One of the first members of the public in Miami-Dade County to receive a COVID-19 vaccine, 81-year-old Patrick Range, has been working throughout the pandemic.
Range goes to work every day at the funeral home in Liberty City that his family has operated since 1953, a place that has seen its share of pandemic-related funerals over the past 10 months. He is the son of M. Athalie Range, a Bahamian-American woman and the first Black person to serve on the Miami city commission.
On Wednesday afternoon, Range was in line for a shot at the recently opened Christine E. Lynn Rehabilitation Center on Jackson Memorial Hospital’s campus. Miami-Dade’s public hospital system held the press event to help convince people to sign up for the two federally authorized COVID-19 vaccines. The hospital said it plans to vaccinate more than 10,000 people in the coming weeks using a shipment of Pfizer-BioNTech vaccine doses that could arrive as soon as Thursday.
Dressed in a black suit and a striped purple tie, Range said he had a message for his Liberty City community, as he took off his jacket and rolled up his sleeve.
“Being in the funeral industry, I’m familiar with this virus,” Range said. “Nothing from the vaccination can be as bad as this virus.”
In the fluorescent-lit room where Range received his first dose, Miami musician Emilio Estefan of the Miami Sound Machine and Nat Moore of the Miami Dolphins had just received their COVID-19 inoculations moments earlier.
Though he wasn’t a celebrity, Range might have felt like one on Wednesday when his shot prompted a round of applause from healthcare workers and media assembled to watch.
“I’ve never been applauded before,” he said.
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Swaying the public
Health officials hope the event with Range, Moore and Estefan will sway a public that has responded to the unprecedentedly quick development of the vaccines with a mix of enthusiasm and skepticism.
That skepticism, termed “vaccine hesitancy,” is thought to be especially prominent in communities without much healthcare access — the same types of neighborhoods served by Jackson.
Miami-Dade administrators said hesitancy about the vaccine is a concern as the county begins to step up use of its own limited supply. The 5,000 doses of the Moderna vaccine obtained from the state went first to the county’s Fire Department under state guidelines that gave priority to some rescue workers.
Even among firefighters and paramedics, most of the department opted not to sign up for the first voluntary vaccinations. A survey of 1,367 Fire Department employees found just 37% said they were interested in a COVID-19 vaccination right away, and 40% said they weren’t interested at all. Another 22% said they were interested in getting a dose, but not right away.
“It’s not that different from the regular population,” said J.D. Patterson, the county’s chief public safety officer, who oversees the Fire Department. “A lot of people in the country are reluctant to step up initially. That doesn’t mean that won’t change over time.”
At the press conference, Mayor Daniella Levine Cava said reluctance about the vaccine is a hurdle for the county’s push to see the broader population inoculated. “Unfortunately, in the general public there hasn’t been yet the enthusiasm for the vaccine we’re seeing on the 65-plus category,” she said.
Miami-Dade is using its 5,000 doses for firefighter and paramedics on the county payroll, and for fire department employees in cities across the county. From there, the plan is to administer doses to home-bound seniors living in county public housing. After that, Levine Cava said, the county will begin expanding vaccinations to vulnerable county workers aged 65 and over, such as police, jail officers and transit workers.
On Wednesday, the county also launched its vaccination website, miamidade.gov/vaccine, with links to some of the hospitals offering vaccinations to the general public.
Miami-Dade’s Jackson, like other Florida hospitals, had to shift its strategies for reaching people this week. Last week, Gov. Ron DeSantis announced that the state would move from vaccinating healthcare workers to focus on seniors.
Dr. David Zambrana, executive vice president of hospital operations at Jackson, said the hospital network is planning a blitz of public service announcements and media interviews aimed at under-served communities in the coming weeks. He said that Jackson will also make inroads in those places by reaching out to its own patients, many of whom live in low-income neighborhoods.
“No organization other than Jackson cares more for the under-served,” Zambrana said. “We’re leveraging that part of our system as a mechanism for vaccination.”
Zambrana said Jackson is also relying on its own employees, nearly 4,000 of whom have already received their first doses of the COVID-19 vaccine, to be ambassadors to the public.
Hospitals’ abrupt pivot
Jackson is the second major hospital system in Miami-Dade to open COVID vaccinations to the public after inoculating front-line healthcare workers, following Mount Sinai Medical Center, which has been inundated with phone calls from older people and their loved ones desperately trying to set appointments as Florida’s hastily constructed vaccine distribution program takes shape. In neighboring Broward County, Broward Health is also administering the shots and has similarly experienced overwhelming demand.
The pivot by South Florida hospitals from healthcare workers to seniors follows the directive from DeSantis a week ago — an executive order that sidelined so-called “essential workers” until large swaths of Florida’s over-65 residents and snowbirds get their shots.
Jackson will open up an online portal on Monday, which it had initially planned “for any Miami-Dade County resident age 65 and older to request a vaccination appointment.”
But the hospital reversed course after Jared Moskowitz, director of the state’s Division of Emergency Management in charge of distributing vaccines in Florida, reiterated on Wednesday that hospitals shouldn’t be requiring proof of residency or considering it when scheduling appointments.
While there’s nothing legally prohibiting Jackson from doling out the doses as it sees fit, a spokesperson said Jackson would abide by the state’s guidance, meaning it will no longer make county residency a requirement for a vaccine appointment.
The third week of Florida’s COVID vaccine rollout encountered some turbulence as hospitals and county offices of the Florida Department of Health began piecemeal efforts to reach out to the public as demand far outpaces the limited allotment of doses trickling to the state from the federal government.
Stephen Kissler, an immunology and infectious disease expert with Harvard T.H. Chan School of Public Health, said that the haphazard nature of the rollout is to be expected, given how little time officials had to plan, and the overwhelming interest from seniors is “a good problem to have.”
But Kissler said health officials and hospitals should move quickly to do more than just offering hotlines and online portals for people to sign up for appointments.
“It’s complicated partly because of the way vaccines need to be stored,” said Kissler, referring to the ultra-cold storage requirements for the Pfizer-BioNTech and Moderna vaccines. “But that said, the outreach can still be done in a much more proactive way, and should be.”
He said outreach will help address disparities in access to healthcare. The reason health officials want to get the vaccine out into the community rather than wait for the community to come to then, Kissler said, is because, like other health issues, inequities and disparities in how people fare largely rise out of swaths of the public not having regular access to healthcare.
“Certain people getting the vaccine later than others can really entrench those disparities,” he said.