Steve Moody, director of nursing at Central Maine Medical Center, mops the floor of a tent outside the emergency entrance to the hospital where patients are tested for of the coronavirus Friday, March 13, 2020, in Lewiston. Credit: Robert F. Bukaty / AP

Maine’s biggest hospitals are working to determine which frontline workers should get the coronavirus vaccine first as a limited number of doses are expected to become available within days.

The state is expecting to get 50,000 doses of new Pfizer and Moderna vaccines by the week of Christmas after the U.S. Food and Drug Administration approved the first U.S. vaccine candidate from Pfizer late Friday. Moderna’s vaccine faces a hearing next week.

Approximately 12,675 doses will arrive in a first round with the state’s vaccine plan saying high-risk health care workers and those in long-term care facilities will be vaccinated first. Roughly 5,850 will go to hospitals in Portland, Lewiston, Augusta, Bangor and Presque Isle, with most of the rest going to long-term care facilities. Hospitals across Maine are expected to get 33,000 more doses in a second round of shipments once the Moderna candidate is approved.

State health officials chose the initial hospitals based on their ability to store the vaccines — which need extremely cold temperatures to remain viable — and their locations, aiming to spread the vaccines out as “equitably” as possible, Nirav Shah, director of the Maine Center for Disease Control and Prevention, said last week.

But the limited supply means hospitals must be judicious in how they vaccinate at first. Even the hospitals that get the vaccine first may not get enough initial vaccines to cover their entire frontline workforce, a relatively broad group that hospitals could prioritize differently as they look to preserve continuity of care with cases and hospitalizations due to the virus hitting highs.

The state plan puts high-risk employees into three categories: intensive care unit employees, the emergency department, and others, including those from respiratory therapists to home health staff. Those individuals, even if they are not attending to the sickest patients, may still be at risk if they frequently interact with people who have tested positive for the coronavirus.

Portland-based MaineHealth has released the most detailed plan. It will distribute nearly 1,900 vaccines first to people on intensive care unit teams, in the emergency department, on dedicated COVID-19 inpatient units and providing “critical and essential inpatient services not available elsewhere,” it said in a Friday news release.

Hospitals that have seen the highest number of coronavirus patients will be prioritized, according to the plan. While the Maine CDC says Maine Medical Center will get all of MaineHealth’s initial doses, the health care group has indicated some of those will also go to Southern Maine Health Care in Biddeford and Mid Coast-Parkview Health in Brunswick.

“We are all anxious to put this pandemic behind us,” MaineHealth Chief Medical Officer Joan Boomsma and CEO Bill Caron said in a message to staff, but they also warned coronavirus-related precautions would have to remain in place as cases continue to climb.

Based on federal guidelines, state health officials have recommended that hospitals give initial vaccine doses to frontline workers at the greatest risk of exposure to the coronavirus, either because they treat infected patients or have other exposures, Shah said Friday.

Those federal guidelines include prioritizing the vaccines for providers who work within 6 feet of other people, who have direct patient contact and who work in residential care or long-term care settings. The guidelines also allow for providers who have already been infected with COVID-19 within the last 90 days to delay their vaccination until near the close of that three-month period.

Still, many hospitals that will be receiving vaccines first are still working out how they will distribute it.

Suzanne Spruce, a spokesperson for Northern Light Health, an organization with several hospitals across northern, eastern and central Maine as well as one in Portland, said “front line employees” who interact with patients will be first in line in the first round of vaccinations at Northern Light Eastern Maine Medical Center in Bangor and Northern Light Mercy Hospital in Portland and Northern Light A.R. Gould Hospital in Presque Isle.

In Lewiston, Central Maine Medical Center is due to receive 475 doses from the initial allocation of the Pfizer vaccine. Of the hospital’s 1,180 workers, 150 are considered to be at high risk for coronavirus exposure because they work in the emergency room, an intensive care unit or other settings, according to the state’s vaccine distribution plan. Its two affiliated hospitals in Rumford and Bridgton each have another 34 high-risk workers.

Dr. John Alexander, the chief medical officer at the parent group of those three hospitals, Central Maine Healthcare, was not able to offer a specific breakdown of how the initial vaccine allocation would be distributed across its hospitals and workers.

But he said the organization will be coordinating with the parent of another Lewiston hospital, St. Mary’s Regional Medical Center, “to ensure that frontline caregivers at both of our organizations are protected” to maintain care for “residents who are most affected by the pandemic, underserved, experiencing homelessness or are people of color.”

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