With Appointments Going Unfilled, Baystate CEO Backs 'More Disseminated Strategy' For Vaccination

May 4, 2021

Massachusetts Governor Charlie Baker this week announced a shift in the state's COVID-19 vaccination strategy, with more doses and appointments now available.

The Eastfield Mall mass vaccination site will remain open in Springfield, but some others in the state will close, aiming to get more doses to primary care doctors and mobile clinics

Joining us with an update on the situation in western Massachusetts is Dr. Mark Keroack, president and CEO of Baystate Health.

Carrie Healy, NEPM: What's your take on the strategy for our region, keeping a mass vaccination site open, and also boosting smaller scale efforts?

Dr. Mark Keroack, Baystate Health: Well, I think it does make a lot of sense. What we've noticed in our own public site, up in Holyoke, is that more than half of our vaccine appointments for last week went unfilled after a couple of days. They usually were gobbled up within a few hours.

And so, I think that a lot of the people who have been very eager to get vaccinated have already done so. And now we're going to be dealing with people who are either hard to reach or more reluctant. And so, we're going to need a more disseminated type of strategy.

That's already started to happen with the availability of vaccine in drug stores. We've gone from 50 to over 800 pharmacies across the state that are administering vaccine.

Hampden County, where your largest hospital is based, has the lowest rate of COVID vaccination by population than any county in Massachusetts. Can you talk about the reasons for this, and how Baystate can help close that gap?

Yes, it's been an area of concern for us. I think that if you look at the populations of individuals who are most hesitant about vaccine, they would include certain racial and ethnic minorities, African Americans, Latinx populations. Young, pregnant women are sometimes a bit more reluctant, and people who describe themselves as conservative Republicans are also less willing to get the vaccine.

We are likely seeing more of those groups here in Hampden County, and so it means that we're going to need to reach out to understand the basis for those concerns, and try to deliver the message about the value of vaccine, using trusted voices.

We are doing that, by the way. We've begun the public information campaign involving three of our younger infectious disease doctors — one an African-American, one a Latino and one who's pregnant — each talking about why they decided that the vaccine was right for them.

State officials report about 1,800 "breakthrough" infections, according to The Boston Globe — people who are vaccinated, but then test positive. That's a tiny percentage of people who are vaccinated, and the vaccines have also been shown to lessen COVID-19 symptoms. Locally, are you seeing breakthrough cases?

We've seen just a handful. I think the national statistics are salient here. The look back, after 77 million people were vaccinated, suggested that the likelihood of getting a second infection — or of getting infected in spite of being vaccinated — was about one in 10,000. And the likelihood of being hospitalized — about one in 100,000.

So those are very good odds. And that suggests that this vaccine is extremely protective, even if it's not 100%.

And that goes for all three of the available vaccines?

That's correct.

An announcement is expected soon on possible FDA approval of the Pfizer vaccine for kids as young as 12. Still, many families will be entering the summer with vaccinated parents and unvaccinated kids. Should they be planning vacations now or wait until everyone can get the shots?

I think that vacations can safely be planned, particularly outdoor vacations. I believe that the vaccines will soon become available after the approval next week. So, yes, I wouldn't alter those plans.

You've often talked about the pandemic's impact on mental health, especially for children. Baystate last week opened a temporary 12-bed inpatient psychiatric unit for kids and teens. Recently, there have been no such beds in the region. We've reported on a troubling backlog with some kids waiting weeks, or even more than a month, for psychiatric beds to become available. Does this move by Baystate go far enough?

Well, it's a temporary measure to deal with an urgent crisis. It's not going to deal with the total demand for mental health beds.

But we are planning to open a 150-bed hospital in Holyoke in 2023. We did feel that we needed to do something in the meantime.

We were also pleased to see that additional mental health beds were coming online at the former Providence Hospital in Holyoke, now run by an independent firm called MiraVista.