The secret to rapid vaccine rollout in North Dakota


Compared to chains, independent pharmacies are more likely to serve rural areas and low-income ones in cities, says Stacy Mitchell, co-director of the Institute for Local Self-Reliance, a nonprofit that advocates for small businesses. companies, and who studied North Dakota Pharmacy Act. A useful comparison is with the state’s southern neighbor, where chains are dominant and rural areas are one-third less likely to have a pharmacy. Independent pharmacies are also more likely to be a reliable source of routine medical care, making them especially useful in times of crisis. “North Dakota has been successful in effectively mobilizing local institutions to meet a sudden challenge,” Mitchell says. She highlights other pandemic successes involving local pharmacies, including the rapid vaccination of residents of long-term care facilities in West Virginia. The big chains recruited by the federal government have struggled to do the same task elsewhere.

Falk grew up in Lidgerwood, an even smaller town west of Hankinson. She decided to become a pharmacist because she loved chemistry and because she believed that the career would allow her to pursue scientific studies and start a family, which she planned to do. She attended Fargo School of Pharmacy, about an hour north, but knew she would come back. “My husband was do not leaving Hankinson, ”says Falk. It turns out that the owner of the town pharmacy had been looking to sell for a long time. After 37 years of work, he was well past retirement age, but he wanted to continue to pass this century-old witness. “He waited and waited and waited,” she said. “He didn’t want the city to do without a pharmacy.” And so, in 1998, after graduation from Falk, the young couple bought Hankinson Drug. It was fate.

The business was successful, and after a few years they opened a second store in Lidgerwood when the pharmacy owners were about to retire. It is a “telepharmacy” equipped with a videoconferencing booth where people could consult the pharmacists of Hankinson. They named it Julie’s Pharmacy. When the pandemic arrived last spring, Falk was leading a staff of 11; at home, six of her eight children attended Zoom school.

Each week, Falk joins a Zoom meeting with other vendors in surrounding Richland County. The goal is to avoid stepping on each other’s toes, says Kayla Carlson, county public health director. “Sometimes it’s very easy. Sometimes it’s a bit complicated, ”she says, given the relatively large number of providers who do immunizations and people will often sign up for more than one immunization list. This week, Falk’s pharmacy had been delivering second doses to the 65 and over age group for three weeks, which had gone well. But the county was also switching to first doses for young people with health problems. It was important that they kept pace with each other and that no one was overwhelmed with demand or left with doses left over. “Doses don’t do any good sitting in the fridge at all,” says Carlson. “So by the end of the week, they should be out of the fridge.”

Recently, it got more complex when the federal government announced that it would start sending doses directly to drugstore chains. Sites that participated in the plan would stop receiving doses from the state, making the Zoom negotiations all the more important. In Richland County, a Thrifty White from Wahpeton was participating in the national plan. The first federal shipment was 200 doses, and Carlson was surprised to learn who received 195: non-staters who signed up on the regional pharmacy website.

Most came from “towns,” as Carlson puts it – Minneapolis and St. Paul, about a three-hour drive away – after finding that North Dakota was further along in the process than Minnesota, which had yet to vaccinate. young people against health problems. Carlson did not see this kind of eligibility trip as particularly problematic; she was thrilled that more people were getting their shots, and it was kind of gratifying to know how well Richland County was doing. The state was less happy. On Monday, Thrifty White closed the “loophole”. Minnesota is expected to catch up.


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