A state committee responsible for recommending the order of coronavirus vaccinations issued its first list Thursday, suggesting the state should prioritize people of color, refugees, adults under 65 with chronic health conditions, frontline workers, people living in multi-generational homes and those living in low-income senior housing.
The recommendations, which will be revisited next week once the state has a chance to analyze them, came after a rushed two-hour meeting that left many members’ questions unanswered.
The committee did little to whittle down groups under consideration, with a working list that could exceed over 1 million people if the group doesn’t make reductions.
With additions and edits up until the last minute, the process reflected not only the state’s urgent need for guidance but also the complex task facing the committee.
It is facing a slew of challenges, including insufficient time to answer everybody’s questions and concerns, a steep learning curve, no actual power and shifting state promises.
“We’re running up against time,” one advisory member, Marin Arreola, said during the Thursday meeting, responding to another member’s concern about the practicality of issuing recommendations during a vaccine shortage. “I don’t want to wait another week.”
The Oregon Health Authority decided months ago that as part of its effort to fight “systemic racism and oppression” it would ask for help from a diverse 27-member group, comprised of people in a position to better understand the needs, concerns and fears of those Oregonians disproportionately affected by the pandemic.
Those include Pacific Islanders, Latinos and African Americans, whose infection rates have exceeded those among whites many times over. It also includes people with intellectual and developmental disabilities and the Slavic community.
The group’s goals are lofty, part of the state’s long-term plan to reshape health care to better serve populations marginalized over generations. Health disparities are believed to have contributed to people of color’s significantly higher coronavirus infection rates.
“We know that structural racism impacts the lives of BIPOC people holistically,” member Aileen Duldulao said. “It’s also insurance, who’s covered by health insurance, who has access to health care, who has the patient provider relationship, who experiences racism in that relationship.”
Gov. Kate Brown and state officials have gradually chipped away at the scope of the committee’s capacity ever since it was formed.
First, Brown declared that Oregon’s educators should be next in line after health care workers and senior care residents and staff. Then, the state decided to vaccinate prisoners to stave off a lawsuit. Finally, Brown said this week that Oregon will follow the federal government’s recommendation that all people 65 and older be eligible for vaccinations.
That means that nearly one third of Oregonians could be vaccinated before the committee’s recommendations make an impact, assuming the state follows them.
“What exactly is this group being asked to prioritize?” one committee member asked the state.
It’s unclear when the state will get through the approximately 500,000 people eligible now and the 850,000 or so additional people who will be eligible starting Jan. 23.
As of Thursday, nearly 120,100 Oregonians have received one shot, and 13,000 have received two. Oregon hopes to soon consistently vaccinate 12,000 people per day. But even at that rate, it would be mid-April before the state’s priority groups are immunized.
The uncertainty was on full display Thursday, when a committee member representing people with intellectual and developmental disabilities asked the state to promise it would follow through with the committee’s recommendations.
“I just want to make sure that we have, moving forward, a commitment from the Oregon Health Authority that when this Vaccine Advisory Committee acts and says who is in the next phases, that you will implement this, with partners, in a way that makes that real,” said Leslie Sutton, executive director of the Oregon Council on Developmental Disabilities. “Because otherwise, we are providing empty hope to people that need it most.”
Rachael Banks, director of the health authority’s public health division, responded instead to Sutton’s concern that people with disabilities have already had tremendous difficulty getting access to coronavirus vaccines, acknowledging certain problems and committing to keep working on improving access.
Banks’s boss, health authority Director Patrick Allen, has said his agency will follow the committee’s recommendations “short of saying that we should do something illegal.”
But a health authority spokesman said Thursday the agency can’t guarantee what Brown ultimately decides to do.
“OHA certainly wants to follow (Vaccine Advisory Committee) recommendations,” Jonathan Modie said. “But we cannot speak for the Governor’s Office in whether it will accept the recommendations.”
The full list of populations to be prioritized for vaccinations that the committee agreed to send the health authority for analysis included: African Americans, Hispanics, Latinos, Latinx, Indigenous, Native Americans living in cities and within tribes, Pacific Islanders, refugees, people 16 to 64 years old with chronic health conditions, people eligible for vaccines who are in jail or prison, frontline workers who weren’t already eligible, people in multi-generational homes and people under 65 living in low-income senior housing or other congregate care settings.
The committee will meet again Tuesday to get more information from the health authority, then will meet Thursday to hear the results of the agency’s analysis of the recommendations.
— Fedor Zarkhin
email@example.com; 503-294-7674; @fedorzarkhin