After ‘unacceptable’ vaccine cancellations, Miami-Dade mayor orders end to overbooking

After two of Miami-Dade County’s largest hospitals canceled thousands of COVID-19 vaccination appointments due to lack of supply, Miami-Dade Mayor Daniella Levine Cava signed an emergency order Friday that she says will give the county more control over the vaccination process by ending hospital overbooking.

The order comes a day after Miami Beach’s Mount Sinai Medical Center called off all first-dose vaccine appointments citing lack of supply, a move Baptist Health made earlier this week when it also canceled future appointments.

Levine Cava called the actions on the part of the hospitals “unfair and unacceptable.”

She added that Miami-Dade County honored all vaccination slots made at county sites, now shut down for lack of supply from the state.

“You all know that there were significant supply issues, and the cancellation of appointments at Mount Sinai and Baptist,” she told county commissioners Friday during an online briefing on COVID-19. “And this is not acceptable. It cannot happen. Too many people in our community are desperate for the vaccine, and trying to get appointments. To be abruptly canceled after they got them is unfair and unacceptable.”

Carlos Migoya, CEO of the county-owned Jackson Health hospital system, which continues receiving doses from Florida, told commissioners Jackson has honored all of its vaccination slots.

“We have never — I repeat, never — set up an appointment that we have not either had doses for on hand, or committed doses that were coming in the door,” he said.

Under the mayor’s three-page order, which goes into effect Saturday, hospital systems and local governments administering the vaccine will now be required to publish daily updates on their progress, including the total number of vaccines on hand from the day before, the sites where vaccines were being administered and the number of doses that had to be discarded at the end of the day.

The order also states that those providing vaccines should not book appointments unless they have already received enough vaccine doses. It does not include any punishment for overbooking appointments, though.

Hospitals will also be expected to send a weekly breakdown to the county of the age, gender and race of those vaccinated and the ZIP Code of each person’s residence.

“This order is meant to ensure that no community is left behind and all residents 65+ have equal access to this lifesaving vaccine,” Levine Cava tweeted Friday. “And I am urgently advocating for more vaccines because the supply we currently have is not nearly enough to meet the enormous demand.”

Mount Sinai Medical Center spokeswoman Tara McNamara declined an interview.

In a statement, a spokeswoman for Baptist Health said that at the time the appointments were offered, Baptist was operating under a directive from the state mandating hospitals vaccinate as many eligible people as possible, as quickly as possible. They said they were operating with the assurance from the state that they would receive additional vaccines as needed “without limitation.”

“We worked hard to do what was right when called upon by government officials with clear direction from the state’s surgeon general and the Agency for Health Care Administration to deliver ‘shots in arms,’ ” spokeswoman Dori Alvarez said. “We had no indication from the state at that time that our supply would be limited.”

Earlier this week when the supply issues at the state level came into focus, Baptist had to make the “difficult and heartbreaking” decision to cancel the appointments, Alvarez said. If they are able to receive additional vaccine, they plan to continue their distribution.

“We cannot express how eager we are to be able to fulfill the appointments we were forced to cancel,” Alvarez said.

The cancellations that spurred the county’s order come as top state health officials acknowledged that Florida is in a “supply-limited situation.”

To date, Florida has vaccinated 1,249,804 people. About 143,257 of those were in Miami-Dade.

According to the News Service of Florida, Surgeon General Scott Rivkees told hospital officials Tuesday that he does not know when additional first doses of the Pfizer-BioNtech or Moderna vaccines will be sent to the state or how many doses would be in a future shipment.

“At the present time, we are in pretty much a supply-limited situation,” Rivkees said on the conference call. “So, as more vaccine becomes available, we will be able to determine when we can send more vaccines out to hospitals for community vaccination.”

At a press conference in Key Largo Friday, Gov. Ron DeSantis said some sites like Hard Rock Stadium have the capability of administering twice as many vaccinations a day as they are now, but are hampered by lack of supply. He said this week the state had hoped to get “plussed up,” meaning the state would be placed into a category by the federal government to increase the supply, but instead, Florida is receiving the same 266,000 doses it received last week.

“We hope we get plussed up in the near future,” he said. “We stand ready, willing and able to handle it. We are hoping we are able to get more.”

Division of Emergency Management Director Jared Moskowitz, who oversees vaccine distribution for the state, told the Miami Herald earlier this week that the federal vaccine allotments for each week are only given to states with six days’ notice, which also makes it hard to plan distribution.

It also leaves hospitals scrambling to schedule highly sought-after vaccine appointments. In the case of Baptist and Mount Sinai, appointments were booked as far in advance as early March, leaving a gap in doses and forcing cancellations.

Mary Mayhew, CEO of the Florida Hospital Association and the former secretary of the Agency for Health Care Administration under DeSantis, said Florida’s hospitals have been told they are not likely to receive more first-dose vaccines as the state maximizes the role of retail pharmacies including Publix, and prioritizes government-run sites.

“At this point, the state has moved to prioritize a county-based approach, using their county health departments, and maximizing the role of retail pharmacies such as those in Publix, CVS and Walgreens,” Mayhew told the Herald Wednesday. “Hospitals are actually rolling back those operations.”

Moskowitz tweeted Friday morning, however, that when the state gets more vaccine “hospitals are still part of the plan.”