State health officials on Thursday acknowledged their current method of allocating COVID-19 vaccine to providers across the state has not resulted in as equitable a distribution of doses as they would like.

“We’re starting to see some disparities in vaccination rates across some of our counties,” newly installed state health director Edward Simmer said at Thursday’s Department of Health and Environmental Control board meeting. “We certainly don’t want to take anything away from the counties that are doing well, but we want to make sure that everyone’s getting equal access to the vaccine.”

DHEC’s current allocation method, which considers vaccine supply, demand and uptake to determine vaccine distribution across the state, has favored urban centers over rural areas, DHEC senior deputy for public health Nick Davidson told the agency’s board.

Davidson, who on Thursday presented DHEC’s board with a plan to distribute vaccine doses to counties based on population, said such a model would be more equitable to rural counties than the agency’s existing allocation plan.

DHEC’s current plan provided far more doses this week to populous counties like Charleston, Horry and Richland than those areas would have received using a per capita model, he said.

Rural counties like Barnwell, Calhoun and Clarendon, on the other hand, received less vaccine this week than they would have gotten if DHEC had distributed doses by county population, he said.

“Compared to current practices, certainly, the per capita model does direct a larger proportion of the vaccine to counties with less population,” Davidson said.

His presentation comes as DHEC’s board grapples with how best to allocate the limited number of COVID-19 vaccine doses flowing into the state.

South Carolina has seen its weekly allotment of Moderna first doses increase about 50% over the past three weeks, from 31,400 in the final week of January to 45,200 this week, but the modest hike has not been enough to keep up with demand, especially as another 310,000 South Carolinians age 65 to 69 became vaccine-eligible this week.

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“Unfortunately, the number of requests far exceeds the ability of the vaccine coming into the state. There’s just not enough,” Davidson told the board Thursday. “We’re still experiencing a significant shortage.”

Nearly two months since South Carolina began receiving shipments of vaccine, the state has gotten only 37% of the doses necessary to fully inoculate all 1.3 million people included in its ever-expanding initial vaccine phase.

Just 35% of all eligible Phase 1a individuals have received a shot in the arm to date, and only about 9% are fully vaccinated, according to DHEC.

At the current rate, DHEC projects it will be early April before a substantial number of Phase 1a individuals have received their first shot and Phase 1b can begin, Davidson said.

He did say, however, that he was cautiously optimistic based on recent conversations with federal officials that South Carolina would continue to receive at least as many doses each week as it currently does.

The head of the federal government’s COVID-19 vaccine distribution program “assured us that we would never get less than we got the week before,” Davidson said. “And that’s a fairly bold statement. But he was very confident to be able to stand by that. So we’re encouraged by that.”

At its January meeting, DHEC’s eight-member board selected a strictly per capita vaccine distribution model over another model that would have taken into account factors like the age, race and socioeconomic status of county residents.

Under the per capita model, 95% of the state’s weekly vaccine shipments would be doled out to counties based on their relative share of the state’s population with the remaining 5% set aside as a contingency reserve.

The board told state health officials to spend a couple weeks coordinating with vaccine providers to iron out details of the plan and work through any potential problems in advance of Thursday’s meeting.

In the meantime, state lawmakers introduced a bill to fund the state’s COVID-19 response that stipulates all first vaccine doses must be allocated by region, not county.

According to the bill, which the Senate approved Wednesday, the doses should be distributed in a per capita manner, with considerations for poverty level, infection rate, age and high-risk populations.

While DHEC board members listened attentively to Davidson’s presentation on the county-based distribution model Thursday and commended his efforts, they ultimately told him to go back to the drawing board.

After meeting for about an hour in executive session following the presentation, the state health board deferred making a final decision on how South Carolina’s scarce supply of COVID-19 vaccine will be allocated, asking instead that public health officials study the impact of regional vaccine distribution, as the recently introduced Senate bill would require.

Davidson said his team had discussed regional vaccine allocation and believed harnessing the state’s existing network of regional health care providers might offer greater flexibility than a county-based approach.

“I think there could be a fair amount of cooperation existing between those counties, and that would assist in making sure that that vaccine gets out to the communities that need it most,” he told the board.

Regardless of what shape the allocation plan takes, South Carolina will be forced to ration its limited supply of COVID-19 vaccine until it starts receiving significantly more doses from the federal government.



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