Central Maine Medical Center Director of the Pharmacy Bruce Campbell places newly arrived COVID-19 vaccine made by Pfizer in St. Mary's Regional Medical Center's ultra cold freezer, Tuesday, Dec. 15, 2020, in Lewiston. Credit: Andree Kehn / Sun Journal via AP

AUGUSTA, Maine — Several hospitals in central and western Maine are seeing staff vaccination rates lower than the corresponding rate for the adult population here, opening them to a higher risk of outbreaks and reflecting the challenges of vaccine hesitancy.

The hospitals with fewer staff vaccinated are largely in regions of the state with lower overall vaccination rates. Seven hospitals spread across Oxford, Somerset, Kennebec, Androscoggin, Franklin and Piscataquis counties saw less than 65 percent of employees fully vaccinated as of the end of May. At the time, just more than 65 percent of Maine adults were fully vaccinated.

In those settings, the numbers come as a stark reversal of trends as Maine’s overall vaccination rate is among the highest in the nation. Health care workers had been eligible for the vaccine for more than five months at the end of May while the general population had been eligible for seven weeks. Providers pointed to vaccine hesitancy as the primary challenge and said they are continuing to work on education with hope of increasing rates.

At Central Maine Medical Center in Lewiston, the state’s fourth-largest hospital, 58 percent of staff were fully vaccinated, according to state data, which is roughly equal to the share of eligible people who are fully vaccinated in Androscoggin County. Hesitancy has been relatively high in that area since the pandemic began, said Dr. John Alexander, chief medical officer for Central Maine Healthcare, which runs CMMC and two smaller hospitals.

Alexander said the vaccination rate at CMMC was probably slightly higher than the state data showed because employees were not counted as vaccinated if they got their vaccine independently. But he said the hospital was still working to educate employees about the benefits of vaccination, particularly with the recent rise of the delta variant, a more contagious and deadly strain that is still blocked by vaccines.

“We’re doing everything that we feel we can right now to educate and inform, and at the same time keeping all of our strict prevention protocols in place in terms of screening and protective equipment,” Alexander said.

St. Mary’s Regional Medical Center, also in Lewiston, reported the lowest vaccination rate of any Maine hospital at 52.6 percent, although spokesperson Steve Costello said figures initially reported to the state included a range of people including inactive student volunteers, and that the staff vaccination rate would rise to about 65 percent when they were excluded.

Some rural hospitals have been more successful in vaccinating employees. Millinocket Regional Hospital has the highest vaccination rate of any facility, with 92.3 percent of its staff members fully vaccinated. Bridgton Hospital in outer Cumberland County, which is part of the Central Maine Healthcare system, had vaccinated nearly 84 percent of its employees. Among large hospitals, Maine Medical Center in Portland had the highest rate at 81.2 percent.

The only way to eliminate risk of COVID-19 outbreaks in health care facilities would be with a 100 percent vaccination rate, said Peter Millard, a physician and former U.S. Centers for Disease Control and Prevention epidemiologist. Vaccinating health care workers, he noted, lowered the risk of disease for older or immunocompromised people who may be vaccinated but not have the full protective benefits.

“The first priority needs to be the safety of the patient,” Millard said.

Recent outbreaks at hospitals have not necessarily hewed to vaccination rates, although an outbreak at St. Mary’s in May infected five staff and two patients, according to the Maine CDC. Costello said the staff who tested positive during that outbreak were unvaccinated, but the original source of the infections was not known.

More than three-quarters of staff are fully vaccinated at Northern Light A.R. Gould Hospital in Presque Isle, where an outbreak infected 13 people in the last month, including at least four unvaccinated workers. Three other Maine hospitals — Charles Dean Memorial in Greenville, Northern Light Eastern Maine Medical Center in Bangor and the Togus VA Medical Center outside of Augusta — have seen coronavirus outbreaks since the start of May, according to the Maine CDC. The latter two only saw staff infected, not patients.

Millard said he thought hospitals should mandate vaccinations for patient-facing workers, as some providers in other states have done, though some have encountered backlash. More than 150 workers in Texas quit or were fired this week after a judge threw out a lawsuit from employees arguing a large hospital system should not be able to require vaccinations.

The Maine State Nurses Association pushed back on a proposed regulation last fall to require health care workers to get a yearly flu shot, saying the rule would make it harder for providers to retain staff. Health care workers in Maine are required to be vaccinated against measles, mumps, rubella, chickenpox and hepatitis B unless they have a medical exemption.

Nirav Shah, director of the Maine Center for Disease Control and Prevention, declined to speculate on the reasons for the low rates Wednesday but characterized them as “concerning” and said the state has discussed vaccine requirements for health care workers but planned to work with providers to increase vaccinations in the coming weeks.

“I’d rather start with the carrot, rather than the stick,” he said.

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