Oxford Town Clerk Elizabeth Olsen outside the first stop of the state's new mobile COVID-19 vaccination unit at Oxford Casino on April 12, 2021. Credit: Patty Wight / Maine Public

Maine launched its first mobile COVID-19 vaccine clinic on Monday morning, marking a shift from directing relatively few doses to large sites to trying to fill gaps in access across the state less than a week after everyone 16 and older became eligible.

The federal-state partnership is one of the more significant developments in Maine’s vaccination effort, which has largely sent doses to established providers like hospitals to date. The two-month roving clinic will send one-dose Johnson & Johnson vaccines to some poorer and more remote areas where people may struggle to get shots relative to other areas.

Rural health experts said the clinics represent an important shift in priorities with more than one-third of Mainers fully vaccinated as of early Monday, although more flexible options may be needed to reach those in remote areas before the state’s goals are realized.

“We have every confidence that this will be one of the things that will be remembered as a positive as we turn the corner to beat this horrible pandemic,” Paul Ford, the regional administrator for the Federal Emergency Management Agency, said at a Monday press conference outside the Oxford Casino clinic.

The sites will be able to provide at least 250 one-shot doses each day and will be jointly operated with FEMA staff, although Robert Long, a Maine Center for Disease Control and Prevention spokesperson, said the site had 1,650 appointments scheduled for the week. The clinic’s schedule is subject to change, but the state is currently projecting it will remain in place for about five days in each place with a day in between before moving to a new location.

The route begins in western Maine and is set to go through Windham, Biddeford, Fryeburg, Turner, Waterville, Old Town, Milbridge, Calais, Madawaska and Auburn. Those areas were chosen because they have high federal vulnerability indicators such as poverty and lacking access to reliable transportation.

That criteria will not always take the clinic through areas where vaccinations are lacking. Its route will go through Androscoggin and Oxford counties, where the rate of fully vaccinated adults is relatively low at just over 20 percent. But it will also travel through Washington County twice, which is leading the state with 34 percent of people having received final doses.

It was not clear how many people scheduled to be vaccinated were from Oxford County, which has 10 vaccination sites included in the state’s list of locations. Long said the state contacted Oxford County residents who signed up to get a shot through its website first before promoting the clinic to those in nearby Androscoggin and Cumberland counties and the rest of the state.

Ann Marie Day, the executive director of the New England Rural Health Association, said incorporating a mobile clinic shows the state has moved past having to be solely focused on vaccinating its most vulnerable residents and working on filling gaps. Two-thirds of those having received their final doses are over the age of 60, according to state data.

These sites may not work for everyone, she said, as most will likely require some kind of transportation. But Day said they could be the difference between someone having to arrange transportation to a site hours away, a trip she has heard people making near where she lives in the Biddeford area if they get an appointment in Bangor.

“It’s not going to reach everyone and everywhere, but it’s a start,” she said about the clinic’s planned route.

Meeting people where they are has been a large part of Penobscot Community Health Center’s vaccination efforts since it started receiving vaccines. Noah Nesin, the chief medical officer for the Federally Qualified Health Center, said it has done more than 60 clinics outside of its main locations including senior and low-incomes housing locations and social service agencies.

Nesin said those efforts are critical to the center delivering all of its roughly 2,500 vaccines it gets weekly through the federal government, because its brick-and-mortar locations would not be able to handle that many people. But he said the state needs to invest in even more flexible options if it wants to close vaccination gaps.

Nesin pointed to efforts like drive-thru clinics or allowing providers to go into places like schools and colleges to vaccinate people directly. Those efforts would target less vulnerable people, but go a long way toward vaccinating young people driving the national increase in new cases.

“The more ways we go at this, the more multifaceted it is, the better,” he said.