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St. Louis Doctors Say Small Clinics Are Left Out Of Coronavirus Vaccine Plans

Dr. Andrea Otto disinfects an exam room the three-person sproutMD clinic in Kirkwood. Otto said small clinics such as hers have received little information from health officials on where and when they can receive the coronavirus vaccine.
Sarah Fentem
St. Louis Public Radio
Dr. Andrea Otto disinfects an exam room at the three-person sproutMD clinic in Kirkwood. Otto said small clinics such as hers have received little information from health officials on where and when they can receive the coronavirus vaccine.

When Dr. Andrea Otto started to see videos online of health workers getting their first doses of the coronavirus vaccine, she was overjoyed. After nearly a year of treating people with the coronavirus at her small clinic in Kirkwood, she saw an end in sight.

But when she asked state and local officials where she and the two other workers at her clinic could find shots, no one helped her. Health departments redirected her calls and didn’t answer emails.

“In the beginning it was just, ‘Where do we stand? When can we expect to be contacted and how?’ And when we started asking questions,” she said, “we realized there was no plan for us.”

Weeks into the state’s vaccine distribution, workers at independent clinics like Otto’s wonder where they fall in line. They describe having to broker their own deals with large hospitals and health departments to find doses, with little guidance from Missouri officials.

Officials have said for months the vaccine is the key to ending the coronavirus pandemic, and those who work directly with coronavirus patients should receive their shots first.

The Missouri Department of Health and Senior Services made health systems like BJC and Mercy a priority to receive vaccines because they have thousands of employees and treat hundreds of coronavirus patients a day.

But health care workers in small settings said they need help too.

“We have to stand up and have a voice because if we don’t, no one will know that we’re here,” Otto said.

While they wait for the vaccine, health care workers at small clinics continue to see patients.

“People like myself in primary care practice who see multiple COVID patients a day and are on the front lines, we’re here in this war and being there to help out to prevent patients from going to the hospital,” said Dr. Mimi Vo, who has a small clinic on south Grand Boulevard.

“But we are actually completely overlooked, and that is so frustrating,” she said. “I want to be there to help out, but I’m not being given a gun.”

Vo tried for weeks to get the vaccine for her staff. Just like their counterparts at large hospitals, they’re treating coronavirus patients daily and are at a high risk of contracting the virus themselves. “And I see that fear in my staff,” she said.

Because she has admitting privileges at Mercy Hospital South, Vo got the vaccine there last month. But her father, who is a doctor, and the three medical assistants at her clinic weren’t as fortunate. They eventually took a five-hour round trip to Lebanon, Missouri, to receive a dose at a hospital there.

Vo and dozens of other clinicians have formed a private group on Facebook to commiserate and send each other leads on where to find doses. Some in the group describe going to other states to receive shots.

“There was a physician in Orlando, Florida, who said ‘Our hospital is vaccinating any health care workers who show up, and it’s an honors system’,” Vo said. “This one doctor said, ‘I may ride to Orlando, Florida, to get vaccinated.’ That’s how crazy it is right now.”

Missouri’s vaccination distribution plan states for hospitals to receive vaccines, they must agree they will distribute them to “all qualified comers.”

But so far hospitals are largely focused on vaccinating their own employees. Vo and Otto are upset when they hear about non-clinical workers who don’t have direct contact with patients receiving vaccine doses.

Hospital officials in the St. Louis region said while they may help distribute vaccine to independent health care workers at some point, it's not their responsibility to vaccinate them.

Dr. Andrea Otto says after weeks of calling hospitals and health departments, she finally received her first dose of the coronavirus vaccine earlier this month.
Sarah Fentem
St. Louis Public Radio
After weeks of calling hospitals and health departments, Dr. Andrea Otto received her first dose of coronavirus vaccine earlier this month.

State Health Director Randall Williams agreed. All health care workers who want the vaccine need to be patient, he said, until the process is finished at large institutions.

“It’s just a matter of logistics once you move beyond a centralized location,” Williams said. “But we are incredibly committed to doing it.

“We’re going to find you, and get you that vaccine,” Williams said.

State health officials aren’t discussing how they’ll ensure all health care workers receive the vaccine. The state is planning to communicate with them through professional associations, said Lisa Cox, a spokeswoman for the health department, in an email.

Many counties in Illinois are distributing vaccines directly through health departments, vaccinating all health care workers who show up. But Missouri’s plan is still unclear. More details about vaccine distribution are expected to be released late this week, Cox said.
The St. Louis County Health Department will distribute some of its 975 doses to health care workers who don’t work in hospitals, officials announced last week. The federal government has not distributed any doses to the St. Louis Health Department.

In the meantime, doctors are increasingly trying to find vaccine on their own.

Dr. Matt Bruckel, CEO of Total Access Urgent Care, turned down a state shipment of vaccine because it came in batches of nearly 1,000 doses, more than twice as much as his clinics needed, he said. Total Access clinics are popular testing sites for the coronavirus. More than 10,000 patients a week receive tests from the company’s employees, he said.

Eventually Bruckel made a deal with Mercy Health to vaccinate his workers.

“It’s push, push, push, until you solve the problem,” he said.

Even though finding the vaccine was difficult, Bruckel understands why large hospitals got the first shipments.

“[It’s] the old story of: You have big rocks, medium rocks, small rocks, sand and water,” he said. “How do you fit it all into the bowl? We always, always start with the big rocks. You can't do anything unless you start with the big pieces first. So the hospital systems are the big pieces.”

But not everyone has the time to broker a deal with a hospital for doses.

“I’m so happy that people are going in droves to get the vaccine,” said Otto, the Kirkwood doctor, last week. “But I just want to know I’m in the plan somewhere.”

Otto has since received her first dose of the vaccine at a Mercy Hospital.

She hopes hundreds of other independent workers will soon have the same chance.

Follow Sarah on Twitter: @petit_smudge

Sarah is the health reporter at St. Louis Public Radio.

Send questions and comments about this story to feedback@stlpublicradio.org.