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Pinal County rejects $3.4 million COVID-19 vaccine grant

Stephanie Innes

Arizona Republic USA TODAY NETWORK

Pinal County, where less than half of the eligible population is fully vaccinated against COVID-19, has rejected a $3.4 million federal grant aimed at improving vaccine equity.

The all-Republican Pinal County Board of Supervisors, which serves as the board of directors of the public health district, voted 3-2 Wednesday against accepting the grant money from the Arizona Department of Health Services.

The decision stunned Pinal County Public Health Services District employees, who say the money would have lasted more than three years and been used to educate underserved populations about the COVID-19 vaccine and to help provide vaccines in disenfranchised communities.

“I just simply would like to note that our public health team is deeply disappointed,” health services district director Dr. Tascha Spears said Wednesday afternoon.

The grant money was federal COVID-19 relief funds allocated to the state health department. More than $1 billion in federal COVID-19 relief funds has flowed into Arizona’s health department, including $66 million meant specifically for vaccine equity efforts.

‘Everybody knows there are free vaccines’

Board member Kevin Cavanaugh was the only member to voice specific objections to accepting the grant money during Wednesday’s meeting, though one other board member questioned wheth-

er the grant money would be redundant, given other vaccine programs in the county like a mobile vaccine unit the board recently approved.

Cavanaugh questioned whether or not Pinal County has a need for creating a job called a “vaccine equity coordina-tor,” which the grant required. He also said he was concerned about how the money overall would be used.

“Did we identify that there was a problem before we sought the grant or did we see the grant and look for a problem?,” Cavanaugh asked Spears during the hearing. “The questions I’m getting from my constituents are, you know, we have Walgreens, Walmart, everybody knows that there are free vaccines.”

Cavanaugh, and supervisors Jeff Mc-Clure and Jeff Serdy voted to reject the funding. Board chairman Steve Miller and vice chair Mike Goodman voted against rejecting it, Pinal County spokesman James Daniels said.

Pinal County, in central Arizona, has a population of about 460,000 people and has a vaccination rate that’s lower than both the state and national averages, data from the Centers for Disease Control and Prevention shows. The most recent U.S. Census data shows 56% of Pinal County’s population is white, 31% is Hispanic, 5% is Native American, 4% is Black and 1% is Asian.

Of the eligible population that is 12 and older, less than half of Pinal County residents — 48.1% — had been fully vaccinated against COVID-19 as of Wednesday, compared with the state rate of 56.3% and the national rate of 61.5%, the CDC data shows.

“The funding was made available based on the CDC (Centers for Disease Control and Prevention) social vulnerability index and that certainly identifies counties and areas in counties that have issues related to limited transportation, different household settings, area where there’s limited English language,” Spears said.

“We also have underserved populations such as the homeless, so there are a number of underserved populations that we could have used these funds for.”

State health officials have said most of the federal vaccine equity funds have gone to local health departments, with the rest going to mobile and community pop-up vaccine events and education campaigns.

Former state health director Dr. Cara Christ told the Arizona Republic in July that some of the federal vaccine dollars can go toward encouraging families to maintain their children’s routine school vaccinations. Compliance with schoolrequired vaccines declined during the pandemic, she said.

“While we’re using that funding to ensure we are vaccinating in an equitable manner, we can use that funding to improve health equity in other arenas as well,” she said at the time.

Boosters and vaccines for younger kids could increase need

Spears said Pinal County was going to use the grant money to hire a public health nurse who would be a vaccine equity coordinator, as well as a medical assistant. The majority — $2.5 million — had been slated to go to contractors to provide COVID-19 vaccines to underserved communities in the county, she said. She added the money would have been available through June 30, 2024.

If the federal government authorizes COVID-19 booster vaccine doses, there will be additional COVID-19 vaccine needs, as there will if children ages five through 11 are approved to receive the vaccine.

The job of the vaccine equity coordinator would have been coordinating with local community health workers and patient navigators to ensure that access and resources were provided to underserved populations so that they could make up their minds about whether to get the COVID-19 vaccine or not, she said.

During Wednesday’s meeting, Cavanaugh was skeptical about how the money, aside from the public health nurse’s salary, would be spent. He asked Spears whether her department identified need based on methods like surveys or man-on-the-street interviews to determine “we actually had a problem.”

Spears explained that the county qualified for the grant based on its social vulnerability index, the federal measure that uses 15 different U.S. Census data measurements communities’ resilience when confronted by external stresses on human health. Those factors include, among other things, the proportion of people with disabilities, unemployment rates and the number of single parent households.

Cavanaugh said the public health nurse position seemed like would probably be funded at about $65,000, leaving millions more of the grant going to, “unnamed contractors.”

“And so we don’t know anything about the contractors, what the goals and purposes are, except for the vaccine equity,” he said. “So, I will make a motion if we’re ready for that, that we not approve.”

‘It made no sense to turn this down’

Will Humble, a former Arizona state health director who is now executive director of the Arizona Public Health Association, said government entities don’t always say yes to every grant. But in this case, “it made no sense to turn this down.”

Pinal County has several areas that score high on the social vulnerability index, which is exactly what the grant was designed to address, Humble said.

“Not all grants are worth applying for, but in this case, here you have an opportunity to really drill down and get vaccines into your harder-to-reach areas, not just short term but long term,” he said.

“And you have a new cohort, probably coming, probably around Thanksgiving, of kids from five to 11 years old, and you could use this money to really put together kid vaccine clinics ... Not only that, the whole grant was designed with health equity in mind.”

Spears said while COVID-19 vaccines are available at pharmacies and clinics, not everyone is able to get them at those places. She cited as examples people who live in rural areas without pharmacies, and people experiencing homelessness.

“In Pinal County there are some communities who are underserved, who don’t have access to COVID-19 vaccines,” Spears told the board. “So this is specifically to facilitate that, so that communities everywhere truly do have a choice about whether they would like to receive the vaccine or not.”

Reach the reporter at Stephanie or at 602-4448369. Follow her on Twitter @stephanieinnes.

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