COVID-19 booster shots too much for some town budgets

HOPKINTON, Mass. — It’s been a pioneer in the fight against COVID-19, but with the latest booster vaccines, Hopkinton’s Board of Health may have met its match.

“We’re buying on the private market,” said Director Shaun McAuliffe. “It’s expensive. We’ve negotiated a better rate than most communities, but it’s still going to run us about, say, $110 a dose.”

And that is the primary reason why Hopkinton, which held several hugely successful vaccination clinics earlier in the pandemic, has nothing planned for now.

“I wanted to attempt to vaccinate 1,000 residents over the age of 18,” McAuliffe said. “To purchase 1,000 doses, it would cost me approximately $130,000. The $130,000 would be 1/4 of my budget. I have a fiduciary responsibility to the residents of Hopkinton. As a result, I’m ordering a limited supply of vaccines. We are targeting that vaccine to those in greatest need and risk.”

In the old days — circa 2021 — the federal government picked up the tab not only for COVID-19 vaccines but also for the ancillary supplies needed to run a clinic — including sterile gloves, alcohol swabs, bandages, and syringes. But Congress declined to continue funding COVID-19 shots — and that left communities trying to figure out whether they can afford the large, short-term hit a clinic would require.

Short-term because, while most insurance companies do cover COVID-19 vaccination, McAuliffe said it can take six to twelve months or longer to get reimbursed. That’s creating a quandary for health departments across the state.

“We have the duty to provide vaccination and care to reduce the amount of communicable disease in the population,” said McAuliffe. “But I have to weigh that with my financial responsibilities to the town and the taxpayers. If you’re asking me to forfeit a quarter of my budget towards a single vaccine purchase, there’s a lot of risk associated with that.”

Of course, that risk is balanced against the possibility that COVID-19 will spread more readily in an unboosted population. Statewide, positive test rates fell slightly last week to 10.06%. In Hopkinton, a youth basketball team recently came down with the virus, McAuliffe said.

And while deaths from COVID-19 have remained at a low, but steady level in Massachusetts — older adults remain disproportionately affected.

Eventually, Hopkinton will have booster shots for those residents and the town also has a free supply of pediatric boosters. But vaccinating those 18-65 may be something left to others — such as primary care physicians and pharmacies — unless the state or federal government can come up with a way to help bridge the monetary gaps that would likely open from mass vaccination clinics.

“We’re all scrambling to figure this out,” McAuliffe said. “And I think the takeaway is that you’re not going to see us running a clinic like we did in Westborough, where we serviced more than 18,000 people.”

And McAuliffe fears the lack of government funding for the new booster could have serious consequences.

“If we’re putting up barriers to access, we’re doing a disservice to our populations,” he said. “And the overall health in our communities is going to suffer.”

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