Amid anger among health care practitioners waiting to be vaccinated against COVID-19 while hospitals give all of their employees a shot regardless of their role, the Oregon Health Authority announced Tuesday that it is opening up vaccines to more categories of people.
State officials said during a news briefing that they want vaccines from Pfizer-BioNTech and Moderna to be available to all four groups in its top tier of people in line to get the vaccinated before the general public. The top tier, called category 1a, includes four groups. Public health officials had originally planned to administer the vaccinations to them sequentially, beginning with the first group that includes hospital, nursing home staff and residents and first responders.
But now the health authority wants vaccines to be made available to all four groups at once, rather than plodding through the list in order.
The change opens up the shots to a range of providers, from a one-physician practice to chiropractors and dentists. It will also give home health care workers, all long-term care facilities, hospice programs and medical transport workers a chance to be vaccinated.
The move marks a major shift from the state’s previous plan. Without this change, hospital bill collectors would have been able to get vaccinated before health care workers in outpatient settings in rural areas, for example.
The Oregon Health Authority listed hospital staff in its first group -- with the caveat that they have the potential for direct or indirect exposure to patients or infectious materials. Dr. Dana Harguani, the authority’s chief medical officer, indicated during the news conference that the agency leaned on hospitals to largely shepherd the vaccine campaign -- along with pharmacies in nursing homes -- because they are often well-equipped with the freezers, for example, needed to keep the Pfizer-BioNTech vaccine cold enough, have a large number of providers and are used to vaccinating people. The authority also has a close relationship with large hospital groups, especially Oregon Health & Science University.
OHSU -- and Providence Health & Services -- were among the hospitals that were planning to vaccinate all their staff in the first round.
But during the news conference, Patrick Allen, director of the health authority, said the current vaccination round was originally only supposed to be directed towards those who had contact with patients or risked becoming infected on the job.
Allen said he’d become aware of vaccination providers giving shots to staff who “go beyond” the definition of the 1a classification. He said the authority will issue more “guidance” to vaccinators, adding that the state shouldn’t be moving to people who don’t have patient exposure.
“The key is contact,” Allen said, referring to the possibility of becoming infected.
His statement followed a report posted earlier Tuesday by The Lund Report, revealing that OHSU had sent a campus-wide message on Sunday, offering shots to all of its employees -- regardless of whether they were working from home, in a lab or in an emergency room. The report also showed that many other hospitals were planning to do the same.
Hargunani said most hospital staff who deal with patients have received a dose, though officials from Legacy Health and Providence told The Lund Report that they’re not likely to finish the first injections until sometime this month. Both the Moderna and Pfizer-BioNTech vaccines require two doses for full inoculation.
In recent days, there’s been a slew of media stories criticizing the health authority over the slowness of the vaccine campaign, prompting Gov. Kate Brown to call on the agency to vaccinate 12,000 people a day by the end of the next two weeks.
Allen said he wants the pace to speed up, too.
"We’re at the beginning of a long race,” Allen said.
Oregon ranks in the middle of the pack nationwide in its vaccination rate, according to the Centers for Disease Control and Prevention. A CDC map shows the state has given about 1,200 people per 100,000 a first dose. That compares with about 4,900 per 100,000 in Montana or more than 7,000 per 100,000 in West Virginia.
However, Oregon cannot blame its bumpy start and shift in messaging on a lack of vaccinations. Most of its vaccination doses remain unused.
To date, Oregon has administered 55,239 doses. That’s slightly more than a quarter of the 202,200 doses received. The vast majority are first doses of the required two doses. Just 329 people are fully vaccinated with both doses out of 54,905 people to start getting doses.
It’s not clear yet how Oregon will be able to quickly vaccinate everyone in the 1a classification, which totals upwards of 400,000 people. However, health officials said the state will need to forge partnerships with retail pharmacists and other groups to get the vaccinations out sooner.
“We will speed the number of doses delivered to health care workers and other phase 1a groups by giving them the option to get vaccinated at retail pharmacies,” Hargunani said.
OHSU also plans on setting up a mobile vaccination unit. Officials did not reveal details about how that would work.
Just a few hours after the announcement by the health authority, Salem Health said that it will hold vaccine clinics with Marion County Public Health at the Oregon State Fair and Expo Center in Salem for county residents in the 1a category.
The clinics, in the Jackman Long Building, will start at 8 a.m. and run to 6 p.m. on Thursday, Friday and Monday and to 5 p.m. this Saturday and Sunday.
“Over the past few weeks we have quickly vaccinated our employees and medical staff in order to protect our patients and those who care for them,” Cheryl Wolfe, Salem Health president and CEO, said in a statement. “Now we are ready to help distribute vaccines, first to other Phase 1a groups, and more broadly as additional vaccine is available and regulators direct.”
This shift was welcomed by health care professionals who are eager to get vaccinated.
"We have to be diligent about the practitioners that are in either close proximity to patients or see multiple patients in a day," said Huma Pierce, a doctor of chiropractic medicine in Beaverton. "Those are the practitioners that need not only to be vaccinated but need to have the proper PPE to do their jobs effectively."
Chiropractors were originally in the fourth group in the 1a category -- along with dentists. Dr. Barry Taylor, executive director of the Oregon Dental Association, welcomed the OHA’s move to expand to all groups. Without the change, dentists would have had to wait to get vaccinated, staying several steps behind hospital bill collectors and office staff.
Dentists need to be well-protected from the virus because they're they treat the mouth and are always close to the face, with the potential to be splashed with contaminated droplets. They also have the potential to play a key role in dispensing the vaccines because they can be trained to administer doses in Oregon. An estimated 200 to 300 dentists and dental students already have that certification.
Taylor said the change is good, though it’s too soon to know the details of how dentists will get vaccinations.
“I’m very, very happy with the news,” he said in an interview with The Lund Report. “Having said that, we still have the hurdle of where, exactly, dentists are going to get the vaccinations.”
Sadly, at least some of the hospital systems have vaccinated at home transcriptionists, that is all of their employees, before this change occurred. Quite incompetent on the part of OHA. Our county has no idea when more vaccine will arrive to begin the rest of the 1a groups. Beginning high risk groups is a distant goal.