The Arizona Department of Health Services will allow Pima County to independently work with FEMA to run a federal vaccination POD, as long as it does not impact state allocation, said ADHS Director Dr. Cara Christ on Friday afternoon.

Christ said a letter was sent before Friday's media briefing that allows Pima County to work with FEMA.

“Pima County has provided their assurances that they will be able to support these sites,” said Christ. “We are hoping that is without having any impact on any of the other currently operating sites or activities that they have planned and to have in writing that FEMA said that this would remain.”

Christ outlined several assurances the state would like to allow at the federal vaccination site in the letter to FEMA Acting Regional Administrator Tammy L. Littrell.

"To accommodate your offer, and the County’s interest, we are working to ensure they have delegated authority to independently partner with FEMA on a site if they deem it appropriate for their community so long as it does not result in a reduction of existing vaccine supply to the state or impact state vaccine resources and operations. This should include fulfillment by Pima County and the federal government to provide the resources required by FEMA of state or local jurisdictions in order to have a FEMA-operated vaccination site.

These include:

On-site cold chain storage for the vaccine, including emergency backup power to the storage equipment to ensure continuous cold storage in the event of a power disruption.

Pharmacy Operations Support.

Appropriate county medical oversight to ensure compliance with state and county direction.

A Vaccine Registration System, because the state will not be able to support onboarding of a FEMA-operated vaccination site onto the Arizona Vaccine Management System.

Locally contracted communication lines and access (e.g., landline/cellphone and computer/internet).

Wrap-around local support services for the site.

Site security at the vaccination site.

She added, "In addition, while not included in the list of requirements provided by your team, the site will need to comply with Arizona immunization reporting requirements, reporting all required vaccination data back to the Arizona State Immunization Information System within 24 hours of administration as required by Governor Ducey’s Executive Order 2021-01.”

Christ noted the state’s hesitancy to authorize the federal vaccination site because of recent experiences with Pima County, citing the county’s request that the state reimburses them for COVID-19 testing during the height of the pandemic and calling them a “frequent requestor” of administrative staff for vaccination sites.

Christ wrote, “Given the dramatic financial constraints they claim to experience from these activities, we would like to get written assurance that Pima County and/or the federal government is able to appropriately fund the activities required to operate a FEMA site until reimbursement from FEMA is obtained.”

Pima County Health Department Director Dr. Theresa Cullen received the news about Christ’s letter during her own briefing and said she was happy to hear about a possible reversal in the decision and hoped to have it in writing soon.

“We've been doing planning, with the expectation that perhaps a miracle would happen that there'd be a significant change in the decision making,” said Cullen. “I think what it points out, in this case, is this recognition that Pima County itself was very vocal in sharing its concern, and its commitment to get additional vaccine into the county. This can only be a win for us.”

Cullen said that while it has been clear to the county and reiterated by FEMA that the federal POD would not affect the federal government’s vaccine allocation to the state, she is unsure whether the county allocation would be affected.

“Now, is it possible that the state itself could then, subsequently, make a decision about our allocation? Yes.

“We have no transparency into how the state decides what to allow to us.”

In discussions with Littrell, Cullen said they discussed the reasons why they would want access to the vaccine and PODs. She told them they “would intentionally focus on improving our access to our vulnerable population” and hoped to show “HHS, FEMA, the state and other jurisdictions, perhaps a more targeted way to do this to reach the more vulnerable populations.”

Cullen said it was difficult to change the number of vaccinated Hispanics, and noted that for two to three weeks it remained at about 14 percent, but changed to 16 percent as of Friday.

Pima County Updates Public Health Advisory

After the decision by Gov. Doug Ducey to loosen restrictions on businesses and sporting events as well as “phase out” mask mandates, Pima County Health Department released their Public Health Advisory on Friday afternoon.

It says that mitigation strategies, including wearing masks at all times in public or when less than six feet from someone not in the same household, and washing your hands. All gatherings should be held outdoors wherever possible. They should be limited to know more than 200 people and only held in settings and venues where social distancing is possible. Indoor events must be in spaces that provide at least 150 square feet per person, with mitigation strategies in place.

More than 1 out of every 450 Pima County residents has died due to COVID-19. With about 90 people in the hospital with COVID-19 and more than 30 in intensive care units and eight cases of the UK variant at the University of Arizona, Cullen is worried but wants the community to continue to comply with layered mitigation measures.

“We know we have not adequately immunized the community. We know we still have reported cases in the community, we still have hospitalizations, we still have ICU admissions,” said Cullen. “Now is not the time for individuals, businesses, organizations or government, in my opinion, to lift any of the mitigation measures that are available to them to help stop the transmission of this virus.”

Pima County also decided not to join the rest of the state after Ducey opened eligibility to all those 16 and older.

The county limited eligibility to those 16 and older living with a disability, experiencing homelessness, living in a congregate setting/receive in-home or long-term care or with a high-risk medical condition.

“The state's decision came as a surprise to us,” said Cullen. “We were not in the discussion and so we heard about it at the same time that you heard about it.”

She said they always anticipated that the county would go to full opening on May 1, when the Biden administration set that date as a goal.

However, in the past few weeks, Cullen said they got an “increasing number of concerning emails, social media and calls from people that had chronic diseases 25-year-olds with diabetes, 32-year-olds who have cancer and they've been unable to get vaccinated.”

They wanted to give them a “protected slice of the pie” and ensure that they could get vaccinated.

Cullen said when more of those in at-risk groups are vaccinated, the county will open up to all 16 and older. She said she expected that to happen in the next 10 days.

As of Friday, Pima County has administered 432, 779 vaccines and 26.6 percent of residents have been fully vaccinated. Cullen said to reach 70 percent vaccination in the county, about 700,000 vaccines are needed.