The initial deliveries of COVID-19 vaccines to Oregon, Washington state and Idaho are spoken for — at least well into next month. High-risk health care workers, EMT/paramedics and nursing homes have top priority to get the vaccine jab. But then who?
Outgoing Washington Secretary of Health John Wiesman said "many, many" industry groups sent him emails to make their case. Likewise, the Oregon Health Authority reported getting lots of entreaties from industry, labor unions, interest groups and other entities.
"We feel torn," Wiesman said during a briefing last week. "There is limited vaccine and we need to do the best decision making we can with the data we have and the values that are out there in terms of trying to share equitable access."
Western state governors and state health officials are now reviewing a finalized recommendation from the federal Centers for Disease Control and Prevention for how to prioritize future vaccination phases.
On Sunday, a CDC advisory panel voted 13-1 to urge states to give the next round of vaccines to people 75 and older along with "frontline essential workers." Then remaining essential workers, seniors aged 65-74 and other high risk people would get the vaccine in the following phase after that.
Jonathan Modie, a spokesperson for the Oregon Health Authority, said his agency was pleased that the CDC elevated the oldest Americans into the vaccination group coming up next. Their turn came later in prior drafts of the guidelines.
"If we could vaccinate the 12% of Oregonians who are 70+ years of age, we could prevent 76% of COVID-19 deaths," Modie said in an email.
States look to the CDC for guidance, but the expert panel's recommendations are not binding, meaning it is possible for interest groups to sway their state's prioritization sequence and potentially jump ahead.
The frontline essential workers placed at the head of the line by the CDC include teachers, day care staff, grocery store workers, farmworkers and food processing, prison staff and postal workers.
Vaccination for this grouping could begin in mid-January at the earliest, according to Washington assistant health secretary Michele Roberts. She said the states do not yet know how many vaccine doses they will get in January, which introduces much uncertainty.
An Idaho committee advising Gov. Brad Little has already ranked and prioritized essential workers for the upcoming next phase, putting police and fire responders who weren't in the very first group at the head of the next line. Those folks would be followed by teachers, correctional staff, food processing workers, grocery workers and Idaho National Guard members, in that order.
The Washington health department and Gov. Jay Inslee's office said an announcement of the state's priority list would be posted as soon as it is ready, possibly within days. A draft plan for the allocation of the COVID-19 vaccine posted online by the state health department several weeks ago includes some modest differences from the newly finalized CDC guidelines.
One difference is that the preliminary state plan prioritized vaccination of inmates in prisons and jails. The new CDC list ranks correctional staff highly but is silent about where inmates belong in the sequence.
"We are concerned that CDC did not call out people who are incarcerated in prisons and jails for prioritization," said Nick Straley, assistant deputy director for advocacy at Columbia Legal Services in Seattle.
"The people who are incarcerated need to be vaccinated as quickly as possible," Straley said, noting "huge and horrendous" outbreaks in Washington state's prisons and smaller outbreaks in various county jails.
A Seattle-based union local representing grocery store workers said it had "strong hopes" that its members would land on Washington state's vaccine priority list after being included in the CDC's guidelines for who should share the next allocation — formally known as Phase 1b of the COVID-19 immunization drive.
UFCW 21 (United Food and Commercial Workers) spokesperson Tom Geiger said the union's staff had spoken recently with both the state Department of Health and the governor's office about why its risk-exposed members were deserving of prioritization.
"The federal government could and should be doing more to maximize the production of the vaccine,” Geiger said in an email. “We are not in favor of one essential worker competing with another essential worker for a vaccine that they both should have access to."
Anthony Anton, the president of a trade organization that represents thousands of restaurants across Washington, said he thought it was appropriate to prioritize teachers for vaccination, so that students could get back in classrooms soon.
The Washington Hospitality Association's Anton said he spoke at a state-run focus group in favor of giving restaurant workers a spot in line after the educators.
"We are hopeful that after those first couple groups, that our workers who are out in the public and can't work from home and from an income/equity standpoint they are living paycheck to paycheck — so, therefore we would love to prioritize them in that next group," Anton said in an interview Monday.
Dara Khosrowshahi, the CEO of Uber, wrote to Inslee, Little, Oregon Gov. Kate Brown and other governors earlier this month to ask that ride-hailing company drivers also be given early access to the COVID-19 vaccine. The Uber chief said they provide an essential service that other frontline workers rely upon.
The new CDC guidelines call out transit operators as frontline essential workers deserving to be in the next vaccination group. A Washington State Department of Health spokesperson said Monday that it is undetermined if Uber and Lyft drivers would fall in the same category.
"We do know it will take many months, probably through the spring and potentially into the early summer, before we have enough vaccine for everybody in Washington who wants to be vaccinated," said assistant health secretary Roberts during a media briefing on December 16.
Roberts said her state is working to build online tools to assess one’s place in line, and then be notified by the state when it is time to be vaccinated. That information system may also provide links to vaccination locations. Health care providers will probably notify their patients who are high-risk when it’s their turn, she added.
In the meantime, even though folks are getting tired of it, people will need to keep wearing masks when around others outside of home, keep gatherings small and maintain social distancing, advise your state and local health officers.