Things are a little better now.
But not long after the COVID-19 vaccine arrived in Washington state in December, when high-risk nurses, doctors and first responders received the very first shots with great fanfare, the days were endless for SheAnne Allen.
As COVID-19 vaccine director at the Washington State Department of Health, it has been Allen’s job to make sure the right people are getting vaccinated at the right time — and have access to the system that makes it all happen.
There have been struggles — with staffing, with online and phone access to scheduling appointments and with the unpredictability around the number of doses being sent to the state.
Four months after the first vaccine shot, some 3.2 million Washingtonians have been vaccinated. And this week, the state opened a new tier of eligibility, making 2 million more residents able to make vaccine appointments.
The state will also no longer require people to use the Phase Finder tool to prove they are eligible for the shot.
Allen, who previously led the DOH childhood and adult vaccine program, thought taking over the COVID-19 vaccine response last spring would be a “natural fit.”
“I understood the infrastructure, the storage and handling, the providers and enrollment process,” she said. “I understood the foundation.
“I thought all of those systems could be easily transferred over,” she said. “And I think I quickly realized we had to enhance those and bring on more staff.”
She started with only five people working on her team. There are now more than 50 — and more being hired.
In August, after talking with representatives of hospital associations and other partners, Allen realized that some “nontraditional” partners didn’t have connections to the immunization information systems, and set out to make things right.
The DOH “is really trying to lead with an equity lens,” she said, “and look at ways to improve communication.
“My goal was transparency and communication,” she said, “and we didn’t get information out as quickly as we’d like to.”
There were older adults who couldn’t get access to the online appointment system. Allen and her team increased the number of phone lines available and set aside 10% of available doses for those people.
“We put more tools in place to reduce that frustration,” she said.
In October, Allen and her deputy started giving regular updates to the pharmacy and medical associations and other organizations — a connection that also helped boost community engagement and provided data on prioritization.
“We were one of the only states that did that,” said Allen, whose annual salary is $97,000. “We are using science as we are making decisions, and incorporating community feedback. That’s always the main goal.”
She also created a cooperative of 500 individuals from different organizations to share ideas and get recommendations about messaging and other issues. Those partnerships and their feedback “helped set us up for success,” Allen said, especially when it came to setting up different tiers.
Right now, the DOH is increasing and enhancing the vaccine locator to see where vaccines are available, and gather available appointments.
“With the feedback we’re receiving and the enhancements we’re incorporating, I feel like we’re getting better,” she said.
“I think [the vaccine program] is evolving. And in many ways, we’re growing in staff and experience.”
Supply has been the biggest challenge, Allen said. She expects that Washington state will have 600,000 doses available every week for the next three weeks, up from 450,000 prime and booster doses available in weeks past.
The DOH uses a social vulnerability index to determine what areas in Washington are most impacted by the coronavirus. Vaccines are distributed based on county size and eligible population.
The agency also looks at providers who might have a high inventory of vaccine “so we won’t allocate to them.”
Allen and her colleagues are aware of people who don’t meet the vaccine requirements and are still getting shots. Some are waiting at vaccination sites at the end of the day when leftover doses are made available to anyone, rather than being thrown away.
Others are finding ways around the qualification questionnaire. Since workers at vaccination sites don’t check IDs for ages or require proof of employment, there’s no system to turn people away.
It would be extra work for vaccine providers to police those who show up for shots, Allen said. It is easier to believe in people.
“When we launched Phase Finder late last year, we always built it on a trust basis to show that we trust Washingtonians,” she said, adding that the prioritization guidance makes it clear who is at the highest risk.
“We are hopeful people will wait their turn,” Allen said, calling on people to remember that President Joe Biden’s directive is that all adults will be eligible by May 1.
Allen, 41, lives in Covington with her husband, who works for the City of Auburn, and their two children: an 11-year-old son and a 9-year-old daughter.
She had planned to study marine biology or maybe physical therapy, but once at the University of Wisconsin, she was drawn to public health and its melding of the public and community sectors. She received her bachelor’s degree in public health and, after moving to Seattle, her master’s degree in the same field from the University of Washington.
She worked for the American Lung Association before joining the state Department of Health as its vaccine-management-section manager, leading the childhood and adult vaccine program.
Once the coronavirus hit and the vaccine was being worked on, her whole life changed.
“Mine are easily 18-hour days,” Allen said. “But months in, I still come to work with a smile on my face, and try to be encouraging to others.
“I would ask people to be patient,” she said, “and know that the health and safety of Washingtonians is top of mind as we are making decisions.”