Around Christmas, Ben Nachum applied to the Philadelphia Department of Public Health to offer COVID-19 vaccine doses at his North Philadelphia pharmacy.

More than a month later, he has yet to hear back. In mid-January, he submitted his information into the state’s application process but hasn’t heard from them either.

”There are five pharmacies around me,” said Nachum, owner of Patriot Pharmacy. “We could easily vaccinate this whole neighborhood if we had the vaccine.”

He is among dozens of local pharmacists, some of whom have invested in technology improvements and new refrigeration capacity, who have gotten no reply from city officials who must grant them permission to carry vaccine. Across Philadelphia, just two independent pharmacies have been approved to provide COVID-19 doses since the city opened the application process in October, city health department spokesperson James Garrow said. Fifteen pharmacies are in the enrollment process, he said, and 25 more have submitted applications that have yet to be reviewed.

“Enrollment is a slow process due to reporting requirements and storage and handling,” he said.

As Philadelphia seeks to recover from the debacle of allowing a group of college students to run a major vaccination initiative, independent pharmacy owners are asking why they have been left out, especially given that they have experience with vaccines and the trust of their customers. Questions go unanswered and applications go unaddressed, they say.

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“There’s a one-page application for PhilaVax,” Mel Brodsky, executive director of the Philadelphia Association of Retail Druggists, said of the city’s immunization information system, “and they send it in and they wait and they wait and they wait.”

A complicated application

Lindsay Dymowski is president of one of the two independent pharmacies in the city approved to carry vaccine. For about two weeks, she said, Centennial Pharmacy Services’ two locations have been able to vaccinate about 1,000 people a week, most of them health-care workers and some eligible seniors. The approval process was arduous, she said, and she believes she was approved because she started back in the fall.

You have to make sure you have the right facilities, the right refrigeration units. You have to do a lot of different checks with them, back and forth,” Dymowski said. “It’s not something that can be done on the fly.”

On top of all that, Garrow said, businesses also have to demonstrate they can schedule appointments so doses aren’t wasted, and can report all doses administered to the city’s vaccine database within 24 hours.

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Establishing links between pharmacies and that database, he acknowledged, has been an obstacle. Training and ensuring privacy and security are challenges, he said, as are some technical aspects of the system.

Pharmacists have become exasperated trying to make their systems compatible with the city’s record-keeping, which is necessary to receive approval to carry vaccine doses, Brodsky said. Richard Ost, who applied just this week to become a vaccine provider, said he had the proper record-keeping system installed months ago, but can’t get it to work. He’s had challenges getting clear answers from the company running the service and the city.

“Something’s wrong and we don’t know where to turn,” said Ost, who owns Philadelphia Pharmacy at Lehigh Avenue and Front Street.

Independents’ unique access

Independent pharmacies, which account for the vast majority of the licensed pharmacists in Philadelphia, are an untapped resource as city health officials seek to serve Black and brown citizens who may be reticent about the vaccine for reasons including a history of poor treatment in the medical community. Just 15% of all vaccine doses in the city have gone to Black residents, Health Commissioner Thomas Farley said Thursday, though they are 44% of the population. Independent pharmacies like Ost’s are staples of their neighborhoods, and owners have long relationships with their customers, putting them in a unique position to know whose medical conditions make them a priority for vaccination.

“Who can do it better than pharmacists?” said Ost, whose pharmacy has served Kensington residents for nearly four decades. “I know who’s the diabetic, I know who’s on different drugs, who’s immunocompromised.”

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Dymowski, whose pharmacy is approved to carry vaccines by both the city and the state, said she has seen the benefits of her customers being able to go to their regular pharmacy for COVID-19 vaccination.

“On a daily basis we get phone calls asking if the vaccine’s safe, if they should or shouldn’t take it,” she said. “We’re able to get to the community quickly and our patient base trusts us.”

In West Virginia, health officials credited a reliance on independent pharmacies, rather than national chains, for the state’s ability to inject at least 7.4% of its population with a first dose, the best rate in the country, the Associated Press reported. Philadelphia, which reported 105,306 first doses administered as of Monday, has given an injection to about 6.6% of the city’s population. While noting West Virginia is quite different from urban Philly, Garrow said the city does want the independent pharmacies’ help.

“We are excited to partner with independent pharmacies in the future and acknowledge that they serve a critical function in their communities,” Garrow said.

On Tuesday, Farley announced vaccination for people over 75 would begin next week at three ShopRites and 20 Walgreens, and encouraged hospitals to play a role in inoculating the general public. He made no mention, though, of independent pharmacies.

Garrow noted that pharmacies need to have enough room to keep vaccine recipients properly distanced while waiting 15 minutes after the injection to ensure there are no adverse effects. Or they could be partnered with businesses to host clinics for workers.

Ost says he could provide doses for 200 people a week, and would likely just mention the service to eligible customers when they come in to pick up a prescription.

“Is 40 a day going to change the world? No,” he said. “But if you have 150 pharmacists doing it every day then you start making a little dent.”

Staff Writer Laura McCrystal contributed to this story.

This story has been updated to correct the spelling of Nachum’s name.