COLUMBIA — The delay in South Carolina of available COVID-19 vaccine doses getting into the arms of eligible health care employees appears to be partly due to hospitals being uncertain whether they should be vaccinating people who don't work for them.
The state Department of Health and Environmental Control sent hospitals additional guidance late last week clearing up the confusion, Dr. Brannon Traxler, the state's public health director, told reporters Wednesday.
Roughly one in three available doses has been administered so far.
"We hope hospitals understand" they are not only allowed to vaccinate people eligible in Phase 1A outside their system, "we actually encourage it," she said.
The Medical University of South Carolina started vaccinating non-employees Saturday, said Dr. Danielle Scheurer, chief quality officer for MUSC Health, adding that more than 60 percent of staff has gotten a shot.
Not all hospitals waited due to the confusion. Lexington Medical Center has offered doses to first responders and other non-employees for weeks.
"We welcome the ability to vaccinate as many people as possible, especially our most vulnerable citizens. But like all hospitals, we cannot vaccinate anyone in our community at will. We rely on guidance and instructions from DHEC," Lexington Medical Center spokeswoman Jennifer Wilson said.
North Charleston-based Trident Health vaccinated eligible, non-employees who were turned away from other hospitals, said Dr. Lee Biggs, Trident's chief medical officer.
South Carolina remains in the first eligibility phase, which focuses on front-line medical workers and nursing home residents.
But the long list of health care-associated jobs included in Phase 1A extends beyond hospitals, which are the only place where those workers — which include coroners, dentists, paramedics, and pharmacists — can get a Pfizer vaccine shot.
In all, an estimated 353,000 people are eligible in this initial rollout, according to DHEC. It's unclear how many of those are residents of nursing homes and assisted living centers, who are getting the Moderna vaccine where they live.
As of Wednesday, 36 percent of the 146,260 Pfizer doses hospitals have received since mid-December have been given, according to DHEC.
Growing frustration at the slow rollout caused Gov. Henry McMaster on Tuesday to set a deadline: Eligible workers need to either get a shot or make an appointment by Jan. 15 to get one, or wait until future eligibility phases. While the federal government provides guidance, who's eligible for the vaccine — and when — is ultimately up to each state's governor.
There is no state signup system, for this phase or any other yet.
Employers — including dental offices, funeral homes and optometrists — are encouraged to provide their local hospital with a list of names and email addresses of workers who want the vaccine. Otherwise, it's up to the employees themselves to make an appointment — and soon — at their nearest hospital, Traxler said Wednesday.
Proof of eligibility will be required. Credentials accepted at appointments can include a badge, business card, or personalized letter from an employer, she said.
By Wednesday, almost 70,000 eligible people had signed up for an appointment, she said.
Despite the deadline, it remains unclear when South Carolina will transition to Phase 1B, which extends eligibility to people 75 and older, teachers, day care workers, and people in other critical jobs, such as grocery store clerks.
The transition will depend on how many appointments are made, how long they extend past Jan. 15, and the vaccine supply. Traxler said Wednesday that Phase 1A is still expected to continue through late January or early February. People not in high-risk categories could get a shot by late spring.
McMaster has promised to order the transition sooner if the pace doesn't pick up dramatically.
Nearly 800 health care providers in South Carolina — including pharmacists, urgent care centers and doctors' offices — are approved by the federal government to provide vaccine shots.
But for now, hospitals remain the only place to get one. And, as Traxler has noted repeatedly, they're overwhelmed by COVID-19 patients filling beds.
The demands of caring for patients and a staff shortage due to some being in quarantine are limiting the number of trained people who can give the shots. DHEC is exploring expanding the pool of those who can do that to include retired nurses who have let their licenses expire, students in their last year of nursing school, emergency medical technicians and dentists, Traxler said.
DHEC did not immediately respond to follow-up questions on what's required to do that or what's holding that up.
According to a timeline DHEC issued Wednesday, the vaccine will be available at some doctors' offices next week and at some pharmacies Jan. 18.
For future eligibility phases, the agency is considering setting up a scheduling system, so people can make an appointment either online or by phone "or some hybrid thereof," Traxler said. "As we get closer to Phase 1B, we will be providing more information about the different options."
Legislators of both parties, who are getting bombarded by calls and emails from residents seeking a vaccine, are exasperated that such systems weren't already in place.
"They've had months to plan for this. What are they waiting on?" asked state Sen. Dick Harpootlian, D-Columbia. "They're lollygagging. There's no sense of urgency."
Other states, including neighboring North Carolina and Florida, have already widened eligibility to seniors who don't live in nursing homes.
Senate Majority Leader Shane Massey said he wishes McMaster had gotten publicly engaged sooner.
"This is a massive failure of leadership. There is no other way to describe this. The hospitals don't know what to do. The public doesn't know what's going on. There's terrible communication," said the Edgefield Republican. "It's beyond frustration. People are angry."
To be fair to DHEC, he said, he didn't think it made sense to task the already overwhelmed public health agency, which has been without a permanent leader for six months, with the vaccine rollout anyway.
"DHEC has never been tasked with something like this and they're still dealing with testing," he said. "Tasking them with doing it was not a smart move."
Mary Katherine Wildeman and Jessica Holdman contributed to this report.