The populous counties that ring Philadelphia are fighting back against state plans to build just two mass coronavirus vaccination centers in a large area stretching from Quakertown to the Delaware state line and from Pottstown almost to New Jersey.
Montgomery, Bucks, Chester and Delaware counties say they want vaccines to be spread out to more providers, which will be easier for residents to get to.
But the state has asked the four counties to identify two mass vaccination sites, one for Bucks and Montgomery residents and the other for Chester and Delaware residents.
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The state has relented somewhat: initially, it had asked for a single mass vaccination site for all four counties.
The counties are four of the seven most-populated in the state, and they have established vaccination sites scattered throughout their geography.
Residents of these counties are upset and confused.
"Where are they going to be? Two is better than one, but why are we doing that? Why are we pulling it from the people who are all set up?" asked Mary Conroy of Media, a medical volunteer.
The regional sites would be operated by the Pennsylvania Emergency Management Agency, or PEMA. They would receive the Johnson & Johnson vaccine and could vaccinate up to 42,000 people per week.
The state says the proposed regional sites would not divert any currently scheduled vaccine doses to local health care providers -- just the new J&J doses.
But local leaders say they want to decide where those J&J doses go. And that would be to already-established providers, which have proven they can vaccinate people quickly, the local leaders say.
The dust-up has gotten public. Delaware County sent a letter to any resident who had signed up for vaccine updates Saturday, saying leaders were "extremely disappointed" that the state would not change its plan.
Penn Medicine, which has large facilities in Radnor and Valley Forge, sent out a letter to patients Friday saying the state had said it would be four to six weeks before Penn gets vaccine supplies at those suburban sites.
"We know our patients who live in the southeastern Pennsylvania suburbs have struggled to access vaccine, compared to other regions of Pennsylvania," the letter read.
The plan for regional sites was proposed by the Pennsylvania Vaccine Joint Legislative Task Force, a bipartisan group composed of a handful of lawmakers from across the state.
After that, all four counties raised questions about equity. How would people who use public transit, the elderly or the homebound make their way to regional sites?
“If we give these doses to our county governments and our county DOHs here in the southeast, we’re able to reach people better through mobile clinics,” said state Sen. Maria Collett, a Democrat who represents parts of Bucks and Montgomery Counties.
“The Commonwealth has asked only one thing of county leaders to bring this life-saving vaccine to their residents: pick a location. It appears that some local leaders have chosen to bemoan even this responsibility, and instead are wasting precious time that could be used to ensure their residents benefit from the mass vaccination site's immediate success,” Pennsylvania Department of Health spokesman Barry Ciccocioppo said in response to a list of emailed questions from NBC10.