More than 100,000 Hawaii residents, including about 80% of medical workers, have been inoculated against the coronavirus since the state received its first batch of vaccine on Dec. 14. The Biden administration’s plans to purchase more vaccine doses could soon speed things up.

The state also faces a potentially lower-than-expected demand for the vaccine that could complicate its goal of achieving the herd immunity required to conquer the coronavirus.

A December survey released last week found that only half of Hawaii residents surveyed said they were likely to take the vaccine if it were immediately available. About a quarter of the 3,846 respondents said they were unlikely to get vaccinated, while the rest were undecided.

Hawaii Health Department Director Libby Char blamed the federal COVID-19 vaccine supply shortage for the slow pace of vaccination appointments available to the public. Screenshot: Brittany Lyte/Civil Beat/2021

Health officials in Hawaii, as in many other states, insist they have the capacity to ramp up vaccinations but have been unable to schedule more appointments because of uncertainty over when and if they’ll receive new doses from the federal government.

“We have a lot of capacity to get more shots in arms,” Hawaii Health Department Director Libby Char told state lawmakers on Tuesday. “We’re just waiting to receive more vaccine.” 

Calling the situation “unacceptable,” President Joe Biden has promised a roughly 16% boost in deliveries to states over the next three weeks. The new administration also said it plans to buy another 100 million doses each from drugmakers Pfizer and Moderna to provide for the long term.

Char said faster access to vaccines would allow the state to give a COVID-19 vaccine to every Hawaii resident who wants one by August or September, insisting that Hawaii has the resources to inject between 60,000 and 70,000 doses on a weekly basis.

“The good news is that it sounds like the federal government is going to be increasing the allotment nationwide for one of the vaccines,” Char said. “But if we continue at our current pace of how much vaccine is being allocated to us, it will take longer than that.” 

For now, the national vaccine shortage continues to hamper the state’s efforts to inoculate the vast majority of adults.

Hawaii got off to a slow start with the vaccination campaign but has stepped it up in recent weeks after establishing mass vaccination centers in Honolulu and other hubs across the islands, including major hospitals.

Vaccines are also being distributed through federally qualified health centers, which are in many cases better poised to serve high-risk residents in rural communities, as well as long and short-term care facilities.

Picking Up Speed

Of the 170,975 COVID-19 vaccine doses that Hawaii has received, nearly 110,000 have been administered as of Monday, according to the health department. As such, more than 7% of the statewide population has received at least one shot. 

More than 80% of health care workers, who were first in line to get the vaccine, have been inoculated, Char said. People who work in the medical field, however, appear to be more willing to get vaccinated than the general public, according to DOH officials.

All told, 203,600 doses of the two vaccines approved for emergency use have so far been allocated for Hawaii residents by the federal government, according to state health regulators.

Health officials say it generally takes two to three weeks from the time a dose is allocated for Hawaii for it to be ready for injection.

Overseas shipping accounts for some of this lag. It also takes a few days to a week to distribute and prepare the vaccine at its final destination, Char said.

“It’s not just about showing up and giving people a shot,” said Eddie Mersereau, the DOH’s deputy director of behavioral health. “In many respects that part of it is really just the easiest part.”

The more time-intensive component of the vaccine distribution process, Mersereau said, involves managing the flow of people in and out of vaccination stations in accordance with social distancing guidelines, sanitizing the stations throughout the day and accurately recording data about who is being vaccinated.

Other challenges include coordinating the number of doses with the number of appointments made to avoid long waits and wasted doses.

“When we compare ourselves to the rest of the nation, we’re actually doing quite well,” Char said. 

Data from the U.S. Centers for Disease Control and Prevention show that Hawaii has administered 7,341 vaccine doses per 100,000 people, ranking 31st in the nation.

Correction: An earlier version of this story mistakenly said Hawaii was fifth in the nation in terms of vaccines administered. Hawaii is fifth in terms of vaccines distributed but 31st in terms of vaccines administered.

Pharmacist Davis Zheng gives a resident the Moderna COVID-19 vaccine. January 5, 2021
Pharmacist Davis Zheng injects a Hawaii resident with a dose of the COVID-19 vaccine manufactured by Moderna. Cory Lum/Civil Beat/2021

Hawaii is prioritizing health care workers, long-term care facility residents, essential workers and seniors.

Eventually, the state hopes to gain access to enough vaccine doses so that the COVID-19 inoculation process will be as easy as getting a flu shot.

But for now, the general public will likely not have a chance to get vaccinated before spring.

A deliberate process must be followed to ensure that the people at highest risk of contracting the virus get a chance to be inoculated first, said Cathy Ross, the DOH’s deputy director of health.

“The future state of this vaccination effort does not require the Department of Health to manage lists and priorities in the way that we are currently doing,” Ross said. 

Regardless of availability, many people in Hawaii have indicated they don’t plan to get the vaccine, which officials have promised will not be mandatory at least in the near term.

The number of people who said they would get the vaccine was up slightly in the December survey at 50% compared with 44% in a similar but smaller survey in November.

“We have a lot of capacity to get more shots in arms. We’re just waiting to receive more vaccine.” — Health Department Director Libby Char

The Honolulu communications agency Olomana Loomis surveyed 3,846 people across the state from Nov. 30 to Dec. 13 as part of the agency’s effort to help the DOH assemble a public vaccine education campaign.

The survey found that men, people 65 and older, health care workers, educators, people with higher income and education levels were most likely to want the vaccine along with those of Caucasian, Korean, Japanese and Chinese ancestry.

Less likely to get vaccinated were women, adults between 18 and 34 and people with lower income and education levels, the survey found. African Americans, Hispanics, Native Hawaiians, other Pacific Islanders and Samoans were also less likely to receive the vaccine.

Vaccine readiness also differed by geography, with people least likely to get it on Maui.

Kauai generally has high levels of vaccine readiness — although communities in the farthest reaches of the north shore are less willing to vaccinate, survey data showed.

On the Big Island, residents near Hilo appeared more likely to get a vaccination than those living near Kailua Kona. And on Oahu, vaccine readiness was highest in communities in or closest to Honolulu.

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