FLEMINGTON, NJ - New Jersey government’s expansions of eligibility for groups and categories of people to receive the COVID-19 vaccination this week created procedural overload for county health departments tasked with administering vaccines, as those seeking to register for a shot faced busy signals over the telephone and constantly having to hit refresh on their computers and devices in attempts to register online for a vaccination.

Through the second week of January, the Hunterdon County Health Department administered over 1,100 COVID-19 vaccinations to eligible individuals in the course of six separate vaccination clinic events, which are currently organized as a drive-through at the county’s Route 12 complex west of Flemington Borough.

The first vaccination clinic organized by the county Health Department was held Dec. 30, 2020, and it was specifically to vaccinate EMS personnel in the county. Since then, over the course of two weeks, it was expanded to add vaccination clinics Jan. 5 and Jan. 7 for category 1A community healthcare workers, and subsequently law enforcement professionals and employees in Hunterdon County once state-designated eligibility covered the groups.

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The county Health Department has requested more COVID-19 vaccinations from the appropriate state-level contacts.

As announced by Gov. Phil Murphy on Jan. 13, beyond the category 1A group of essential healthcare workers and the first responders’ groups ranging from EMS to police and fire departments, the COVID-19 vaccine eligibility in New Jersey has been expanded to include individuals over 65 years old, plus individuals 16 years old to 64, who have certain chronic, impairing and/or autoimmune medical conditions.

As of Jan. 15, all county vaccination appointments for the upcoming clinics to be held on Jan. 19, 21, 26 and 28 (likely representing the remaining dates for this month) are fully booked.

“At this time, the State Department of Health has been unable to fulfill the number of vaccines requested, that we’re asking for,” said Hunterdon County Health Officer Karen DeMarco. "We did not receive an increased amount of vaccines corresponding to the expanded eligibility groups and criteria, so at this point the county Health Department has scheduled appointments for the vaccine we have on-hand. We did not receive the amount of vaccines for the next week (of administering the vaccine) that we requested from the state, but we are able to fulfill all of the vaccine appointments that we have already scheduled for next week.”

“We will continue to increase appointments and schedule more vaccination clinics as we receive additional vaccines,” she added. “At this point, we’re waiting to see how much vaccine supply we will have and we are prepared to then schedule and provide additional clinics and vaccination appointments.”

Hunterdon County Health Department receives the Moderna COVID-19 vaccine from the state. The two-dose series of shots need to be administered 28 days apart.

“When people register for a vaccine clinic with the Hunterdon County Health Department, they are automatically scheduled for their second dose 28 days after the first,” DeMarco said. “Currently, we have provided the vaccination clinics two to three times per week, but we plan for this schedule to increase when we hit that second-dose time frame. At that point, we plan to offer the vaccination clinics four to five days per week, as we will also offer the second-dose clinic date for those who received their first dose, plus first-dose dates, of course, contingent on the county’s vaccine supply from the state.”

With Murphy’s announcement of opening up vaccine eligibility to the next category of potential recipients, specifically for the 65-plus and those over 16 with certain medical conditions, there was a surge in phone calls to the county Health Department phone line. On Jan. 14, DeMarco reported, close to 1,000 calls specifically on the vaccination program came into the department.

In response to this call volume and to better assist residents seeking appointments, the county modified the phone answering system with the option for callers to “dial 1” for information pertaining to COVID-19 vaccinations and testing. DeMarco noted that this is the “COVID-19 specific line within the department as of Jan. 15.”

“This week, the health department was working on providing vaccination appointments for those within the category 1A group, as well as for the first responders population as well as answering the many phone inquiries, and we understand people are very interested in seeking the vaccine,” she said. “We do ask for patience, but with the dedicated line, we do have additional personnel available to answer the phone calls and inquiries. Callers will be held in queue as we work to answer each inquiry. We are also directing people to our website, with specific information listed for Hunterdon County about the vaccine and the scheduling system, but we’re also directing people to visit covid.nj.gov as well, for other frequently asked questions.”

The county continues to proactively seek information from state health officials as operations move forward week by week, and contingent upon supply. But DeMarco said Hunterdon County has been advised about a plan being developed by the state Department of Health to provide details on the volume of vaccine supply that the county Health Department can anticipate receiving each week.

“That information will assist the department in planning and providing more vaccination clinics as well,” she said. “Though the upcoming clinic appointments are full at this time, the county Health Department will be adding more dates and times as we have more vaccines on-hand. As we receive supply, we can tailor our plans based on what Hunterdon County’s needs are and our population as well. At this point, we’re planning with the supply of vaccines that we have. At the same time, we work toward more vaccination clinics to provide vaccines.”

“The Health Department is also observing an increase locally in COVID-19 activity, in terms of the illness spreading,” DeMarco added.

As of Jan. 14, New Jersey had 549,840 lab-confirmed cases, and 59,881 probable cases. According to the state health department, COVID-19 has been the attributed cause of death for 18,162 people, confirmed with aggregated data.

As of Jan. 15, New Jersey’s statewide transmission rate is 1.10. The state health department notes that anything above 1.0 means the spread continues, and that each infected person is likely spreading COVID to at least one other individual.

DeMarco noted that the highest daily COVID-19 case counts and reported case counts are taking place in January 2021, “higher than what we saw in spring 2020.” The county Health Department maintains its persistent and round-the-clock efforts for COVID-19 contact-tracing and case investigations, now in its 10th month of operations.

“We are seeing clusters of COVID-19 cases within households and workplaces,” she said. “The department carries forward in both aspects of pandemic response, a process of administering vaccinations and in preventing the transmission of the illness. We are seeing increased case counts not only with more positive cases, but increased hospitalizations due to COVID-19 and an increase in calls for medical assistance related to COVID coming in to Hunterdon County’s 911 dispatch center. All of that COVID-related activity is continuing to happen, while at the same time the county Health Department works to provide vaccinations at clinics as well, with plans and scheduling contingent on the vaccines’ supply.”

The drive-through setup at Hunterdon County’s Route 12 complex has proven to be efficient in the operations there so far, as DeMarco noted the ability for physical distancing; being able to move vaccine candidates through the queue of cars quickly so they are able to vaccinate more individuals. Also, she said, being outdoors offers a safe and spacious environment for Health Department staff in the four-hour windows of 10 a.m. to 2 p.m., plus the necessary event and safety setups they manage on-site.

DeMarco said the clinic site was evaluated and planned as a central location for Hunterdon County, “seeking to provide the resource for Hunterdon County residents.”

The Joint Counties’ COVID-19 Testing Site, for which Somerset and Hunterdon counties partnered on, ran effectively early on in the pandemic, for close to three months at Raritan Valley Community College. At a board meeting last July, it was noted that RVCC was being underutilized by Hunterdon residents after early stages of the pandemic last spring.

Testing programs for COVID in Hunterdon transitioned to offer county-based resources and operations.

“Currently, there are Hunterdon-specific testing sites available to residents as since July we’ve offered the (Rt. 31) COVID-19 testing site through the County’s partnership with Hunterdon Medical Group," DeMarco said. “In addition, the at-home test kits are available for county residents through our partnership with Vault Medical Services. We direct residents to look at those resources, and both have been working very well.”

She added that some of the high call volume the Health Department’s COVID call center is experiencing comes from residents seeking testing. Detailed information on accessing testing is posted on the Health Department’s website.

DeMarco advised that as many people seek the vaccine, and others seek different forms of testing, everyone will need to continue to use caution and to practice social distancing, wearing masks and washing their hands frequently, and to limit contact with those outside their household.

The short-term outlook for COVID-19 vaccinations, as reported during the Jan. 5 reorganization meeting of Hunterdon County’s governing body would also include teachers within the county.

DeMarco noted that there has been no word from state health officials about opening to the category 1B group. Statewide, the phased approach continues so none of the 21 individual New Jersey counties or medical providers “can move to vaccinate beyond the groups stated as eligible as of this point.”

Once more people are eligible for the vaccine, the Hunterdon County Health Department would have the potential for organizing one or more school campuses to serve as vaccination clinic locations. Such plans can only evolve once there is direction from the state health department, but within Hunterdon County, a long-term, highly-collaborative relationship already exists for the Health Department and local districts to build upon with the pandemic response.

The goal for the department of partnering with schools, in every capacity, persists.

“We have worked with our schools in the past to conduct drills and exercises for mass vaccinations,” DeMarco said. “At this point, we’ve just been focusing on the Rt. 12 drive-through operations. But if we have enough vaccines on-hand to provide a large clinic setting, we may consult with schools about utilizing that resource. Throughout this pandemic, and even prior to the pandemic, we’ve partnered with schools in the county. They continue to be strong partners with the Health Department. Schools in Hunterdon deserve so much credit for the many ways in which they’ve altered and adjusted the school environments, for all that has been done to keep school environments healthy and safe for students, faculty and staff, as well as in their working with us to conduct contact-tracing.”

For the Rt. 12 vaccination clinics the Health Department is working in coordinated efforts with the county Office of Emergency Management, led by OEM Coordinator Brayden Fahey and staff, as well as Sheriff Fred Brown and the Hunterdon County Prosecutor’s Office, “to be able to establish and run this clinic operation as smoothly as it does,” DeMarco said.

“The Health Department, OEM, the Sheriff’s Office and more county departments all come together to help provide that resource and service to our residents,” she said. “We will be able to announce the additional plans and updates for the schedule of clinics, and whether they are for specific category groups or populations, based on the vaccine supply.”