5 things to keep in mind when comparing Dallas and Denton’s COVID vaccine efforts

No two Texas COVID-19 vaccine hubs are exactly the same.

With so much confusion and competition to get the life-saving doses — which continue to be in short supply — you’d be forgiven if while waiting for your number to be called, you get a little jealous looking over the county line to see thousands vaccinated in one fell swoop.

That’s exactly what happened this week when Dallas County politicos and residents turned their attention northeast to Denton County — which appears to have successfully pulled off one of the largest vaccination efforts in the United States.

“It’s very fitting and symbolic that thousands of people are crossing the finish line with COVID at Texas Motor Speedway,” Denton County Judge Andy Eads said Thursday.

Meanwhile, Dallas County’s public health department site at Fair Park has been tortured by technical issues and political spats.

But it wouldn’t be fair to compare the work of the two county health departments, officials say. That would be like comparing a super-charged speed racer to a more sensible passenger van the family took to get to the racetrack.

However, both models can be measured on their own merit and provide lessons as the vaccine effort evolves.

The state health department, which decides how many doses each hub receives, is monitoring the different approaches and hosting conference calls with its largest sites to discuss what’s working.

Chris Van Deusen, spokesman for the state’s health department, said officials will continue to embrace various types of vaccine distribution models — from door-to-door efforts in Corpus Christi to the massive event in Fort Worth this week.

“There isn’t one model that is going to work everywhere,” he said. “It’s going to take all the models. We’re going to be at this for a while.”

Here are five things to know about the different vaccination efforts in Dallas and Denton counties.

Number of doses is key

What happened this week at the speedway is an anomaly in Texas’ vaccine portfolio. No other state-authorized hub has received this sort of influx of doses — 32,475 — in a single week. The second-largest provider this week, Houston Methodist Hospital, was shipped less than half of what Denton got: 13,650 shots. Dallas County’s health department received 9,000.

Each hub receives a weekly allotment and must use it within a specific time frame. In Denton County, the extra-large volume of doses necessitated an extra-large distribution plan. Prior to this week, Denton County received no more than 9,000 shots a week — typically much less — and distributed them at smaller sites.

Matt Richardson, Denton County’s public health director, said the county and its statehouse delegation in recent weeks had lobbied the state for more vaccines. At the same time, the county was coordinating with local fire departments, municipalities and the speedway to put something big together if the doses showed up.

Their wish was granted when the state discovered a trove of shots meant for long-term care facilities that went unused.

By 5 p.m. Thursday, Denton County had used 18,100 doses since the site opened Tuesday.

Different missions

When Dallas County set out to create its own vaccine hub, officials proclaimed that equitable access to doses was the priority. They strategically placed their hub at Fair Park, south of Interstate 30. The highway has for decades served as a dividing line between Black and white, rich and poor.

Focusing on equity meant, in part, thinking about prioritizing underserved groups with the categories of people the state said was eligible. That set up several political slug matches, especially when early data showed the county had fallen short of vaccinating people who live south of I-30.

The commitment to equity helped the county pick a walk-up model, which has proven to be more logistically fraught and slower-paced.

Meanwhile, Denton County officials declared speed and efficiency as their top goals. Denton officials decided early on to help keep the train running smoothly by requiring appointments. But it was first come, first served.

“We made the early decision to get as many shots out as fast possible,” said Eads, the Denton County judge.

Richardson acknowledged that choosing speed over equity is a trade-off — one he is willing to make while the vaccine is still in short supply and public health departments are expected to focus on the general public.

“As access to the vaccine increases — when we’re not expected to carry the heavy load of mass events — then we can prioritize populations, and we can really go to those underserved communities,” he said.

Eric Boerwinkle, dean of the UTHealth School of Public Health, said both counties’ goals are valid.

“We should never stop thinking about equity,” he said. “And that’s why we should let a thousand flowers bloom. Having these large events serves one segment of the population. And having targeted events can serve another. These need to be going on at the same time.”

Different booking systems

Both Dallas and Denton county health departments built all or a portion of their registration and appointment systems in house. Denton, however, brought in outside companies to help with data management earlier than Dallas.

Denton also adopted unique barcodes for registrations from the beginning, avoiding the invalid appointments that dogged vaccine programs at both Fair Park and the Kay Bailey Hutchison Convention Center. At both sites, residents used weblinks shared by friends and family to book appointments without being first invited by the county and city.

Dallas is in the process of transitioning to a new singular registration system that will track residents from start to finish rather than an amalgam of different software options trying to talk to one another.

Another big difference in the counties’ registration lists is who they allow to sign up. Denton prohibits young and healthy people who don’t work in health care from joining their waitlist. This helps ensure that anyone they give a shot to matches the state’s criteria.

Meanwhile, anyone can join Dallas County’s waitlist. The county then spends time inviting people in specific priority groups.

One hub vs. multiple sites

Despite the slick setup and national attention, Denton County, as a geographical region, still received fewer doses than Dallas this week.

Combined, the six state-authorized hubs in Dallas County’s borders received 43,150 shots compared to Denton’s 32,475. Collin County, which also saw a one-time surge of doses this week, split its additional shots among various hubs.

Other hubs in Dallas include Parkland Health & Hospital System, UT Southwestern Medical Center and the city of Dallas.

Drive-through shift

The drive-through model does appear to be more efficient, and Dallas County’s Fair Park location is shifting to that model.

Dallas County Health Director Dr. Philip Huang this week told county commissioners that the Fair Park location, in an effort to expand its services, has begun offering a drive-through service. But that experience is still limited.

On Wednesday, about 550 doses were given to individuals at the drive-through.

Dallas County health department spokesman Christian Grisales said Thursday he expects the Fair Park location to transition to a drive-through model next week. However, the county will maintain a walk-up option for those who lack transportation.