Gov. Janet Mills speaks at a news conference alongside Nirav Shah, the director of the Maine Center for Disease Control and Prevention, on Thursday, March 12, 2020, in Augusta. Credit: Robert F. Bukaty / AP

AUGUSTA, Maine — Groups jockeying for coronavirus vaccine priority say Maine should be more clear about how it is making those decisions as the state refrains from making future commitments.

The state has not said who will be eligible in a coming “critical frontline worker” phase of vaccinations, the third part of Phase 1B in the state’s plan. Decisions are in the hands of Gov. Janet Mills, who has chosen to vaccinate Mainers aged 70 and older after an initial phase for health care workers and long-term care facility residents and workers. 

The federal government has said anyone from food and grocery workers to daycare employees could fall into the next broad category, but states have significant leeway. Representatives from various groups have been in communication with the state and are occasionally consulted by public health officials, according to Maine Department of Health and Human Services spokesperson Jackie Farwell. 

That department and the Maine Center for Disease Control and Prevention make recommendations to the Democratic governor. Maine officials have said that the limited national vaccine supply is keeping it from making decisions now on who should be included in next steps. Officials say they want to protect the most vulnerable while following federal guidelines

But other states have been more explicit about how they will prioritize groups and many interest groups lobbying for access say the state not providing that hierarchy or further fleshing out how vaccine decisions are being made is causing confusion and frustration among Mainers.

“It’s not clear to me how the state is making those decisions,” said Lori Parham, the state director for AARP Maine. “I think there is an opportunity to try and coordinate across groups, so older Mainers can get the help they need.”

Parham said the state has been good about communicating with her organization when asked, but finds members who are unclear about where they fall in the process, particularly if they do not watch twice-weekly state media briefings. There needs to be “overcommunication” on vaccines, she said, because there is “confusion and fear” about when people will get their turn.

The timeline for vaccinating teachers has been hotly debated as schools periodically go remote if cases are detected. Federal health officials have said teachers do not need to be vaccinated for schools to reopen. A Kaiser Family Foundation analysis found that teachers are currently eligible for vaccination in 23 states and three counties across the country.

These hierarchies vary between states. In neighboring New Hampshire the group will fall at the top of the state’s second phase, anticipated to begin in March. In Hawaii, the group is already getting vaccinated. The Maine Education Association is calling for teachers to be vaccinated as soon as possible.

Other groups have also requested priority, Farwell said, including groups representing TSA employees, staff at Federally Qualified Health Centers, vulnerable seniors, primary care providers, jails and prisons, food and beverage employees and people with disabilities who live in congregate care settings.

For example, Brad Sawyer, a spokesperson for the Maine Rural Water Association, said he reached out to the state in December about moving water and wastewater employees up in the timeline from a tentative position in Phase 1C to the current phase. 

Maine Center for Disease Control and Prevention Director Nirav Shah said last Tuesday those workers, while critical, are not among the most at risk. Sawyer said his group has not gotten further explanation as to what makes them less at risk. 

“They’re frustrated and feel they’re being left out because they know the work they do is critical,” he said.

Rep. Michele Meyer, D-Eliot, who co-chairs the Legislature’s health committee, said she is often contacted by constituents concerned about their priority status, including home care workers, hair salon owners and food pantry workers. 

There is “definitely” a need for clarity around priorities, Meyer said, but she added that supply is a serious barrier for the state and the CDC has been open about its process to lawmakers. She said she hopes to have Shah speak before her committee weekly going forward.

“It does matter [who is prioritized],” she said, “but it is hard to make everyone understand just how little vaccine we have.”

In addition to receiving input from interests, Farwell said the state meets with an internal work group comprised of hospitals, other providers and pharmacy members who have vaccine provider agreements with the state. That group does not make policy decisions or recommendations, but it helps coordinate the state’s vaccine plan. The group appears to meet weekly, according to a state website, but meetings are not noticed in advance. Farwell did not provide more specific information on who participates in the group.

Limited supply of vaccines is not the only thing that can affect the state’s distribution plans, Shah said during a Tuesday press briefing. The introduction of new vaccines, such as Johnson & Johnson’s proposed one-shot vaccine, could affect critical aspects of distribution and allow the state to increase supply or target populations difficult to schedule for second doses.

“If that vaccine is authorized and it starts arriving in states in sufficient quantities, that’s not a game-changer,” he said. “It’s just a different game altogether.”

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