State Sen. Maria Collett was beyond frustrated – and she wasn’t trying to hide it.
“I have not heard a lot about logistics from the Department of Health this morning,” Collett said, punctuating each word of speech for emphasis, as she addressed the state’s top health official at a Feb. 4 public hearing. “I’ve heard a lot of talk about accountability, transparency … but I’d like to hear more about logistics – please.”
As a state lawmaker from populous Montgomery County, Collett, a Democrat, has had a front row seat to Pennsylvania’s rocky vaccine rollout. She’s fielded complaints from local officials who say their hard-hit region isn’t getting enough doses, and from constituents who feel defeated by finicky appointment software.
But as a former nurse, Collett also knows what it takes to administer a massive vaccine operation. And so far, Pennsylvania’s efforts to quickly and equitably inoculate millions of citizens against COVID-19 are falling short of her expectations.
“One thing I find lacking is the specifics,” Collett told the Capital-Star recently, referring to the state’s planning efforts. “What this is really going to come down to … is understanding what a logistical enterprise of this nature really takes.”
Pennsylvania’s vaccine program has moved sluggishly since the Department of Health started inoculating healthcare workers in mid-December.
The state has made millions of people eligible to receive vaccines and tapped 1,700 pharmacies and healthcare providers to administer injections.
But the patchwork system quickly bred problems: each provider has its own system for booking injections. People seeking vaccines say that snagging a coveted appointment slot is competitive and time-consuming – an effort that feels more like winning the lottery than securing critical healthcare.
The state Legislature ramped up its scrutiny of the vaccine program when it returned to Harrisburg in January. Though the effort is run by the Department of Health, lawmakers have tried to exert oversight through legislation and in hours-long public hearings with state health officials.
Leading the way are lawmakers, such as Collett, who previously worked as nurses – and who say their experience as frontline healthcare workers is helping them confront a public health problem that’s too big to let fail.
“We nurses tend to encounter a problem and just go right for the solution,” Rep. Bridget Kosierowski, D-Lackawanna, told the Capital-Star. “We don’t look for who or what’s to blame. We just immediately work towards a solution.”
“I just know we have to get it fixed”
Healthcare professionals comprise one of the biggest workforces in Pennsylvania: roughly one in twenty Pennsylvania workers were registered nurses or home health aides in 2019, national data show. Home health and personal care aides represented the single biggest labor force in the state that year.
But healthcare workers are typically underrepresented in elected office. Data from the National Conference of State Legislature found a negligible number of healthcare professionals win seats in state legislatures nationwide.
In Pennsylvania, voters are more likely to send former attorneys, business professionals or career politicians to Harrisburg than they are nurses, doctors or personal care aides.
Groups that represent nurses say the pandemic has underscored the need for health professionals to pull policy levers in the statehouse.
“If it weren’t for nurses in the halls of power who cannot be ignored, we would be in a far worse situation,” said Nurses of PA, a group that lobbies for new regulations for nurse staffing levels and other healthcare policies in Harrisburg.
Kosierowski worked as a registered nurse for 26 years before winning a state House seat in a 2019 special election. Last week, she was one of four lawmakers tapped by the Wolf administration to serve on a new joint task force on COVID-19 vaccines, which aims to improve communication about the vaccine rollout between the legislature and the executive branch.
Kosierowski said she’ll use her new role “to be the eyes and ears of constituents” and raise their challenges with the Wolf Administration.
“[Lawmakers] need to make sure there is constant, clear communication between all branches of government right now,” Kosierowski said. “That’s the most important part.”
State Sen. Judy Ward, R-Blair, a former cardiac care nurse, also thinks lawmakers can help the Wolf administration better understand the on-the-ground realities of its vaccine program.
Ward has proposed legislation that would allow a wider scope of healthcare practitioners, including pharmacy and nursing students, to administer vaccines – a move that she says would make it easier for the state to staff mass vaccination clinics.
But right now, she says, she’s focused on fixing the complaints she’s heard from senior citizens, who say they’re having trouble navigating vaccine registration online.
“I think what we can bring at this point is just some practical experience and practical issues we’re hearing from our constituents,” Ward said, adding that her nursing experience “helps me understand the enormity and complexity” of a safe vaccine rollout.
Ward, Collett and Kosierowski all say they’ve seen some signs of improvement from the Department of Health as the vaccine program enters its third month.
They think the task force Wolf announced last week will make it easier for them to relay concerns from constituents to state officials in Harrisburg.
They also agree that the biggest problem facing the state right now is one it has limited control to fix: a short supply of vaccine doses.
But the lawmakers also see fault lines in the state’s plans.
Ward and Collett, who chair the Senate’s Aging & Youth committee, have called on the Department of Health to pay closer attention to the needs of elderly Pennsylvanians and nursing home residents.
In a letter to the Department of Health this month, they said that rollout to nursing homes has been too slow, and called on the agency to work with elder care advocates who “have repeatedly offered their support and collaboration to find solutions.”
“I don’t know where the breakdown is happening, I just know we have to get it fixed,” Ward told the Capital-Star. “Our long-term care folks have to get vaccinated ASAP because they are our most vulnerable.”
She also said she wants to see long-term care facilities adopt detailed plans to safeguard their staff and residents until vaccines are widespread, by making sure every new admission and staff member is vaccinated.
Ward and Collett also asked the Department of Health to create a working group of elder care advocates, industry leaders and state officials.
Collett said she was encouraged to see state Secretary of Aging Robert Torres appear alongside Gov. Tom Wolf at a press conference last week, where they highlighted local agencies that had found success getting senior citizens vaccinated.
She also welcomed the Wolf administration’s announcement that it would withhold doses from vaccine providers that don’t administer them quickly enough, or that don’t report demographic data for the people they vaccinate.
But Collett said “there is still an incredible gap between what [state officials] are saying and what people are personally experiencing” – especially when it comes to registering for a vaccine.
Acting Secretary of Health Alison Beam has said Pennsylvania won’t create a central registration system to help people get appointments. Collett has called on the state to reconsider that decision, and last week circulated a memo with Democratic colleagues proposing a statewide database to match vaccine seekers with providers.
Collett says she’ll continue to call on her nursing background as the state expands its vaccine program this year. That may even mean suiting up in scrubs and administering injections herself – just as she did when she visited a vaccine clinic in her district earlier this month.
“The more hands on deck, the better off we’ll be,” Collett said. “When we’re talking about a deadly disease and a mass vaccination rollout that can ensure more safety for our vulnerable populations, we don’t have a day to wait.”