It seems that every week we struggle with the last existential question “COVID-19 and me”. In the beginning, it was, “Should I clean my Amazon boxes?” Then, “How do I get my kindergarten student to participate in a Zoom call with his teacher?”
Today, the Great Coronavirus Question posed to OPB reporters is this: “When will I get the vaccine?”
The short answer is: we really can’t say. The Oregon Health Authority Vaccine Advisory Committee, a diverse group of public health experts and community representatives selected from 400 candidates across Oregon, met for the first time on Thursday to decide who will be vaccinated next, and in what order. So far, no decision has been made.
The longest answer for Oregon’s inhabitants is: Distribution problems at the federal level and logistical challenges at the local level have slowed the state’s deployment and delayed planning. Oregon was to vaccinate 100,000 people by the end of December 31. As of Friday, November 8, Oregon was only two-thirds of the way to achieving that goal. And with more than 300,000 health professionals in the state, there is a long way to go.
But it is much more complicated than that. And hearing “we don’t know” doesn’t help much. Therefore, we are answering all your questions with what we know and why there is still so much in the air. Is most of it a little unstable inside baseball? Yes, like this.
Is Oregon vaccinating more slowly than other states?
The Oregon Health Authority says Oregon is in the middle of the list when it comes to states’ vaccination efforts. By the end of last week, 1.5% of Oregon’s total population had been vaccinated. Forty states and Washington, DC, the District of Columbia vaccinated a larger percentage of the population than Oregon.
The number of vaccines a state receives, and when they arrive, depends primarily on the federal government. But that alone cannot explain the reasons for Oregon’s slow implementation.
Another metric is to look at the percentage of vaccines delivered that have been administered. As of Friday, Oregon was in 36th place. So far, Oregon has used just under a quarter of the doses of the vaccine it has received.
How can I know when I will be vaccinated?
First, you need to find out at which stage of the launch you can be vaccinated. It is divided into four phases and several sub-phases.
Who created the levels?
The vaccine implantation phases were developed by the CDC’s Immunization Practices Advisory Committee. This advisory panel is composed of virologists, outbreak specialists and medical ethics specialists. They have issued recommendations for states to follow at each stage of vaccine launch.
Here’s who the CDC advisory panel recommends that the state vaccinate at each stage:
- Phase 1: Frontline workers and people at high risk.
- Phase 2, 3 and 4: Not yet determined. The Advisory Committee on Immunization Practices has not yet issued any recommendations. It is safe to say that if you are not included in phase 1, it will take several months before receiving the vaccine.
Phase 1 is divided into several sub-phases, and these are the groups of people who are being vaccinated now.
Who decides who is at which stage?
ACIP issues recommendations to those who get the vaccine when, but ultimately, states have the authority to determine who gets vaccinated and when. Just to make things even more confusing, individual hospital systems and county health programs may have additional priorities and strategies for administering the vaccine.
This means that no two states are vaccinating people in the same way. There are similarities – all states are following the recommendations of the CDC’s Immunization Practices Advisory Committee to some extent, but each state can choose to define “frontline workers” and “people with pre-existing diseases” as they wish. The committee also issued guidelines on how to sub-prioritize people at each stage.
Oregon has a vaccine advisory committee that will meet regularly to decide how best to follow federal recommendations in Oregon. Who does the CDC advisory committee recommend to be vaccinated in Phase 1 and when?
He divides Phase 1 into three groups. Phases 1a, 1b, 1c.
Phase 1a is comprised of health professionals, residents and employees of long-term care facilities. States can define these terms as they wish.
Phase 1b includes frontline workers (defined differently from essential workers), as well as people over 75. The federal government advises to prioritize the elderly because people over 65 constitute about 15% of the United States population, but 80% of all COVID-19 deaths. By prioritizing the elderly, many deaths can be prevented.
Phase 1c includes “essential workers”, people aged 16 to 64 with high-risk medical conditions and people over 65.
The Advisory Committee on Immunization Practices recommends that everyone else be vaccinated in a different group.
The committee defines “essential workers” as those whose jobs are needed to keep the state and country running. Frontline workers are a subset of essential workers who have close contact with others. So, for example, a utility maintenance specialist is considered essential, while a supermarket cashier is essential and on the front lines. The cashier would be vaccinated first because they are the most likely to get sick.
How does Oregon’s plan differ from federal recommendations?
Oregon has adopted some major variations from federal recommendations compared to other states.
Phase 1a includes health professionals who have direct contact with patients. Unlike some states, Oregon has prioritized the hospital’s non-medical staff, such as phase 1 attendants, janitors and cafeteria staff, along with doctors and nurses. Hospital staff and administrators should not be vaccinated in Phase 1a, but this has not prevented local hospitals with an excess of vaccine from providing them. Oregon also includes home health workers in Group 1a.
Controversially, workers in correctional facilities are included in Phase 1a, but prisoners are not. To avoid legal action, Oregon will now allow incarcerated people to receive the vaccine in Phase 1b.
Related: Oregon faces precarious legal situation while COVID-19 in prison lawsuit continues
Phase 1b in Oregon includes essential frontline workers and people over 75. Oregon was one of the first states to emphasize the vaccination of teachers in Phase 1b, when Oregon governor Kate Brown asked teachers to be “first in line” to help with school reopening.
At a news conference on Friday, Brown confirmed that teachers will have priority in the next round of vaccinations: even ahead of people over 75.
Who are we vaccinating now?
We are vaccinating Phase 1a. Oregon initially tried to prioritize groups within Phase 1a, then the emergency team and staff working with high-risk patients were vaccinated first. But screening proved to be a challenge and delayed launch. Now all Phase 1a members are being vaccinated.
There are more than 300,000 people in Phase 1a, and Oregon is only a fraction of them. Oregon initially planned to start vaccinating people in Phase 1b in mid-January, but now it seems unlikely that 1b will start here before February.
Oregon Health Authority officials are reluctant to set firm dates for the next wave of vaccinations, citing unpredictable vaccine deliveries and conflicting information from federal agencies.
Are the other states still stuck in Phase 1a?
Many other states, including Washington and Arizona, are about to start vaccinating people in Phase 1b or have already started. Some are on their way to finish this phase before Oregon even starts.
What is Oregon doing to speed up the vaccine launch?
Anyone in Phase 1a – that is, all healthcare professionals and workers in long-term care institutions – can now receive the COVID-19 vaccine. As of Monday, three-quarters of Oregon’s COVID-19 vaccines had not been administered. By expanding the number of eligible people, the Oregon Health Authority hopes to accelerate the process.
OHA also says it will also expand the pharmacy program and partner with unions and other organizations to put the vaccine in more arms.
How will Oregon prioritize people in Phase 1b? Who gets vaccinated first? Teachers? Or the elderly?
At least for now, we’re still not sure.
Oregon Governor Kate Brown asked the Oregon Health Authority to put teachers first in line when Phase 1b begins. This would be a direct contradiction to ACIP’s recommendations, which suggest prioritizing those over 75 over frontline workers.
Initially, it was not clear whether teachers would be vaccinated at the same time as high-risk elderly people. Controversially, this no longer seems to be the case. Governor Brown stated unequivocally on Friday that teachers would be vaccinated before any other group.
Related: Governor Kate Brown wants Oregon children back to campus on February 15, but many teachers will not be vaccinated until then
The Oregon Vaccine Advisory Committee met on Thursday to decide how to prioritize people within each group. They were instructed to consider the best ways to quickly slow the spread of the virus and, at the same time, ensure that the distribution is fair and meets the needs of the communities they represent.
Many members expressed concerns about the speed of delivery of the vaccine and how to balance the urgency of the situation with the desire to perform the next phases correctly.
Muriel DeLaVergne-Brown, director of the Crook County Health Department, encouraged members to give health workers in rural counties the flexibility to vaccinate out of order, especially if there are unused vaccines. Representatives from other smaller communities said that flexibility would help them get vaccinated faster and waste fewer doses.
Still, no decision was made, and the committee did not complete its agenda before the end of the meeting. The group planned to meet every Thursday, but as there is so much to do and so little time, they hope to schedule additional meetings sooner. During Friday’s press conference, OHA Director Patrick Allen said he expects the Vaccine Advisory Committee to complete work on Phase 1b by the end of the month.
The final result:
The vaccine launch will look different in each community and health system. Depending on the amount of vaccine available locally, some areas can move much faster than others. Rural areas are likely to move much faster than urban areas as well.
Vaccine implantation plans are fluid. As Tuesday’s decision to open vaccination for everyone in Phase 1a showed, even after decisions have been made, they are not immutable.
So, when will you get a vaccine? Unless you work in healthcare, the most direct answer remains: “not yet”.