Cambridge Public Health Department chief medical officer Lisa Dobberteen, in a screen capture from Monday’s meeting of the City Council.

While many Cambridge residents scrambled to find appointments for scarce Covid-19 vaccine, the Cambridge Public Department maintained a “call list” of people who could be offered vaccination at short notice if doses might be wasted otherwise. Fewer than 50 people were on the list, and its existence wasn’t known to the public.

Information about the list emerged after chief public health officer Claude Jacob told councillors at their last meeting Monday that some people who got their first dose of vaccine at a city clinic weren’t assured of second doses from the city. Asked who was affected, Cambridge Public Health Department spokeswoman Susan Feinberg said Wednesday evening that fewer than 50 people on a “call list” had been vaccinated at clinics in February and that they had been told beforehand that the health department couldn’t guarantee a second dose “due to ongoing constraints with vaccine supplies and availability.”

Second doses are assured for groups that the health department targeted in clinics: “first responders, health care workers, homeless shelter clients and staff, and people who live and work in Cambridge Housing Authority senior and disabled housing buildings,” Feinberg said. They either have already received second doses or will get them, she said.

Feinberg said all the people on the call list were eligible to be vaccinated under the state’s rules, and she reiterated that the city “has not wasted a single dose of vaccine at the city-operated clinics.”

In September, during a time many residents were having a hard time reserving slots for Covid-19 tests, city staff admitted that clinics were accepting walkups without advertising it.

How the list formed

Feinberg didn’t answer when asked how people got onto the health department’s call list. After Cambridge Day sought comment from city councillors, councillor Quinton Zondervan put the same question to Jacob. The answer, from health department chief medical officer Lisa Dobberteen: People could get on the call list if they couldn’t keep a clinic appointment for their group, or if “they reached out to us [at the health department] directly.”

Examples included “health care providers in private practice, clergy and first responders unable to make the first clinic, etc.,” Dobberteen said. “We have been meticulous about not vaccinating ineligible individuals and we have been meticulous about not wasting doses.”

Does Cambridge Health Alliance have a similar call list? Yes, but it includes only people who already had an appointment, on a different day. “We keep a list of people who are scheduled for vaccination the next day and can be available to come in if doses are available at the end of the prior day,” Cecere said.

The only two vaccines approved by the federal government until very recently require cold storage and must be used within a limited time after being thawed, presenting logistical challenges to vaccination providers. They also require two doses. On Feb. 27, the U.S. Food and Drug Administration approved the Johnson & Johnson vaccine, which can be stored at refrigerator temperatures and requires only one dose. Supplies in Massachusetts are limited.

First dose mystery

As the state continued to frustrate many residents with its vaccine rollout, the Cambridge Health Alliance remained unable to offer first doses of vaccine to its patients since Feb. 23, while most other hospitals resumed giving first doses. No one has explained why except to cite “state guidance” or limited vaccine supply.

CHA was forced to postpone 2,400 first-dose appointments from the last week of February to the first week of March. The state apparently shipped Johnson & Johnson vaccine to the Alliance to allow it to honor the previously made appointments, but that was the end for first doses, for now.

CHA has been using its supply of Moderna vaccine to give second doses to its patients, but figures obtained in a public records request indicate it doesn’t have enough to provide all the needed second doses. Asked what the Alliance will do when it runs out of its stock of Moderna, Cecere said: “Once we exhaust our vaccine supply we will reschedule appointments as needed.” The Alliance could still get more vaccine from the state for second doses.

Second dose mystery

How the state deals with second doses has been a mystery. Last week Massachusetts reduced appointments for first doses at its mass vaccination sites and offered more slots for second doses. State officials have said the roughly 150,000 doses of vaccine that Massachusetts gets weekly from the federal government is all for first doses.

At the January meeting of the state Public Health Council, health commissioner Monica Bharel seemed to imply that the state also gets vaccine for second doses. “No vaccine doses are held back in [Massachusetts]; as second doses are received they are delivered to where the first doses were administered,” she said according to minutes of the meeting.

Pennsylvania ran into problems with second doses last month when the state used vaccine that was supposed to be reserved for second doses to administer first doses, resulting in thousands of second-dose appointments being postponed, according to news reports. The reports said the state gets vaccine categorized separately as first doses and second doses from the federal government.