A surprise Tuesday announcement about Johnson & Johnson COVID-19 vaccine availability has complicated the city of New Orleans’ mass vaccination plans, and after a flurry of injections this week, the pace of mass vaccinations in the city may slow down again.
The New Orleans Health Department is opening a new mass vaccination center at the Ernest N. Morial Convention Center this week. It plans to scale back city-run COVID-19 testing sites to focus on the immunization effort, officials announced on Tuesday.The Health Department testing sites, run in partnership with LCMC, and some of the first community testing sites in the country, will come to a halt next week.
The Convention Center site, also operated with LCMC, and funded by a $4.1 million FEMA grant, will provide thousands of Johnson & Johnson doses this week to people already eligible under state guidelines.
But it’s not clear exactly how many doses will be available the rest of the month. On Tuesday, state officials announced that Louisiana wouldn’t receive more shipments of the Johnson & Johnson vaccine until the end of March. Those vaccines — which are administered in a single dose and can be stored at normal refrigerator temperatures — are easier to administer at mass vaccination sites, and city officials had expected them to underpin the effort.
New Orleans Health Department Director Dr. Jennifer Avegno said in a Wednesday interview that the news “means that we won’t be able to scale up to the full complement we think we can do right away,” but that the site will remain open.
“LCMC thinks that we can do 3,000 a day, maybe more,” she said. “If all we can do is 500 a day, that’s still a lot, and it’s better to keep it open.”
Closed test sites
Avegno said that the changes to testing wouldn’t substantially reduce the number of tests available.
“The volume [at city testing sites] has dropped off in the last few weeks,” she said.
But, she said, “the number of overall tests are still pretty high. I think people have a lot more options now.”
Other no-cost testing sites, operated by the Louisiana National Guard and by the nonprofit CORE, will remain in place. The National Guard testing occurs at drive-through sites in Westwego, Armstrong Park, and the University of New Orleans. CORE’s sites rotate through a variety of churches and community centers, although they regularly appear in the Lower 9th, Metairie, St Roch, and New Orleans East.
The city’s COVID metrics have improved over the course of February, and as of last week, the city returned to “modified phase 2” restrictions on businesses. That included allowing bars and restaurants to resume limited indoor and outdoor service. (Throughout the crisis, Mayor LaToya Cantrell’s administration has taken a more cautious approach to reopening than the rest of the state. On Tuesday, Gov. John Bel Edwards announced that the state would move into the less-restrictive phase 3 reopening plan on Wednesday. Cantrell had no immediate plans to join other parishes in lifting phase 2 restrictions.)
As of Tuesday, New Orlean’s test positivity rate was 1.8 percent, and about 45 new cases have been diagnosed for the last week. However, hospital capacity remains at critical levels, and daily new cases have risen slightly since Mardi Gras.
At a Tuesday afternoon press conference, State Health Officer Dr. Joseph Kanter noted that testing volume had declined sharply statewide over the past week. He partly attributed that drop to the recent winter freeze. In New Orleans, the rolling seven-day average test volume was about 3,500 a day, up slightly from a low point of about 2,700 during Mardi Gras.
Avegno didn’t have exact numbers on how many tests non-city-operated sites provide each week, but said that city sites were providing only about 150 per week, a small fraction of the city’s total test volume. She estimated that the National Guard sites were doing 100 tests a day.
“We use WHO modelling to predict how many [tests] we needed per day to get a handle on the pandemic, and it was 500,” she said. “We’re still doing way more than we need to.”
However, a substantial portion of those tests come from Tulane University, which runs hundreds or thousands a day, mostly on its undergraduate population.
Avegno also said that the city is ready to set up testing sites again if there’s another surge. “It’s just a matter of getting a site and making a schedule,” she said. “It would be pretty easy to do it within a couple days.”
At the same time, the city has opened sign-ups for its first official mass vaccination site at the Convention Center, using an initial shipment of 2,700 Johnson & Johnson vaccines.
Moving resources away from testing allows the city to focus on that effort, Avegno said. “It’s not so much a cash issue, but it is a manpower issue. Every person that I’ve got working at a testing site is one that is out of working at a vaccine site.”
On Wednesday morning, the site opened for a dry run on people from the city’s wait list. Injections scheduled through a public LCMC hotline and 311 will begin tomorrow.
“Yesterday we found out that we were getting 2,700 [Johnson & Johnson] doses, plus the regular Pfizer and Moderna, so we decided we could be live to take new appointments,” Avegno explained.
The vaccination site will schedule all of those doses within the next few days. “The state wants to see the shipment of Johnson & Johnson doses used by the weekend,” Avegno said.
At the same time, she said, the Health Department will continue to use its allocation of Pfizer and Moderna vaccines to run smaller neighborhood vaccination sites, with some sign ups reserved for nearby residents. “Mass vaccination sites are great, but if that’s the only thing you’re offering in your community, you’re going to leave a lot of people out.”
Avegno said that on Thursday, the city would be working with the Musician’s Clinic to vaccinate culture bearers, and that in a few weeks, it would be partnering with the Zulu Social Aid and Pleasure Club. Previously, small, mobile vaccine sites have targeted Central City and the Lower 9th Ward.
Those sites had been providing several hundred doses a week. According to records provided by the city, as of mid-February, 30 percent of those it had vaccinated were Black, about 60 percent had no documented race, and about 1 percent each were white or Asian.
Johnson & Johnson delays
City officials have said for weeks that they were waiting for an increased supply of vaccines, and especially Johnson & Johnson doses, to open mass vaccination sites.
At a Tuesday morning press conference, Cantrell spokesperson Beau Tidwell had said that the opening of the Convention Center “is largely contingent on the availability of the Johnson & Johnson vaccine.” That drug, approved for emergency use on Sunday, requires only a single shot, and can be stored in a refrigerator, making it much simpler to administer in mass vaccination events.
This week, Louisiana received 37,900 doses of the Johnson & Johnson vaccine. But in what Kanter described as “disappointing news,” the state was informed Tuesday morning that it would not receive more shipments next week.
“We were told this morning that there might not be additional shipments of the J&J vaccine until the end of this month,” he said. Johnson & Johnson has experienced national manufacturing delays, and recently announced a partnership with pharmaceutical giant and competitor Merck to speed up production.
Avegno said that the city intended to keep the Convention Center site open every day, even if it won’t offer many appointments at first. “If you look at community testing, [National Guard sites] have been really successful because people know where they are, they know they’re open every day, and it’s just routine.”
Because the mass vaccination site is being operated in partnership with LCMC, Avegno said, it will draw on both the city’s and the hospital system’s supply of Pfizer and Moderna vaccines. “[LCMC] wants to keep vaccinations going in their hospitals and their clinics, but how can they reallocate some of that to the Convention Center to keep it going?”
She added that the gap in Johnson & Johnson doses didn’t change the city’s plan to scale back testing. The Health Department is now running four neighborhood vaccination sites a week, and Avegno said that the city wait list “has thousands and thousands of people on it” who need to be connected to appointments. “My team is working honestly 24/7 to make this work as fairly and equitably and quickly as possible.”
Free shuttles from the West Bank and eastern New Orleans to the Convention Center are
available through the Regional Transit Authority, and sign ups can be made by calling (504) 290-5200 or 311.