The lack of clarity about vaccine launches is confusing in Maine

As limited supplies of COVID-19 vaccines head to Maine, hospitals and other health care providers are confused about who can be inoculated now and when the eligibility fund will expand under the state’s changing vaccination plan.

Officials at MaineHealth, which operates one of the state’s largest hospital networks, said they were seeking additional guidance from the Maine Center for Disease Control and Prevention on whether they should vaccinate non-health workers. from the MaineHealth system. Company officials are also seeking information about Maine’s CDC plan to distribute vaccines to out-of-hospital health care providers.

MaineHealth spokesman John Porter said Tuesday that while the current focus is on vaccinating front-line staff, such as the emergency room and COVID workers, the company anticipates that it will have to make decisions. in the near future regarding the unemployed, such as private practitioners, therapists and doctors with admission privileges.

“We are working with the CDC,” Porter said. “We want to make sure we do it right and do it efficiently and effectively.”

Private practitioners working with patients at risk for serious complications from COVID-19 are also seeking guidance – and reassurance – from both the Maine CDC and the hospital networks that administer this first wave of vaccinations.

Dr. John Paul Winters, a hematologist / oncologist at New England Cancer Specialists in Scarborough, said many of the staff at the cancer treatment clinic have a lower risk because of age and relative health. But Winters said “what keeps you awake at night is that you can become an asymptomatic carrier and transfer the virus to one of your cancer patients.”

Doctors and nurses often spend an hour or more in small patient rooms, and staff in the “infusion room” have close personal contact with patients when administering treatments to fight cancer and other diseases.

“Because we’re in a private cancer practice, we may not be in the forefront of caring for COVID patients in a (emergency department) or in intensive care,” Winters said. however, we are not able to practice telemedicine much. We are practical and our patients are very ill. “

Dr. Nirav Shah, the CDC director in Maine, said Monday that he is aware of at least one health care system that administers vaccines to employees working at the company’s locations. However, he acknowledged that they do not yet have explicit guidelines on vaccination of non-employed healthcare providers.

The Maine-specific vaccination plan is changing in response to evolving federal guidelines based on vaccine availability and the latest pandemic science. An interim draft plan posted on Maine’s CDC website in October is now partially outdated, as health officials have since adopted multi-phase vaccination plans proposed by the U.S. Centers for Disease Control and Prevention.

For example, the Maine CDC added residents of long-term care facilities to the first phase of its vaccination plan in response to federal guidance. In the latest adjustment, Shah said Monday that Maine will follow a federal advisory committee’s recommendation to include people 75 and older, as well as “essential” front-line workers in the next phase of vaccinations.

This means that tens of thousands of teachers, police officers, correctional officers, grocery store workers and postal employees could be eligible for vaccination as early as late January or early February if vaccine supplies and federal distributions keep up.

CDC Maine spokesman Robert Long said Tuesday that the agency largely complies with federal recommendations for the current administration of the vaccine during what is known as Phase 1A. Phase 1B would involve employees aged 75 and over and essential non-health workers, while Phase 1C would include those aged between 65 and 74, younger people with high-risk medical conditions. and other essential workers.

In these scenarios, the rest of the general public in Maine may not be eligible for vaccines until late spring or early summer.

Long said the CDC in Maine is waiting for the Immunization Advisory Committee to finalize the recommendations approved Sunday, including a proposal to move people 75 and older to a higher priority category.

“Until more clarity comes from them, we will continue to focus resources on obtaining available doses of vaccines for groups in phase 1A,” Long said. “We also want to make sure that manufacturers can deliver full vaccine orders consistently in Maine before making further adjustments to the state’s vaccination plan.”

The rapidly evolving situation and changes to the multiphase vaccination plan have led to confusion among health practitioners as well as the general public. Many employees, especially those over the age of 60 or with health conditions that put them at higher risk of death from COVID-19, have contacted doctors, police stations, fire departments and the media. wondering when and how they can be vaccinated.

Maine Health’s request for clarification appears to stem from confusion over who would be responsible for vaccinating private office workers and other employees outside of large hospital networks.

During a Monday afternoon briefing, Shah said the Maine CDC “asked hospitals to do what I think is the right call, given the risk to employees or health care providers” at COVID. 19.

While Shah said the CDC in Maine needs to provide hospitals with more uniform guidance, he added that the agency is “in mass vaccination mode right now” focused on vaccinating everyone in Maine as soon as possible. Shah suggested that the agency would not issue granular guidance, specifying, say, how many hours or patients a provider must register to qualify for a vaccine.

“If I’m a health care provider who meets patients in that unit, we need to keep our health care system healthy and have those people vaccinated,” Shah said.

Victoria Foley, director of marketing and communications at New England Cancer Specialists, said administrators at Portsmouth Regional Hospital in New Hampshire have already contacted her group’s local office to let them know they will be contacted when the vaccines become available. Foley said she is optimistic, based on ongoing discussions, that MaineHealth will be able to include Maine offices in their immunization plan for health care workers.

“We are very pleased to hear that there is a discussion about how private practices and private practice physicians will be incorporated into the vaccination program,” Foley said.

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