertension or obesity become eligible for doses after the state and county expanded its eligibility requirements on Tuesday. The county is giving doses to workers in Phase 1a1, 1a2 and 1b, phases which include health care workers, first responders and education staff, as well as people ages 65 and older.

Starting Monday, the state and county will include Phase 1c, which includes people with chronic health conditions and those with weak immune systems, pregnant women, people receiving chemotherapy and individuals with HIV/AIDS. The move likely adds tens of thousands of people to the eligible list in the county. According to the county health department, eight of the leading 10 causes of death locally were from chronic diseases, including heart disease and cancer. Around one in three Hamilton County adults is obese, according to a 2019 study of the county's health.

These conditions are more likely to affect Black residents than white ones in the county, according to the study. Limited access to health care and underfunding in health interventions have made some Hamilton County ZIP codes among the worst in the state for negative health outcomes.

The county is averaging 1,368 first-dose vaccines a day and 853 second-dose vaccines a day in the past week, according to data from the Hamilton County Health Department. More than 15,700 doses were administered in the county in the past week, which includes first and second shots. While supplies remain limited given the demand and size of the eligible population, they are expected to increase in the coming weeks.

On Tuesday, Tennessee Health Commissioner Dr. Lisa Piercey said the state expects to receive 192,000 doses of Pfizer and Moderna vaccine this week, as well as 54,000 doses of the newly authorized Johnson & Johnson vaccine.

"So by the end of the month, it is plausible that we could be getting 300,000-plus vaccines per week," Piercey said. "That thrills me to think, because that's quite the opposite of what I was telling you just 30 days ago where we were struggling to get maybe even 80,000 a week in the state."

As the guidelines for who is eligible for a vaccine ease and supplies increase, here is what you need to know about the changes:

WHAT'S NEW AS TENNESSEE ENTERS PHASE 1c?

Finding available vaccine could take longer for awhile

Wednesday's announcement that Tennessee will move to phase 1c opens up vaccines to the widest pool of people yet, and demand for vaccines already outpaced supply before the latest eligibility expansion. Though state allotments continue to increase, with Tennessee expecting to receive about 300,000 doses of vaccine per week by the end of the month, a low-ball estimate is that 1.1 million Tennesseans have health conditions or life circumstances that make them newly eligible.

All providers who are administering vaccines are required to adhere to the state's vaccine plan, which outlines who's eligible and can be found on the Tennessee Department of Health website.

However, some providers — including all health department sites throughout the region — aren't requiring that the newly eligible offer proof of their conditions and instead are relying on the "honor system." That move could open the door for more people who technically shouldn't be getting vaccinated until later phases to flood the system.

Finding open slots will get easier throughout the spring. President Joe Biden said Tuesday there should be enough doses to cover all U.S. adults by the end of May thanks to a new deal under which pharmaceutical company Merck will help Johnson & Johnson ramp up its coronavirus vaccine production.

Until then, exercise patience and explore all the available options in your area, health officials said.

"Get it wherever you can get it, whenever you can get it," said Cara Barrett, director of Galen Medical Group's COVID-19 team. "If you're on our waitlist, but an opening happens at the county, then go to the county and get it. I think the common goal is just to reach that herd immunity as quickly as possible."

 

There are more places and ways to get shots

Though demand will be high, many different locations are now offering vaccines, and casting a wide net in your search could mean the difference between getting a shot sooner rather than later.

In addition to local health departments, an increasing number of independent pharmacies, large retail chains and physicians' offices are beginning to offer vaccines to eligible people regardless of whether you're a regular customer or established patient. Vaccine "pop-up" events, such as those that occurred over the weekend at some Hamilton County schools, are starting to happen and plans to host large-scale, mass vaccination events are underway. Some providers have waitlists of "backup" people they can call in case leftover doses are available.

Also, don't forget to check with your primary care provider to see if they're planning to offer vaccines or can help you find a place to get one.

With these new sites come new ways to sign up, and almost all locations require an appointment but use different processes that don't communicate with each other. The Hamilton County Health Department has its own signup system and requirements that are different from the other health departments in the region, which use the state's website for signups.

The website vaccinefinder.org attempts to list locations in a given area that are approved to administer vaccines, but people should call or go online to determine each provider's processes. As of Wednesday, 50 sites were listed within a 50-mile radius of Chattanooga.

One of those is Galen Pharmacy, an independent pharmacy in Chattanooga affiliated with Galen Medical Group.

Aaron Garst, pharmacy director for Galen, said that although Galen is listed on vaccinefinder.org as having vaccine available, that doesn't mean anyone can show up and get a shot. Galen's process is to have eligible people call its hotline to be screened for eligibility and put on a waiting list, which now has more than 1,000 people.

Availability is dependent on how much supply Galen is allotted by the state, and that remains extremely limited.

"We still have individuals that are in [their] 70s, 80s, 90s that have not received this vaccine, and we're trying to be as equitable as possible," Garst said. "When we do have doses available, we're able to call those individuals and get them in here."

Often, when Galen calls people on its list, the patients have already managed to find a vaccine elsewhere.

 

More options for vaccines are available

Until this week, the two-dose Moderna and Pfizer vaccines were the only options. But over the weekend, a third COVID-19 vaccine from Johnson & Johnson was authorized for use in the United States and will be available in Tennessee this week.

The Pfizer and Moderna vaccines each boast about 95% efficacy against preventing COVID-19 symptoms after two doses, but it's difficult to compare those to the Johnson & Johnson vaccine, because their clinical trials were set up differently.

Johnson & Johnson's single shot was found to be around 70% effective at preventing COVID-19, but for severe or critical disease, the vaccine was 85.4% effective after 28 days.

Most sites that have been offering the Moderna and Pfizer vaccines are likely to continue doing so for now, and availability of the Johnson & Johnson vaccine in Tennessee is expected to be limited until the end of the month.

In general, sites will only offer one type of vaccine, which they should disclose during signups.

Contact Elizabeth Fite at efite@timesfreepress.com or follow her on Twitter @ecfite.

Contact Wyatt Massey at wmassey@timesfreepress.com or 423-757-6249. Follow him on Twitter @news4mass.

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