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Since the emergence of two new invasive meningococcal disease cases in Prineville, healthcare providers and pharmacies have faced a rush of residents wanting the vaccine.
While people can get it at several places in town, each venue comes with a different set of restrictions, supply, and cost, potentially leaving residents unsure where to turn.
The Crook County Health Department, for example, has had to turn away many residents who do not fit their state-mandated criteria.
According to Health Department Director Muriel DeLaVergne-Brown, because the state provides their vaccines, the Health Department can only give it to people who meet American Committee on Immunization (ACIP) criteria.
“We have to follow state-standing orders around that vaccine,” she said, “because they give us the vaccine and then we provide it to clients.”
At this time, those guidelines only allow them to immunize 11 to 18-year-olds and people 9 months to 55 years old with specific medical conditions.
“This is the group that is at the highest risk,” DeLaVergne-Brown said. This is the group we are encouraging to get a vaccine.”
Pharmacies do not have to follow the same rules. Since they purchase the vaccine, they can provide it to a broader range of people. According to Susan Leversee with Clinic Pharmacy, they will vaccinate anyone age two and up on a first-come first-serve basis. While that is the case, they do face some restrictions of their own. Oregon Pharmacy Board law does not allow pharmacies to immunize children ages 2 to 10 without a prescription.
At Bi-Mart, pharmacist Levi Martin said they do not vaccinate 2 to 10-year-olds at all. He explained that pharmacies only recently started immunizing that age group, and consequently their staff lacks the necessary training. They do, however, provide vaccines to people 11 years and older.
Along with the varying restrictions, vaccinations tend to differ in cost depending on health care coverage and where you receive the vaccine.
At the Crook County Health Department, eligible recipients covered by the Oregon Health Plan (OHP) do not have to pay out of pocket. In addition, per Oregon state law, the Health Department will not turn away people who lack insurance and cannot pay for the vaccine.
For those with private health care coverage, DeLaVergne-Brown typically suggests they visit their primary care physician to obtain a vaccination. At this time, the Health Department is only able to contract with OHP and PacificSource and therefore cannot bill other insurance companies.
At local pharmacies, they can bill more companies, but costs tend to vary from person to person.
“There has been no rhyme or reason to what they (insurance companies) cover,” Leversee said.
As a result, local residents could have to pay as much as $180 for the vaccine.
While people face potential cost and eligibility hurdles, they may face the possibility of a depleted supply as well.
“We’ve got lines out the door,” Leversee said of Clinic Pharmacy on Wednesday. “We ran out (of vaccine) yesterday.”
Bi-Mart has experienced a similar response.
“We’ve had our phones ringing off the hook since yesterday (Tuesday),” Martin remarked.
Despite the high demand, both pharmacies have managed to keep up so far. When Clinic Pharmacy ran out of vaccines by the end of the day, Leversee said their supplier provided more to carry them through the next day. Bi-Mart can provide vaccines within one day of requests as well, Martin said.
The Health Department ran out of vaccines near the beginning of the week, but ordered more. They should receive them by next week, if not sooner.
Despite the increased prevalence of meningitis in Crook County, DeLaVergne-Brown is urging residents not to panic. She stressed that the illness, while serious and potentially deadly, is still rare and difficult to catch.
“The big thing is we are not in outbreak status,” she said.
If Crook County encounters three cases with the same serotype within three months, the Center for Disease Control (CDC) could declare it an outbreak. If the latest case, which is currently under investigation yields a C serotype, the community would meet those criteria.
If Crook County reaches outbreak status, it could prompt an increase in local vaccine supply or loosened restrictions on who can receive them. However, the CDC makes those decisions, and no details on potential action has been made available at this time.
