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Waiting for a COVID Vaccine Appointment? Here’s an Inside Look at Distribution Logistics

March 09, 2021

Eric Arlia can see into the future.

Three weeks into the future, to be exact. That’s how far ahead the state Department of Public Health plans its base amount of COVID-19 vaccines available for distribution through Hartford HealthCare and other providers across Connecticut.

Arlia, the Senior Director of System Pharmacy at Hartford HealthCare, and his team use that information to create the number of weekly available vaccine appointments at HHC’s 29 vaccine sites. It also has to account for vaccines set aside for specific demographics the state has designated as a priority.

“Each week we have a conversation with the Department of Public Health, and they tell us how many doses we will have,” he said. “We currently have a baseline allocation of 6,800 doses per week, and this goes three weeks out. So we create our appointment plan based on that.

“But it’s a weekly conversation,” he added, “and there is often the opportunity to obtain more (doses). Now, they might be for a targeted group, like right now the state has asked us to vaccinate teachers, but other times it might be for towns that have a low vaccine rate, or an area where accessibility is a concern. But sometimes, it’s simply more doses, and we can add more appointments for the eligible public.”

For example, Arlia said, on Sunday the state emailed him that there was a batch of vaccines available from a pharmacy that wasn’t going to be able to use all of its allotment.

“They told us we could go pick up this 1,100 doses of the Pfizer vaccine, and so we were able to open up 1,100 more appointments for this week, because we suddenly had extra doses.”

It’s the fluidity of the vaccine supply that leads Arlia to always counsel people to “keep trying. If you have been unable to get an appointment, I tell everyone, just keep checking. Because it can change from day to day.”

Of the base allocation each week, 25 percent is set aside for:

• Disadvantaged communities identified by the state by ZIP code.
• The statewide 2-1-1 system.
• Hartford HealthCare’s mobile vaccine vans, three of which travel the state reaching hard-to-reach demographics like the homeless and those in rural areas.

The rest goes into the HHC vaccine system, which supplies 22 regular sites and seven mega-sites across Connecticut.

Arlia noted that HHC’s base allocation of 6,800 weekly doses doesn’t include Johnson & Johnson, recently approved for use and just now entering the supply stream.

“I fully expect our base allocation will increase shortly,” he said. “The state is doing everything it can to quickly move the vaccine. If they see (a provider) is not using all of their allocation, they will move it to another provider. ‘Use it or lose it’ — they really mean it. They are very serious about it. This is why when we get extra doses, we add appointments very quickly.”

Opening mega-sites that can process 1,000 or more vaccines in a day – even when there aren’t enough doses on hand to do that – is important because such a large-scale system needs to be tested before it’s pushed to capacity, Arlia said.

“We can do 1,000 doses at Foxwoods,” he said, “but we need to know we can actually do 1,000 doses, which is why it’s important to get these sites up and running so that when the time comes, we are ready.”

Hand in hand with the number of doses (all of which come with their requisite supplies, such as syringes) is having the staff trained and ready to run the site and administer the shots.

“Our regional leaders have done an outstanding job of creating these teams that can ramp up quickly,” Arlia said. “They have gotten everything to the point where we can nimbly increase staff as needed.”

As proud as he is of the system HHC has built to distribute hundreds of thousands of shots into the arms of residents, Arlia looks forward to the day when the mass vaccine approach can be retired.

“There’s been a tremendous amount of learning in this process,” he said. “I hope we never have to do it again. But we know that the knowledge and experience has been built into multiple organizations in the state, so if we need to, we can do it again.”