In a January 31 letter to North Carolina Department of Health and Human Services (NCDHHS) Secretary Mandy K. Cohen, MD, County Board of Commissioners Chairman Randy Thompson voiced commissioners’ concerns over the county’s allotment of COVID-19 vaccines. Thompson’s communication came after Cohen’s response to his January 8 letter to Governor Roy Cooper about this issue.

Earlier last week, Thompson had been apprised by NCDHHS, and Cohen on January 27, that the state would work to increase vaccine access to counties with larger populations of persons over the age of 65. But it turned out not to be the case.

“You can imagine our shock and disappointment the following day when we learned Brunswick County would only receive at a minimum 1,275 first doses for the next three weeks,” Thompson wrote. In the three weeks prior, providers in Brunswick County had been receiving an average of 1,717 first doses per week.

“Even with the 300 doses providers are being sent from the set-aside allocations to support equity in the first week of February, this still puts us behind what we were receiving before,” Thompson added. “We have to ask: What happened?”

He noted that Brunswick County has arguably the highest senior population in the state, relative to total population at 32.6 percent. Most other counties in the state with a higher percentage of seniors have a total population ranging from 10,000 to 35,000; Brunswick County’s total population is 143,000, making it a unique outlier according to Thompson.

“We all know the supply sent to North Carolina is too low and that you are trying to distribute it in a way that is fair and equitable. But it is hard for us to understand why a county that has worked so hard to do everything the state has recommended and more than meets the first criterion for set-aside allocations seems to have been cut short,” Thompson stated in his letter to Cohen.

“We are also concerned that there are some counties in our state and region that still seem to receive more vaccine because they have a larger total population than Brunswick County, but have fewer seniors when factoring for age,” he added.

Thompson reiterated that Brunswick County is demonstrating an exceptional display of partnership with its hospitals and federally qualified health centers to pool vaccines, staffing, and resources to provide a mass vaccination clinic to county residents - a clinic that could easily increase capacity for more appointments.

He also stated the county’s health and emergency services teams are selecting potential sites and preparing operational plans to open more locations to improve clinic accessibility for residents. That planning includes ways to reach more residents in Black and Latinx communities to ensure everyone in Brunswick County gets a vaccine.

“But we cannot increase capacity at our current clinic nor spread our vaccine outreach further without more vaccine itself. We would need at least 2,250 first doses a week among Brunswick County Health Services, Novant Health Brunswick Medical Center, and Dosher Memorial Hospital to sustain our current schedules and sufficiently meet the demand in this county,” Thompson said.

He also relayed to Cohen four questions commissioners feel are on the minds of many community members:

• Are there other factors that influenced the decision to send Brunswick County fewer vaccines even after the state acknowledged it wanted to help counties that have a disproportionate number of seniors?

• What calculation data is the state using to determine how it distributes set-aside allocations to Brunswick County and the rest of the state for equity, and will the state provide a copy of such data to the county?

• Was Brunswick County’s baseline allocation affected by the state trying to make up for other counties that received fewer in the previous weeks?

• From its supply of 55,000 set-aside allocations, will the state commit to increasing Brunswick County’s share to above 300 for the two weeks yet to be assigned to support efforts to equitably vaccinate those older than 65 and/or who are from historically marginalized populations?

“With the current baseline allocation we are set to receive for the next three weeks, Brunswick County is moving backwards, not forwards,” said Thompson. “Should Brunswick County only receive its baseline allocation going forward, our health professionals will be forced to reschedule up to 2,400 appointments for first doses currently scheduled in the second and third weeks of February,” he added. He noted that the county very much wants to work with the state to distribute the vaccine supplies it does receive, as quickly as possible.

“However, if Brunswick County continues to receive unrealistic vaccine allocations for the population make-up we have, we fear we will be too far behind to adequately address even more eligible individuals when the time does come for the state to announce the transition to the next group,” Thompson concluded.

Thompson’s letter is available to view at https://www.brunswickcountync.gov/brunswickcountychairmanletter-1-31-21/.