As the rollout of the COVID-19 vaccines began late last year and into January, federal, state and local public health leaders faced a difficult question: What’s the fairest way to distribute doses of the vaccine?
South Carolina, like other states, set up a system of phases that dictated who could get a shot, and when. As the vaccine rollout has continued, public health experts have emphasized: The most important thing is getting shots into people’s arms.
But in Horry County, when COVID-19 vaccines were still in short supply earlier this year, a dispute between the county government and the state Department of Health and Environmental Control (DHEC) caused the vaccine rollout to falter, potentially slowing the pace of vaccinations.
The Horry County government, DHEC alleged, gave doses to unauthorized people, an accusation that set off a drawn-out dispute between DHEC and county government resulting in the health department cutting off Horry County government’s vaccine supply for a period of time.
Emails obtained by The Sun News shed light on how — and why — that may have happened.
Who was eligible for the vaccine under the ‘mission-critical’ designation?
An apparent miscommunication about who was eligible for the vaccine under DHEC’s first phase, Phase 1A, led to Horry County government vaccinating its employees during that initial stage. As Horry County Fire Rescue vaccinated county workers, it opened up eligibility to others who fell under Phase 1A, seemingly in an effort to use up its supply of doses as quickly as possible, emails indicate.
But when DHEC learned of how Horry County Fire Rescue was distributing its 3,500 doses of the Moderna vaccine, senior officials took issue.
The back-and-forth, which lasted weeks, can be traced back to a misunderstanding about the meaning of the phrase “mission critical.” In South Carolina’s first phase of the vaccination effort, vaccination priority was given to healthcare workers, people over the age of 65, staff and residents of long-term care facilities and government employees who are “mission-critical for maintaining operations of COVID-19 vaccinations and testing in S.C.”
Horry County officials, in emails, said they viewed most, if not all, county employees as “mission critical.” In one email exchange with a DHEC official, Randy Webster, Horry County’s emergency management director, said that the county considered police officers, firefighters, EMTs and all associated support staff to be so-called mission critical.
Mark Hendrix, a DHEC official focusing on public health in the Pee Dee region, sent an email Feb. 18 to Webster seemingly agreeing with Webster’s understanding of eligibility for first responders.
“Any first responder that fits into the current phase, which is 1a at this time, can receive a vaccine,” Hendrix wrote, including a list of eligible employees. “I highlighted a few that should apply to the county, but the county may employ others from this list that I am not aware of.”
But DHEC later disputed that.
“As we discussed, law enforcement officers, public safety officers, county administrative staff, or other similar individuals are not Phase 1A eligible,” Louis Eubank, a DHEC official involved in vaccine distribution, wrote in an email Feb. 23.
Horry now among most-vaccinated counties in SC
The specific meaning of “mission-critical” remains a mystery as emails between the two entities don’t include a definition. Laura Renwick, a DHEC spokesperson, wouldn’t answer questions from reporters about the meaning of the phrase and if the definition had changed over the course of Phase 1A. Kelly Moore, an Horry County spokesperson, also declined to answer specific questions, including one about how the county had defined “mission critical.”
With 28,956 cases and 441 deaths since the beginning of the pandemic, Horry County now has one of the highest rates of vaccination in the state, behind only Charleston, Georgetown and McCormick counties. Around 48% of eligible people in the county have gotten at least one shot.
But the progress hit a bump in the road during the dispute between the county government and DHEC, raising the question: Could Horry County’s vaccine progress have gone quicker if the health department didn’t cut off supply to Horry government?
What is known, though, is this: Horry County lost one source of vaccine doses as rollout was ramping up.
Reports that Horry County was ‘intentionally vaccinating’ unauthorized people
By all accounts, it appears that the spat between Horry County and DHEC began in mid-February when Horry County Council member Johnny Vaught shared an internal county email with WMBF News, which reported that the county was offering the vaccine to all employees.
Up until that point, emails show, DHEC officials were regularly communicating with county staff about receiving a shipment of Moderna vaccines for distribution and planning and publicizing other vaccine clinics in the county. The Sun News later reported on emails and interviews showing that the county had allowed employees to bring a “designee” or “plus one” to be vaccinated, too.
But Eubank, DHEC’s deputy branch chief or immunization, wrote to Webster to inquire whether the county was “intentionally vaccinating individuals outside of the Phase 1A priority groups.”
“Most importantly, we wish to know whether Horry County Fire/Rescue did indeed schedule and vaccinate county employees or others who are not recognized as being Phase 1A eligible,” Eubank wrote.
‘A degree of confusion’ between Horry County and DHEC
County officials have maintained that other DHEC officials gave them the green light to vaccinate employees and plus-ones who fit Phase 1A criteria.
“There is in all of this a degree of confusion on our part in that the process we initiated and have undertaken with respect to the vaccines we have received was discussed with the representatives of DHEC,” Webster wrote in one February email to Eubank.
But DHEC has said the county was out of line. Eubank told Horry County officials Feb. 18 that they needed to “immediately cease” allowing a “designee” to get the vaccine as well.
Neither the county nor DHEC would answer questions from reporters about the specifics of the guidance DHEC gave to the county ahead of administering the vaccine.
“We’re now forward-focused on working with Horry County officials and all Horry County providers to continue our joint efforts to get shots into arms as safely, quickly and easily as possible,” DHEC spokesperson Laura Renwick wrote in an email to The Sun News, adding that the agency gave statements on the issue while it was happening.
Similarly, Moore said “continued debate” wouldn’t be productive to the relationship between the two entities. She said the goal now is to get vaccines to everyone who wants one.
New doses aren’t coming to Horry County government due to dispute
DHEC ultimately cut off future first-dose shipments of the vaccine to Horry County, a move that frustrated officials. In one email, Webster told Eubank that DHEC’s strict rules for distribution now negatively affected the county’s ability to offload its vaccine supply. Many county employees were now not eligible to receive the vaccine, and the county worried it would have trouble finding community members to take the shots.
“And now, we basically have been directed to hold back the (administration) of vaccines, the quantity of which we have received from you being considerably more than we would need to provide to those in Horry County Government that meet what now seems to be from DHEC a narrow construction of the 1a criterion you reference,” Webster wrote.
Eubank responded to that email informing Webster that DHEC would be pausing the vaccine allotment to Horry County Fire Rescue. He said the county’s unused doses should be used for second doses and any leftover doses would be transferred to McLeod Health ahead of a mass vaccination event.
The following week, officials from DHEC and Horry County discussed the issue on a phone call to clear things up. Following that call, Eubank sent an email Feb. 23 to participants saying DHEC won’t be sending more first doses to Horry County government.
Even though the county still hasn’t gotten more doses from DHEC, it was able to resume vaccinations in early March, shortly after South Carolina had moved into its second phase of the vaccine plan. Instead of getting its supply from DHEC, the county divided its remaining doses in half to be able to hold vaccine clinics for both the first and second doses, according to Renwick.
To find a COVID-19 vaccine site, visit https://vaxlocator.dhec.sc.gov/ or call DHEC at 1-866-365-8110.