Updated 4:25 p.m.
Nearly five months after the first COVID-19 vaccines were administered in Massachusetts, Gov. Charlie Baker said Monday the state was moving into a new, more targeted phase of its immunization effort, with the state on track to meet its initial goal of fully vaccinating 4.1 million people by early June.
Baker said the revised vaccine strategy would see the administration begin to dial back its reliance on mass vaccination sites and increase vaccine distribution to regional vaccine sites, mobile clinics and primary care providers to improve access to harder to reach populations.
Four of the seven high-volume mass vaccination sites — Gillette Stadium, Hynes Convention Center, Natick Mall and Danvers Doubletree — will close by the end of June, leaving sites in Boston, Springfield and Dartmouth.
More than 2.6 million people in Massachusetts have been fully vaccinated against the COVID-19 virus to start the month the May, and over 70% of adult residents have had at least one dose, according to state and Centers for Disease Control data. More than 85,000 doses a day are being administered and 180,000 people are registered to get their first dose over the next week, the governor said.
"This represents an incredible achievement. The people of Massachusetts are outperforming the rest of the country by leaps and bounds," Baker said at a Statehouse press conference.
But with appointments available around the state and supply more ably meeting demand, Baker said his administration would begin to shift its strategy away from pushing vaccine through high-capacity mass vaccination sites in favor of more community-based settings, including primary care providers.
"Now that we believe we are going to hit the 4.1 million goal we started with over the next few weeks, it's time to adapt our vaccination effort to make sure we get to some of the harder to reach populations," Baker said.
The new targeted approach will start with increased supply being shipped to the 22 regional vaccine collaboratives, and Baker said the boards of health and other operators of clinics in the state's 20 "equity" communities will see their allotment of vaccine doubled.
The state also plans to increase its use of mobile clinics, especially in hard-hit communities of color where rates of vaccination are lower, to bring vaccines to houses of worship, YMCAs, senior centers and other community anchor organizations.
Mobile clinics have been used to administer 21,000 doses in Boston, Chelsea, Brockton, Fall River, Springfield and New Bedford, and Baker and Health and Human Services Secretary Marylou Sudders said the state will be looking to do more with pop-up clinics and walk-up sites.
Baker said some of this is already starting to occur with the Metro North Regional Collaborative running clinics at Encore Boston Harbor Casino, Tufts campus in Medford and Cambridge Health Alliance in Somerville; Boston Medical Center setting up an appointment scheduling location at South Bay Shopping Center; and Lynn, New Bedford, Fall River and Worcester using mobile clinics at churches to reach people.
"The mobile clinics have been particularly effective in our equity communities and to reach people of color," Baker said.
Finally, the administration is talking with the Massachusetts Medical Society to work through vaccine storage and appointment scheduling logistics that will enable it to begin to increase supply to primary care providers by the middle of May.
"The declining numbers of hospitalizations and deaths affirm vaccination is effective, and we believe that physicians can deploy a personalized approach to reaching patients who have yet to be vaccinated - especially those who must overcome a lack of access due to gaps in equity and those who still may be vaccine hesitant," said Dr. David Rosman, president of the Massachusetts Medical Society.
Surveys have shown that vaccine hesitancy rates are very low in Massachusetts, and Baker said that of the 30% of the adult population still unvaccinated the administration believes fewer than 10% of those residents have decided fully against being vaccinated.
"In some cases it's literally just us getting to them and making it easier for them to get vaccinated," Baker said.
Rosman said patients contacted directly by a primary care physician who they trust may be more willing to receive a shot in a familiar health care setting.
Baker said that since the vaccination program started more than 1.2 million doses have been administered at state-supported mass vaccination sites and 500,000 people have been fully vaccinated at these centers.
The sites are already scheduled to administer 250,000 second doses in May, and 180,000 first doses over the next seven days.
Lt. Gov. Karyn Polito said that as four sites wind down over the next two months the three remaining mass vaccination sites, as well as the pre-registration system that has fed that system, will remain open as manufacturers move close to approval for a vaccine for children aged 12 to 15.
While reaching 4.1 million residents with vaccines will mean about 60% of the total population and 80% of the adult population has some immunity to COVID-19, Dr. Paul Biddinger said there is increasing doubt about the country, or states like Massachusetts, reaching herd immunity.
"I think probably not," he said.
Biddinger, the medical director for emergency preparedness at Mass General Brigham and chair of the state’s COVID-19 vaccine advisory group, said that while it may not be possible to fully eradicate the spread of COVID-19 in the community, the goal is to "minimize the consequences" through vaccines and make the virus something more comparable to the common cold or an "ordinary infection."
Biddinger stressed the efficacy seen so far in the ability of the three approved vaccines to prevent serious illness and urged anyone not vaccinated to schedule a shot.
Baker said that the state would also be monitoring the development of a vaccine for children under 16 and talking with experts to make sure there is an infrastructure in place to vaccinate that population if and when a shot becomes available.
The governor said he would consider requiring a vaccine for students returning to school in the fall if one becomes available, but he pushed back against questions about why he didn't want to force state employees or other groups to get vaccinated as a condition of their return to work.
"The focus here really ought to be on creating positive incentives to get vaccinated. The idea that I would kick somebody out of a job, especially in the kind of economy that we have now because, quote unquote, they wouldn't get vaccinated right away on an EUA approved vaccine. No I'm not going to play that game," Baker said.
He said the state's role should be in making clear to people that the vaccine is safe and effective and giving people access to it if they want it.
"The idea that we would take those folks and basically make them choose between their rent and their food on the table and all the rest when they have in some cases very legitimate reasons to be nervous about a government run program that's going to put a shot in their arm, no, I'm not going there. I'm not going there," he said.
