Oregon Health Authority Director Patrick Allen cautioned that the state will see chaos as it makes COVID-19 vaccines available to senior citizens starting next week.
Allen framed the reason in simple terms: Other states have experienced that problem, so Oregon will too.
“You’ve seen that every state that has opened to seniors has had some form of chaos on its hands,” Allen on Wednesday told the Oregon House Subcommittee on COVID-19. “I want to be completely transparent; we’re going to have some form of chaos on our hands too.”
Partly the problem is the inevitable result of trying to organize vaccination in a state of 4.2 million people -- including nearly 770,000 people 65 and over -- with vaccine arriving now at just 50,000 doses a week.
But Oregon has experienced chaos of the state government’s own making in recent weeks, too. The state initially insisted that only hospital workers would get vaccinations first. Then it backtracked and opened up the entire top priority group -- 1a -- for shots after hospital office workers and telecommuters ended up getting doses before medical professionals in clinics with far more exposure to patients.
Oregon also has come under fire for pushing to vaccinate K-12 teachers and other school staff ahead of senior citizens, and for initially understating how many people were in the K-12 group. State officials insisted prioritizing educators was necessary for an orderly opening for schools this year, even though vaccinations alone will not guarantee that schools re-open. Each local school district makes that decision, based in part on advisory health metrics such as local case counts and infection rates.
In recent weeks, Allen said Oregon would try to anticipate and avoid the chaos that has beset other states.
“We’ve seen how chaotic the expansion of vaccinations has been to seniors in other states,” Allen said at a Jan.15 news conference. “We’re taking steps to anticipate and mitigate similar challenges here. Though it’s a very large population and I anticipate it will still be a difficult rollout.”
Further complicating matters, a judge ruled this week that Oregon inmates must get vaccinations as part of the state’s 1a priority group. That came after a lawsuit from inmates with civil rights attorneys. Under the state’s plan, the inmates were to get vaccinations in the 1b group, which comes after senior citizens and includes many essential workers plus people with underlying conditions between ages 16 and 64. Now, the state will vaccinate inmates on an accelerated schedule.
“The court’s decision is clear, and the state has decided not to appeal,” said Charles Boyle, a spokesman for Gov. Kate Brown.
As of Wednesday, Oregon has vaccinated 273,000 people with one dose and about 97,000 with the required two doses for full vaccination.
Even as the state opens up to senior citizens, it is still working through phase 1a, which includes health care workers and residents and staff in long-term care facilities.
The first seniors to get vaccinated will be those 80 and older starting next week. Each week, progressively younger seniors can start the vaccination process until seniors age 65 and older are eligible the week of Feb. 28.
Sign-up Will Overwhelm Providers
But it’s one thing to be in a category that is eligible. It’s another thing to get that vaccination.
It’s largely up to individuals to seek out county- or hospital-run vaccination clinics, pharmacies and other locations, sign up on waiting lists, and watch for emails inviting you to show up.
Allen said the system will get clogged as people try to sign up.
“Phone lines are going to get overwhelmed,” he said. “Scheduling sites are going to have challenges. This is a lot of people who are going to want to come to the system at once.”
Based on the current vaccine supplies coming into Oregon, the vaccination rollout for seniors will take 12 to 16 weeks to complete, Allen said. The demand will snowball. There are far more young seniors than old ones, and as their turn comes, the waits will grow, he said.
“We’re adding a very, very large number of eligible people compared to the supply of vaccines that we have,” Allen said.
The state is planning different ways for people to schedule vaccination appointments and get information. The options range from an online app to a phone number to call for the less tech savvy. As of Thursday, there was no phone option statewide. Individual counties are launching online signup pages, as are pharmacies that are slated to get the vaccine.
The speed of the rollout also depends whether the federal government approves more vaccines for distribution. Johnson & Johnson, for example, is submitting an application to the Food and Drug Administration this week for emergency approval for its vaccine that could bolster supplies and requires only one dose instead of two.
Hospitals hope the state will soon have more vaccines on hand. Currently, the federal government and two pharmaceutical manufacturers -- Moderna and Pfizer, Inc. and BioNTech -- ship the supplies to states. The health authority does not directly receive the vaccines, but allocates how many will go to different points, including hospitals, other health care providers and public health districts.
The limited supply makes it difficult for hospitals to staff and plan large-scale vaccination clinics, said Becky Hultberg, president and chief executive officer of Oregon Association of Hospitals and Health Systems.
“It’s critical that we plan now for the time when we receive additional supply,” Hultberg said.
Mass distribution sites have had to stand down because they don’t have enough supplies, Hultberg said.
Starting next week, the federal government is shipping vaccine to select pharmacies -- in Costco, Albertsons, Safeway and Health Mart and in Oregon -- but supplies will be very limited to start.
Meanwhile, the state is working on its plan for the 1b group, which comes after seniors. Allen said he’ll have more information about that group in two or three weeks, noting that the state has about three months before seniors are done.
Salem Health has vaccinated more than 36,000 people, primarily at fairgrounds in Marion and Polk counties.
Sarah Horn, chief nursing officer of Salem Health, told lawmakers that her organization could more than double its vaccinations, if it had the doses.“The on and off nature of the supply creates logistical challenges,” Horn said.
Health care providers are already facing a swarm of phone calls as they prepare to scale up. “We’ve been inundated with questions,” said Wendy Watson, chief operating officer of Kaiser Foundation Health Plan and Hospitals of the Northwest.
Kaiser is involved in the COVID-19 vaccination site at the Oregon Convention Center along with Oregon Health & Science University, Legacy and Providence.
Dr. John Hunter, executive vice president of OHSU, said staffing is key as the vaccine rollout ramps up. Currently, hospital employees who already work another five-day a week job are doing extra duty at vaccination events.
OHSU, Kaiser and Legacy are in talks about how to create a workforce hired specifically for the vaccination clinics, Hunter said.
State Prison Vaccination Plan
Lawmakers also heard from state corrections officials. In Oregon, 42 adult inmates have died from COVID-19 in state prisons among a population of nearly 13,000.
Since the pandemic started, the state has had nearly 3,400 positive cases among its adult inmates. Among staff, 806 members have tested positive.
Dr. Warren Roberts, chief medical director of the Oregon Department of Corrections, said prison outbreaks impact surrounding communities, as staff and inmates come and go from the communities and enter and leave prisons.
State prisons started to vaccinate employers and contractors on Dec. 28. The department has given about 1,500 first doses to staff. Roberts said it’s difficult to gauge the total number of staff who are vaccinated because they also can get shots from sources outside the corrections agency. The agency has about 4,600 employees. The agency will get 5,000 doses of Moderna vaccine each week for inmates until its job is done, he said.
Inmates can opt out, Roberts said, but the department still seeks to have them talk with a health care provider who can provide information.
You can reach Ben Botkin at [email protected] or on Twitter @BenBotkin1.