Gov. Kate Brown Mounts Defense Over Decision To Vaccinate Teachers Before Seniors 

vaccine Kate Brown at vaccine clinic.jpeg

Gov. Kate Brown on Friday mounted a vigorous defense of her move to vaccinate teachers and other K-12 school staff ahead of senior citizens, insisting it’s necessary to get students into classrooms as soon as possible while elderly Oregonians wait longer. 

But criticism continues to grow in different quarters on her COVID-19 strategy. About 90% of Oregonians who have died from COVID-19 are age 60 and older. The state teachers union backs vaccinations for seniors before educators. The state’s hospital association said Brown’s move will spark confusion and possibly chaos. 

At her Friday press event, public health officials and two educators tried to sell the public on the merits of the governor’s plan.

The state has about 105,000 teachers and other school staff, and 47,000 early childhood educators and workers. It would take just over 300,000 doses of the vaccine to inoculate them all. The state has about 700,000 people age 65 and older, requiring about 1.4 million doses - although those 65 and older in care homes are already being vaccinated.

The state is receiving about 50,000 doses a week.

Deciding just who gets dibs on those doses has sparked fierce debate.

Brown’s press event lacked data weighing the health and life-or-death effects of vaccinating teachers and other school staff first. When asked, Brown and public health officials were unable to provide any details or analysis on how many senior citizens might contract COVID-19 and die due to the delay in getting vaccinations because teachers are first in line. 

Instead, Brown and Oregon Health Authority officials insist that it’s critical to reopen schools quickly so youngsters languishing at home and relying on online instruction can get back into the classroom, socialize with their peers and not fall further behind in their studies. 

For senior citizens age 65 and older, the state’s message is simple: Be patient and wait your turn. The state estimates that the start of vaccinations for the oldest seniors -- those 80 and older -- will be delayed two weeks because of Brown’s plan to vaccinate teachers first. 

“Educators can be vaccinated quickly, district by district,” Brown said. “This choice represents a rapid action that will have an outsized impact on Oregon kids. If we were to vaccinate every Oregon senior first, the harsh reality is that many of our educators would not get vaccinated this school year, and Oregon kids would continue to suffer.”

Brown and public health officials continue to hammer the point that vaccine supplies, which are all controlled by the federal government, are limited. 

“The harsh reality is we are managing a scarce resource right now,” Brown said. “I wish we had more vaccines to give.”

The state allocates the incoming vaccines to hospitals, clinics and other facilities, which each develop their own vaccination schedules for categories of people approved by the state for vaccination.

Becky Hultberg, president and CEO of the Oregon Association of Hospitals & Health Systems, warned that the group is concerned that Brown’s approach will add “stress and potential chaos” to facilities inundated with requests from people seeking the vaccine.

“Since the state does not control the vaccine supply, Oregonians are being asked to take it on faith that the state can keep to the governor’s timeline,” Hultberg said in a statement. “In some regions of the state, supply can meet the demand. It is important that these areas are free to move ahead with their vaccination efforts. However, it is critical that all Oregonians understand that given current supply, some hospitals will be unable to meet the demand for vaccinations.”

Vaccine Rollout Plans

Rachel Banks, public health director of the Oregon Health Authority, said the plan to vaccinate educators first gives schools a chance to reopen this school year. The size of the K-12 workforce is small enough to vaccinate most of them before Feb. 8, and the state can then begin vaccination of seniors 80 and older, state officials said.

So far, the pandemic has killed 1,865 people in Oregon. Overall, the state has had nearly 137,000 COVID-19 cases. 

Oregon has vaccinated about two-thirds of the people in its 1a group, which includes health care workers and people who live and work in nursing homes and other long-term care facilities. 

In the past week, Oregon has hit its target to administer at least 12,000 doses per day.

Even at that rate, however, Oregon, with a population of 4.2 million, still faces a long slog. The vaccinations require two doses per person, so Oregon and other states hold second doses in reserve for people who have received the first shot.

Oregon has administered 270,452 first and second doses of the vaccine. Overall, the state has received 487,700 doses. David Baden, chief financial officer of the Oregon Health Authority, said that while educators get vaccinated, the state will keep doses on hand for people in the 1a group who haven’t yet received vaccinations. Currently, Oregon is on track to get about 50,000 vaccine doses per week from Pfizer and Moderna combined. It’s unclear whether the federal government will be able to increase that.

Next week, the state plans to administer about 30,000 first doses to educators and hold the rest in reserve. The following week, starting Jan. 31, the state plans to give educators 31,624 doses. The week of Feb. 7, when seniors age 80 and older become eligible, the goal is to provide about 25,000 doses to educators. With each subsequent week, younger groups of seniors can become eligible for vaccinations in five-year age increments of 75 and older; 70 and older and 65 and older. This means that the soonest people ages 65 to 69 can receive a dose is the week of Feb. 28.

With that timeline, the state expects to have a “critical mass” of seniors vaccinated by the first week of May, Baden said. 

Wendy Watson, chief operating officer at Kaiser Permanente Northwest, spoke at the press conference about Kaiser’s vaccination work at the Oregon at the Oregon Convention Center in Northeast Portland, which is being done in coordination with Legacy Health, Providence Health & Services and Oregon Health & Science University. 

On Wednesday, when it launched, the site administered 1,365 doses. The site will give an estimated 4,000 doses on Monday and Tuesday to caregivers and medically fragile children, and start vaccinating educators on Wednesday. 

Next week, the site has 12,000 doses for teachers and about 15,000 doses for the week after that, Watson said. The site also has about 12,000 doses to continue vaccinating members of the phase 1a group.

Officials stressed that the timeline could change based on the availability of the vaccine.

“We’re moving as fast as we can with the limited doses we get,” Banks said.

Hultberg, with the hospital association, said separately that the rollout will take several weeks to vaccinate teachers in the Portland metro area alone and will create confusion.

“At 15,000 doses a week in the Portland metro area, we should all be honest about the fact that there will be significant wait times for vaccines and that completing our efforts will take many, many months unless supply increases,” Hultberg said. “Setting unreasonable expectations will not speed up vaccinations but will lead to confusion on the part of Oregon seniors, and will increase the operational burden borne by hospitals tasked with explaining to those who believe they have a place in line that they will have to wait even longer.”

Experts Question Plan 

Regardless of the supplies available, Brown’s plan has drawn criticism from experts and even the state’s teachers union. 

A central bone of contention is whether the move will put the lives of frail seniors at risk for the sake of opening schools sooner.  

Nationally, seniors are among the most vulnerable population, along with people who have underlying medical conditions like diabetes or breathing disorders. 

As a result, most states, unlike Oregon, have prioritized senior citizens rather than putting teachers first. Oregon’s approach is unusual compared to other states. An analysis by the Oregonian/OregonLive found that at least 45 states will vaccinate their seniors before Oregon. 

Courtney Campbell, ethics professor at Oregon State University with a specialty in biomedical ethics said Oregon’s approach of putting teachers before senior citizens appears to be prioritizing a social good, not health care or saving lives.

"We’re going to have to decide which communities or which kinds of people receive priority," Campbell said. "We don’t have enough to go around. We have to make decisions about priorities."

Campbell said the "best use of the vaccines when you don’t have a lot to go around" is focusing on people who are at higher risk.

There also are risks to reopening schools, even with masks and strict social distancing enforced.

Chunhuei Chi, director of the Center for Global Health at Oregon State University, said there are public health risks with reopening schools, even if educators and other school staff are vaccinated. While children usually escape serious illness from COVID-19, they are still capable of transmitting the virus, he said. 

“That means if a family puts a child back in school, the whole family is at risk,” Chi said. 

With in-person schooling, the student might be more likely to transmit the virus to a vulnerable family member, such as a grandparent or sibling with a compromised immune system.

Some families will be comfortable sending their children to school, and others will not, especially given that the state has not yet reached herd immunity, which requires about 70% or more of the population to be vaccinated. That jeopardizes the likelihood of broad acceptance of school reopening, Chi said.

“If that’s the goal, then I doubt it will be very successful,” Chi said, noting different family opinions about safety.

The reopening of schools depends on more than simply vaccinating teachers and school staff. School districts make the decisions locally. The state has set advisory guidelines on local case rates and infection levels for districts to consider. As a result, even with vaccinations in place, school reopening will be on a district-by-district basis, not statewide. 

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.

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