A state committee responsible for recommending the order of coronavirus vaccinations reduced its provisional list to 60% of Oregon residents on Thursday, amid the first signs of tension about how best to tackle historic inequalities and at the same time be fair to everyone who needs a vaccine.
The last iteration of the 27-member committee’s recommendations would include two distinct but overlapping groups, which together total more than 2.5 million Oregon residents. If the recommendations continue, they will be vaccinated after about 1.4 million people that the governor has already prioritized for vaccines.
For now, the Vaccine Advisory Committee is recommending that BIPOC communities, totaling about 806,000, and people with underlying chronic illnesses, totaling about 1.8 million Oregonians, be vaccinated next. They would follow health professionals, residents and senior citizens, prison inmates, teachers and some seniors who are or will be eligible soon.
The result of Thursday’s deliberations was a marginal analysis of last week’s recommendations, which also included refugees, frontline workers and prisoners.
“We have real work to do to prioritize this,” Kalani Raphael of the Oregon Pacific Islander Coalition said of the group’s original recommendations. “Otherwise, we will have no priority, actually.”
The group will reconsider and probably narrow down further and then vote on the suggestions at its next full meeting on January 28. The committee has until mid-February to tell the Oregon Health Authority who should be vaccinated after the governor’s priority populations.
The health authority created the group as part of Oregon’s stated 10-year goal of neutralizing generational racism by overhauling the health care system. The agency said it would follow the committee’s recommendations, assuming that they passed the legal and practical assessment and obtained approval from the governor.
But in a reflection of the extraordinary challenge behind combating a concept as amorphous and simultaneously concrete as “systemic racism”, one of Thursday’s two proposals is already in the minds of health experts and government officials: focus on people with chronic health conditions.
The justification put forward by some of the proponents of the approach was that minorities are more likely than whites to suffer from chronic diseases that make coronavirus infection particularly dangerous, such as diabetes, cancer or HIV infection.
But the proposal was hardly original, since the federal government already recommends that people with chronic diseases be vaccinated next, along with those over 65 years old. Governor Kate Brown decided not to prioritize people with chronic conditions, allowing teachers to be vaccinated on January 25 and people aged 80 and over on February 8, with more seniors becoming eligible weekly.
In light of the committee’s fundamental purpose – to help launch Oregon’s battle against historic inequalities – one of the committee members was irritated when members proposed that people with health problems be prioritized before or instead of minorities.
When these members objected, Kelly Gonzales practically accused them of being accomplices in an attempt to maintain white hegemony.
“We are also dealing with our own conditioning of white supremacy as it appears in our decision-making,” said Gonzales, a member who represents Native Americans living in cities.
Finally, blacks, indigenous people and others of color were included in the list, above those with underlying diseases. It is unclear whether the committee will end up recommending that BIPOC communities be vaccinated before people with underlying diseases.
Last week, the group started its discussions with an extremely broad and asked the health authority to analyze how it could vaccinate: BIPOC communities, refugees, people aged 16 to 64 with chronic health conditions, people eligible for vaccines who are in prison or prison, frontline employees who were not yet eligible, people in generational multi-households and people under 65 who live in homes for low-income seniors or other places of home care.
An official from the health authority began Thursday’s meeting by saying that perhaps the most practical way to address the priorities the group outlined a week ago would be to reach neighborhoods based on a combination of metrics such as demographics, prison population and occupational risks .
This would allow the health authority to target multiple committee priorities at the same time, said Rachael Banks, the agency’s director of public health.
This idea did not seem to get much from the group, especially after one member pointed out that vaccines are sensitive and taking them to the appropriate neighborhoods without wasting any doses can be challenging.
Whatever the content of the final list that the committee sends to the state, its recommendations will have to work with three fundamental obstacles: the legal viability of the recommendations, Brown’s existing priorities and the availability of the vaccine.
To date, Oregon has administered approximately 254,000 vaccines out of the 479,000 received.
The state has already built a long line, including some 250,000 health professionals and elderly care residents and employees who have not yet received an injection, 100,000 preschoolers, day care centers and staff from K-12 and 768,000 Oregon residents aged 65 or older. more.
Oregon expects only 1.1 million doses of vaccines by February.
Still, where exactly millions of Oregon residents will stand in line behind them may depend on the committee’s next decisions.
– Fedor Zarkhin
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