Nirav Shah, director of the Maine Center for Disease Control, is pictured on Water Street in Augusta on Sept. 10. Credit: Natalie Williams / BDN

Some health care workers not employed by hospitals will begin to get coronavirus vaccinations next week as independent providers jockey for priority alongside their colleagues, Maine public health officials said Thursday. 

Independent practitioners and outpatient providers will begin to see vaccinations next week, said Nirav Shah, director of the Maine Center for Disease Control and Prevention. The former will be able to get their first dose through the hospitals where they receive care, with the state primarily asking hospitals to identify patients.

The agency has also begun offering vaccinations to health care workers outside of hospitals, with more than half of next week’s doses targeted at physicians and nurses at federally qualified health care centers and those who provide outpatient care such as dialysis and oncologists. Sites with more employees will get the vaccine first, while smaller clinics who may not have the staff sizes to use an entire shipment of either vaccine may have to wait a few weeks, officials said.

“The problem we are attempting to solve is that many of the practices are not of sufficient size to receive an entire shipment of vaccines,” Shah said.

The Maine CDC ordered an additional 17,000 doses of the vaccine, which would bring the state’s total capacity for vaccinations to 81,850 people in the first four weeks. That is 100 fewer total doses than expected, Shah said, but he did not know the reason for the reduction.

About 70 percent of those vaccines are going to hospitals, outpatient groups and emergency medical services, Shah said. The rest will be going to chain and larger independent pharmacies managing the long-term care facility vaccination program. Maine has finished vaccinating skilled-nursing homes, allowing the program to focus on other types of facilities.

Maine is also expecting to receive its second doses for the first wave of vaccinated health care workers next week, which will complete their vaccination process. It will take a few weeks for those people to build immunity to the virus, although it is still unclear whether the vaccines authorized for use block the coronavirus itself or just prevent symptoms.

The state began its first vaccination waves over two weeks ago by prioritizing health care workers in hospitals who have the most direct contact with COVID-positive patients. Skilled nursing home residents and staff were part of the second week, although distribution of those doses is handled by the federal government and a partnership with two major pharmacy chains. Maine has seen more than 27,000 confirmed first vaccinations as of Thursday.

Independent providers who test and regularly see sick patients — some of them in larger hospitals — have been frustrated by uncertainty about where they fall in the first wave. The state has given some leeway to hospitals to determine who they consider most at-risk, but hospitals have asked for more specificity on who they should include in their efforts. Shah has said those individuals should be part of the first wave, but has not said when and how they would be vaccinated.

The reduction in vaccine doses Maine and other states have seen has prevented Maine from being able to plot who gets vaccinated next beyond the immediate group being inoculated, Shah has said.

The state’s plan currently has two phases, with the first being broken into three smaller steps. Frontline health care workers and long-term care facility residents are first, followed by people over the age of 75 and frontline essential workers; and people ages 65 to 74, people ages 16 to 74 with comorbidities and underlying conditions and other essential workers.

The Maine CDC has estimated it could be weeks before the third step in the first phase is reached. Shah said the state expects to move to the second step of the first phase by the end of February, depending on how many vaccines it receives. The second separate phase, when the vaccine is expected to reach the general public, is projected to not start until the summer of 2021.

BDN reporter Jessica Piper contributed to this report.

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