On Christmas Eve, Roberta Smith decided to do something special at work. She put on a Santa costume, complete with bells and striped stockings, and got in her car.
In the back seat sat a toolbox. Inside, a small, blue Igloo cooler carried a chilled vial of Moderna’s COVID-19 vaccine. Smith, Routt County’s director of public health, was on her way to vaccinate 10 people at the South Routt Medical Center in Oak Creek, a rural community roughly 25 miles southwest of Steamboat Springs.
“It’s a lot more convenient for people living in this part of the county to come here,” Smith said. “We definitely have people that are testing folks for COVID that are at risk, so we wanted to make sure they got vaccinated, even if it’s on Christmas.”
Many of Colorado’s rural communities have been hit just as hard by the coronavirus pandemic as more populated areas. They’ve had to manage outbreaks with fewer tests, medical workers and ICU beds. And now, as vaccines are being rolled out across the state, local health departments are trying to make sure rural residents have equal access.
In Routt, the health department has diverted thousands of dollars of CARES Act funding to create a special mobile health clinic specifically for delivering vaccines to rural communities. By doing so, the agency hopes to eliminate barriers like transportation that might otherwise deter people from getting vaccinated.
The money, Smith said, subsidizes the cost of extra syringes, gas and employee wages. It’s the first time the county’s health department has tried to prop up such a clinic.
“It was very, very helpful to us,” Smith said. “It wasn’t a ton of money, but it has totally made a difference.”
On the clinic’s first run in Oak Creek, 10 frontline medical workers were scheduled to get vaccinated. Smith and another staff member set up shop in one of South Routt’s patient exam rooms.
The first was Ken Rogers, the clinic’s district manager. He smiled and waved as another employee took a picture for the clinic’s Facebook page.
“It’s been a really difficult year for the medical community, Rogers said. “So we’re very happy.”
Having the vaccines delivered directly to Oak Creek will be a game changer when supply increases into spring and summer, Rogers said. Many of South Routt’s patients don’t have access to transportation to make the long drive up to Steamboat Springs, which is where the county’s current stock of COVID-19 vaccines is being stored.
“They have to rely on friends, family, the county council on aging has some transportation for seniors,” he said. “They just don’t have that resource.”
Another factor benefiting rural communities is the arrival of Moderna’s vaccine in Colorado. Unlike Pfizer’s vaccine, it doesn’t require storage in ultra-cold freezers, which many rural clinics don’t have. The looser storage requirements make it easier to transport vials long distances.
South Routt can store Moderna vials in its on-site freezer, which will allow residents from Oak Creek and other surrounding communities to call and schedule an appointment once supply increases. Rogers is also considering taking the vaccine door-to-door if residents aren’t able to make it in for an appointment.
“That will absolutely help with deployment,” Rogers said.
Routt County received 100 doses of Moderna’s vaccine in the days leading up to Christmas. The health department is expecting to get another shipment in January.
As of Dec. 30, Colorado had administered doses of COVID-19 vaccines to more than 70,000 people.
The state is currently in “phase 1” of its vaccine prioritization plan, meaning only health care workers, first responders and nursing home residents are eligible to receive the vaccine. Once the state receives more supply from the federal government, it will move into phase 2, which includes residents older than 65 and some essential workers. Phase 3, which includes the general public, will likely begin in early summer.
Roberta Smith expects the county’s mobile clinic will visit many more rural communities in the coming months. The exact schedule is still evolving. On Dec. 29, the team completed its first clinic at a long-term senior living facility in Hayden, 25 miles west of Steamboat.
The clinic will also circle back to every stop to make sure residents get their second doses, Smith said. In the case of Moderna’s vaccine, that’s 28 days after the first shot.
“We want to cover everyone and make sure people have access throughout the pandemic,” she said. “We’ve seen some disparities (in rural communities) and we’re working hard to make sure we address all of the people in our community.”
Making sure none of the vaccine gets wasted is another logistical challenge for the clinic.
During the team’s first trial run in Oak Creek, they encountered an unexpected problem: They ended up with two extra doses of vaccine and no one around to take them.
Using vaccines quickly is important, as the product can go bad if left out of the freezer for too long. Many health care providers are finding that Moderna and Pfizer’s vaccine vials hold an extra dose.
In response, Smith called a nearby nursing facility and local first responders to see if any staff were able to make a last-minute appointment. Thankfully, they were.
“Ultimately, it makes it better for vaccines in our community,” Smith said. “We got more (doses) than we expected. So that’s great.”
In the exam room, Gene Bracegirlde rolled up his sleeve. A local firefighter and EMT trainee, he said his mind was blown when he learned he was eligible.
“I did not expect (the vaccine) to be this rural that quick,” Bracegirdle said. “It's exciting to see the initiative being taken.”
