Oregon Officials Warn Of Delays As Vaccine Eligibility Expands

vaccine Kate Brown at vaccine clinic.jpeg

Oregon continues to advance its vaccine rollout, and on Friday said it is making family members of front-line workers eligible for vaccines starting Monday. 

But the state still faces challenges and is tamping down its earlier projections that everyone who wants a shot will have received one by the end of May. The culprit: Oregon, like other states, is suffering from a delay in Johnson & Johnson vaccine doses after a manufacturing error spoiled millions of doses. 

However, Oregon officials are sticking to their vaccine rollout schedule to make frontline workers eligible on Monday and everyone 16 and older eligible by May 1.

In a press conference on Friday, Gov. Kate Brown announced that family members of front-line workers will be eligible on Monday. Brown said that’s part of a strategy to keep the vaccine rollout “fast and fair.”

“If you’re a frontline worker, when you make an appointment for a vaccination for yourself, make one for your entire family,” Brown said.

It’s unclear how many more members of the public this makes eligible, as there is overlap among people eligible for different reasons. For example, some frontline workers also have underlying health conditions and some household members already are eligible due to their age.

Eligibility Expands

On Monday, Oregon opens its vaccine eligibility statewide to front-line workers, people 16 to 44 with underlying health conditions and people in multi-generational households. Front-line workers are those in any occupation with extended in-person exposure to people outside their house and who cannot work from home. Multi-generational households qualify if they have three generations, but can also have just two generations, such as a grandparent caring for their grandchild.

Twenty-three of the state’s 36 counties have attested that they can move on to vaccinating that broad group and have done so. Counties move to that group ahead of the state schedule only if they had open slots after vaccinating all senior citizens who wanted doses. 

Officials also expanded the underlying health conditions that qualify people for an early jab, due to new Centers for Disease Control & Prevention guidelines. That expanded list now includes neurological conditions, type 1 diabetes, liver disease, substance abuse and current or former smoking.

The original list included cancer, chronic kidney disease, chronic obstructive pulmonary disease, Down Syndrome, heart conditions like heart failure and coronary artery disease, weakened immune systems, such as from organ transplants or HIV, obesity, pregnancy, sickle cell disease and type 2 diabetes.

Officials Warn Of Surge

After steadily dropping, COVID-19 case numbers are now increasing, prompting state officials to urge Oregonians to continue to social distance, wear masks and avoid large gatherings.

“The fourth surge of this virus is at our doorstep,” Brown said.

Dr. Dean Sidelinger, state epidemiologist, warned that cases have started an uptick in recent weeks. The last weekly report statewide showed 2,456 new cases, a 28% increase, Sidelinger said. 

“These are indications that despite the progress we have made, the virus appears to be rebounding,” Sidelinger said. 

Oregon officials and others across the United States are concerned about the presence of variants like the B.1.1.7 variant, which can spread more easily and are more likely to make the carrier seriously ill. The state has stepped up efforts to monitor for variants, such as through its public health laboratory and labs at the University of Oregon, Oregon Health & Science University and Oregon State University. But not every COVID-19 test is checked for variants because of the genomic sequencing involved in the process. 

Brown said: ‘’Don’t let the vaccines and sunny spring weather give us the false sense that we’re in the clear, because we’re not. This virus has proven that it can mutate.”

Existing vaccines are believed to be highly effective against the variants, but testing on the issue is continuing.

Johnson & Johnson Error Hits Oregon

Oregon Health Authority Director Patrick Allen said the state will not delay its vaccine eligibility timeline, despite the disruption in Johnson & Johnson supplies.

Johnson & Johnson raised eyebrows after an error at a manufacturing plant in Baltimore ruined as many as 15 million doses. Vaccine ingredients were contaminated, a human error that sparked delays in the federal Food and Drug Administration authorization of the plant’s production lines, according to news reports. The one-dose vaccine is the latest to gain federal emergency approval and it’s a key part of a rapid vaccination plan. The other two vaccines, manufactured by Pfizer and Moderna, each require two doses spaced several weeks apart. 

But the overall work of vaccinating every Oregonian who wants a dose may take longer. 

“We may need to temper our hopes to vaccinate all Oregonians by late May and bump that back,” Allen said. 

The disruption in Johnson & Johnson doses is an estimated shortfall of 200,000 to 300,000 fewer doses in April for Oregon. Allen said that’s the equivalent of an eight or nine-day setback.

Next week, Oregon expects a temporary surge of 61,400 Johnson & Johnson doses in the state’s allotment and another 60,000 doses in the federal retail pharmacy program. 

That will bring the state’s allotment up to 275,000 doses, accounting for doses from all three vaccine manufacturers.

After next week, the state’s allocation will drop down to 150,000 doses a week and stay there until the week of May 3, Allen said. At that point, it will rebound to about 230,000 doses if the Johnson & Johnson supplies come back online, Allen said.

County Vaccination Rates Uneven

Overall, about 1.2 million of Oregon’s 4.2 million residents have received at least one dose of the vaccine. That’s about 28% of the overall state population. 

Children under 16 cannot get the vaccine, although manufacturers have trials underway and a vaccine for children could become available as early as this fall.

In March, Oregon focused the bulk of its efforts on vaccinating senior citizens. As it stands now, about 70% of seniors 65 and older are vaccinated statewide. However, rates in some counties are much lower than others, which concerns officials because demand is softening, Allen said.

For example, less than half of senior citizens are vaccinated in seven counties: Douglas, Gilliam, Grant, Lake, Malheur, Morrow and Umatilla. In comparison, eight counties exceed the state’s 70% average vaccination rate among seniors:  Benton, Deschutes, Hood River, Lane, Lincoln, Multnomah, Polk and Tillamook.

“I want to encourage every older adult who’s waited to get vaccinated to make an appointment today,” Allen said, adding that the state will support county vaccination efforts and outreach to boost participation.

Of the nearly 2,400 Oregonians who have died of COVID-19, some 91% were 60 or older, state data show.

Oregon Concerned About Its Vaccine Share 

Officials said they are concerned and trying to get more information from the federal government about its state-by-state vaccine allotment. They worry that Oregon may not be getting its share, in proportion to its population. But they stopped short of calling it unfair. The federal government controls all vaccine supplies, sending most directly to states for redistribution to providers and agencies that perform the vaccinations, but also directing other supplies to pharmacy chains, military bases, American Indian tribes, and the Veterans Administration. Allen said the distribution of vaccine supply is complicated and not a “straight per capita” system. 

“We’re concerned about the number  of doses we’re receiving,” Allen said, adding that the state has asked questions of the White House and Centers for Disease Control & Prevention to learn more about the formulas for allocating doses. 

Brown said Oregon’s congressional delegation and the state’s relationship with the Biden-Harris administration will help if they discover a problem.

“We will move heaven and earth to make sure we are getting our fair share,” Brown said, adding that she is sure the state will “get this matter resolved quickly.”

Washington State Rollout

Washington state is making everyone eligible for the vaccine on April 15. Washington, with a population of 7.7 million, has administered 3.7 million doses statewide. Like other states, Washington had a phased approach with priority groups up to this point.

“The federal government said vaccine allocations will continue to increase,” Washington State Department of Health officials said in a news release. “This, combined with continued hard work from our providers across the state to get shots in arms, has allowed the state to open eligibility sooner than expected to help us stop the spread of the virus.”

Side-by-side comparisons show that Washington state has administered slightly more doses on a per-capita basis than Oregon, CDC data show. 

Oregon’s rate is 46,023 doses per 100,000 people. Washington state is at 49,185 doses per 100,000, federal data show.

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

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