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Rural communities, small pharmacies may struggle with Johnson & Johnson vaccine pause

Posted at 9:40 PM, Apr 14, 2021
and last updated 2021-04-15 06:25:53-04

GREENFIELD — Following the news of the temporary pause on distributing the Johnson & Johnson COVID-19 vaccine Tuesday, mass vaccine sites at the Indianapolis Motor Speedway and in Fishers were able to switch to using Moderna or Pfizer.

However, that was not the case for every clinic in central Indiana.

In Hancock County, state data shows a little more than 1,500 Hoosiers received the Johnson & Johnson shot before the pause. One pharmacy in Greenfield said they would have been the first state provider in that county to give neighbors the option to get the Johnson & Johnson vaccine, but Tuesday’s news derailed their plans.

“We posted the appointments and within 24 hours I would say they were all filled up,” Riley Warner, staff pharmacist and Clinical Program Director at Medicap Pharmacy said.

Warner said Hoosiers coming from as far as Muncie scooped up the 200 appointments for the Johnson & Johnson COVID-19 vaccine being offered during the pharmacy’s multi-day clinic. Tuesday was supposed to be the first day of that clinic.

“My gut dropped because all this work, all this time we spent waiting to get vaccines,” Warner said.

A vaccine clinic is something the pharmacy has been ready to do since January, Warner explained. The staff was not able to host a clinic until the first shipment came last week after delays in vaccine shipments.

“We’ve been here since 1997 and our community, I think, has really come to depend on us. They still think of us as that like mom-and-pop store. We try and take care of everyone the best way we can and that was a huge part of it was being able to offer COVID-19 vaccines,” Warner said.

Warner feels the pause shows the system in place is working. Thomas Duszynski, Director of Epidemiology Education at IUPUI’s Richard M. Fairbanks School of Public Health, agrees.

“This should be a good sign to Hoosiers and the American public that we are doing our homework around this and we are watching out for their safety,” Duszynski said.

In terms of short-term impact, Duszynski said he believes there will not be a major disruption to the state’s vaccine roll out.

“[A] vaccine site like IMS was able to transition and pivot very quickly to the Moderna vaccine, so that tells me we have adequate vaccine supply in the state,” Duszynski said.

For other sites depending on the Johnson & Johnson vaccine, Duszynski said the pause may slow the roll out down. He feels the biggest impact will be in the rural areas and smaller pharmacies that do not have the capabilities of storing Moderna or Pfizer.

“That’s why Johnson & Johnson was so important to us. One it’s a single dose,” Duszynski said. He continued, “And second, the Johnson and Johnson, unlike the Moderna vaccine or Pfizer vaccine, didn’t need special refrigeration."

Medicap Pharmacy only recently bought a small freezer that could store the Moderna vaccine. It is not cold enough for Pfizer.

“It’s a question of if we can get the Moderna, so at this point going forward we haven’t had that discussion yet on if we’re going to try,” Warner said.

Tuesday’s, Wednesday’s and Thursday's appointments at Medicap are canceled. For those who scheduled those appointments, they are not able to make them up and will have to reschedule elsewhere or go through the state's website again if those appointments become available again.

Warner released the following statement on rescheduling:

For those appointments that we had to cancel, we are unfortunately not able to hold appointments if the hold on J&J vaccination gets reversed. We have advised patients to reschedule their own appointment through the state website once it is available again. If we get the go ahead to administer the J&J vaccine, we will likely be so busy that calling patients back to reschedule will not be realistic. We have 200 doses of J&J available with another 300 on order. Our capacity really depends so much on whether our shipments are released from our drug distributor. If we are running at full capacity, we expect we would be able to administer at least 1000 doses a month. We have been primed and ready to administer doses since early January, but we have been stopped by the lack of vaccine shipments.

Warner said the staff is now waiting on guidance from the FDA and CDC before deciding what to do next.

“As soon as we have vaccines that we’re allowed to give, we will be giving them. It’s just that question of which vaccine will it be and when are we going to be able to have it?” Warner said.

Warner said the pharmacy currently has 200 appointments and there are another 300 on order. She said if the pharmacy is able to run "at full capacity," she expects to be able to administer 1,000 doses a month. However, capacity is based on if "shipments are released from our [Medicap Pharmacy] drug distributor.