Maine changes vaccination plan to comply with Biden directive

Peter DiPietrantonio, DO, receives a COVID-19 vaccine at Mid Coast Hospital’s vaccine clinic at Brunswick Landing. Photo courtesy of Mid Coast Hospital

Maine will expand vaccine eligibility to all adults on May 1 to align its COVID-19 immunization strategy with a directive from President Biden.

The state is currently taking an age-based approach, with those 60 and older eligible for vaccines. Eligibility will expand on April 1 to include residents 50 and older.

On May 1, all adults will be eligible for vaccination. Before the new directive from the Biden administration, Maine was slated to vaccinate those 40 and older starting in May.

The accelerated timeline will strengthen protection for Mainers against the deadly virus. But it also will pose challenges for the state, which already has grappled with confusion over vaccine registration systems; competing demands for priority among population groups, and concerns about racial and geographic equity in obtaining inoculations.

“With the Biden administration promising to increase the supply of vaccine in the next few months, we will do what we had always hoped we could: accelerate our vaccine timeline,” Gov. Janet Mills said in a statement Friday.

“As the Biden administration works to get us shots, we will continue our work to get them into arms,” Mills said. “The future is getting brighter, but there is more to do – and my administration will continue to work with the president and with health care providers across the state to get people vaccinated and move us closer to getting back to normal.”

Jeanne Lambrew, Maine’s health and human services commissioner, said in a statement that getting vaccines administered “quickly, efficiently and equitably as possible will put our state on a path to recovery.”

“While we must all remain vigilant against this virus, these additional doses on the horizon bring the hope of a healthier Maine summer,” Lambrew said.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said in a statement that mass vaccination clinics and partnerships with hospitals, pharmacies, doctor’s offices and other inoculators will prepare Maine to “be ready when larger allocations arrive in the state.”

While increased vaccine doses starting at the end of March or early April will help match supply with demand, the vaccination rollout since the first doses started arriving in Maine in late December has experienced some rough patches. Many seniors, especially when supplies were lower in January and February than they are now, complained of difficulties in making appointments.

Maine was slower than other New England states to announce a detailed vaccination strategy for groups younger than 70, and was criticized by some for an entirely age-based strategy that did not prioritize high-risk health conditions or essential workers. And Maine still does not have a centralized online booking system, although Shah said on Thursday to expect one “soon.” Biden said a federal website also will help people find the nearest place to get vaccinated.

There’s also wide geographic disparities. For instance, while Cumberland County has more than 25 percent of its residents receiving at least the first dose and Lincoln County 27 percent, Somerset County has only 15.5 percent of its population having received at least the first dose.

Despite Maine’s problems, it is among the states that are getting shots into arms fastest. Maine ranked eighth-highest among the states for the percent of the population receiving at least the first dose, according to the Bloomberg News vaccine tracker, at 23.8 percent on Friday. The national average is 19.9 percent.

Jeff Zients, the White House COVID-19 coordinator, said in a news conference on Friday that the Biden administration will employ several strategies to help quicken the rollout as more supply becomes available.

“Over the coming weeks, we will deliver vaccines directly to up to 700 additional community health centers that reach underserved communities,” Zients said. “We will work to double the number of pharmacies participating in the federal pharmacy program. We will make the vaccine available at more than 20,000 pharmacies across America.”

The Biden administration also is deploying 6,000 active-duty troops to assist in the vaccination effort, including at Federal Emergency Management Agency mass vaccination sites.

Meanwhile, Maine will be expanding its efforts in island communities, as well as in rural areas of Washington, Aroostook and northern Penobscot counties.

Maine changed its vaccination plans last week and began immunizing school staff of all ages after Biden told states they must prioritize teachers and other school employees to help schools offer more in-person learning. Maine was originally not going to deviate from its age-based initiative, although it was setting up dedicated clinics for teachers who met the age criteria.

Maine was slated to start vaccinating everyone 40 and older in May, and reach all adult age groups by July, but based on Biden’s order, announced in his prime time speech Thursday night, all adults will be eligible beginning May 1.

Mills said in a statement on Thursday night that she shares Biden’s goals to ramp up vaccination.

“I want every person in Maine to be vaccinated as soon as possible so that grandparents can hug grandkids, friends can spend time together and businesses can thrive again. While the Biden administration works day and night to increase the supply of vaccine, my administration will work day and night to get shots into arms so that come May 1 every Maine person will be eligible,” Mills said.

Stephen Kissler, a research fellow in the department of immunology and infectious diseases at Harvard University, said in a conference call with reporters on Friday that he believes increasing vaccine supply this spring combined with months of time to learn how to overcome logistical obstacles in distribution should make the May 1 goal achievable.

“Will it go totally smoothly? Certainly not,” Kissler said. “Lots of factors will lead to frustration and could lead to delays in accessing the vaccines. While I can’t guarantee it will go perfectly smoothly, I am confident we will be able to rise to the challenge.”

Kissler also is encouraged by the Biden administration’s goal to reach people who may not currently have easy access to vaccinations, such as minorities and other harder-to-reach populations. Kissler said the federal government seems to be committed to going into communities that traditionally have had less access to the vaccine, and not relying entirely on mass vaccination clinics.

“We have a long way to go make sure we are distributing the vaccine to communities who need them the most,” Kissler said.

Dr. James Jarvis, COVID-19 incident commander at Northern Light Health, which operates the mass vaccination clinics at the Portland Expo and Cross Insurance Center in Bangor, is concerned that Biden’s directive will have the unintended consequence of leaving behind minorities, immigrant communities and people who otherwise have difficulty navigating the system. But he said the Biden administration seems focused on equity, and state initiatives, such as free rides to COVID-19 vaccine appointments, will help improve access.

Aside from concerns about equity, Jarvis said that staffing is an issue, but the network has six weeks to plan, and the Mills administration is making it easier to train people to draw and administer vaccines, including allowing veterinarians and dentists to volunteer to help give shots.

“We’re eager. We want to put vaccines into people as quickly as we can,” Jarvis said. When fully operational, the Cross Insurance Center could vaccinate about 3,000 to 5,000 people per day, and the Portland Expo about 1,500 to 2,000 people daily.

John Porter, spokesman for MaineHealth, which operates mass vaccination clinics at Scarborough Downs and the former Marshalls store in Sanford, said the vaccination sites are ready to double capacity should supply increase. He said the logistics behind making the vaccines available to all adults in Maine would be a “good problem to have” because that means supplies would be plentiful.

“We built into the system a lot of capacity in anticipation of more supplies,” Porter said.

Maine reported 209 new cases of COVID-19 on Friday, the first time in a week that the daily case count climbed over 200. There were no additional deaths.

Since the pandemic began, Maine has recorded 46,650 positive cases of COVID-19, and 723 deaths. Currently, there are 74 people hospitalized with COVID-19 in Maine, including 25 in intensive care.

Through Friday, 302,301 Maine people had received at least their first dose of a COVID-19 vaccine, representing 22.49 percent of the state’s 1.3 million population. Also, 178,337, or 13.27 percent of the population, had received their final dose of vaccine.

Next week, the federal government will ship 34,020 doses to the state vaccination program, an increase of 520 doses from this week. In addition, the state will receive more doses through a federal retail pharmacy program that includes Walmart, Sam’s Club, Walgreens and Hannaford. Those numbers for the federal program are typically released Sunday or Monday, and for the last two weeks have been about 12,000 additional doses.

Maine should expect to receive about 46,000 or more doses next week, similar to the 45,150 doses this week, but less than the 55,060 doses the state received last week. The doses in recent weeks are more than double Maine’s weekly allocation of about 20,000 doses in early February.

Shah has said that he expects shipments of vaccines will substantially increase in the last week of March or early April, based on conversations he’s had with federal officials.

The bulk of next week’s doses – 28,950 of the 34,020 – will be sent to hospital systems. Shah said the mass vaccination clinics, such as at the Portland Expo, Scarborough Downs, Cross Insurance Center in Bangor, the former Marshalls in Sanford and the Auburn Mall starting on March 17, are one reason Maine is ramping up the pace of immunization. More mass vaccination sites are expected to open in the near future.