RI health officials dive deeper into discussion on Phase 2 vaccine prioritization

Coronavirus
12 on 12: Vaccine 101

PROVIDENCE, R.I. (WPRI) — Over a month into Rhode Island’s COVID-19 vaccine distribution, a state subcommittee is continuing discussions for who will be vaccinated in the next phase.

Friday morning, the Rhode Island COVID-19 Vaccine Subcommittee held its twelfth overall meeting, and sixth since the first vaccine was approved by federal regulators, and dove deeper into a discussion on the state’s Phase 2 population, which has not been finalized yet.

The R.I. Department of Health provided a prioritization proposal for the Phase 2 population, which it noted would be primarily based on age, with accelerated distribution in the most vulnerable groups and individuals with health conditions known to put them at risk.

The prioritization would begin with adults ages 65 to 74 (adults 75 and older are in Phase 1), then those with high-risk conditions in Rhode Islanders aged 16-64, with older residents going first, followed by individuals without high-risk conditions based on age.

The subcommittee noted how geography would be considered across every phase as well, in order to address equity concerns.

McKenzie Morton, who facilitates the subcommittee meetings, said the goal was to focus on individuals living in high-density communities.

“Are they going to have enough pharmacies? Are they going to be enough vaccination sites in those communities to make that everyone has equitable access, regardless of where they live,” Morton said.

Morton said the health department also collected data on hospitalization from all adult COVID patients in Rhode Island, and noted the admission rates based most prevalent pre-existing conditions.

“Renal disease, cardiac disease, lung disease and diabetes really stood out in the state of Rhode Island as the highest risk of the high-risk conditions,” Morton said.

Immunocompromised, hypertension, obesity and hypercholesterol were listed as the next highest pre-existing conditions.

Last week, subcommittee members and members of the public provided feedback and comments on populations they believe should be prioritized to get the vaccine, including caretakers of those living with ALS, or people living with Type 2 diabetes.

However, notably absent from the prioritization proposal was consideration by occupation.

The state previously identified about 220,000 potential frontline essential workers that didn’t qualify for Phase 1 — the biggest includes roughly 36,000 in the education sector.

Subcommittee member and superintendent of the Bristol Warren Regional School District, Dr. Jonathan Brice, again advocated on behalf of school staff to specifically be prioritized in Phase 2.

RIDOH Director Dr. Nicole Alexander-Scott said she believes the proposal already includes teachers who are considered most at risk, without needing to make a specification by career.

“When you look at just high-risk condition alone and age, we cover almost 50% of teachers using that categorization,” Alexander-Scott said.

“When you add geography, which was brought up and has been something that we are considering, it puts us at over 50%,” she continued.

The state is currently receiving about 14,000 first doses each week, meaning roughly 1.4% of the state’s population can be vaccinated weekly if supply does not increase.

State officials said Friday they did not expect the vaccine supply to change dramatically in the near future, but were optimistic about the proposed strategy of reaching the next phase of Rhode Islanders quickly.

“A strategy like this will allow us to put out very simple messaging that shows when we expect based on our current supply, where different age groups would fall, and allow people to say, ‘OK, I understand that my age group will likely fall in May, unless more vaccine becomes available,” Department of Human Services Director Courtney Hawkins said, noting the frustration being felt by some residents.

“This strategy, in addition to achieving public health goals, checks the operational and communication boxes that we were really seeking to achieve,” Hawkins said.

Before next week’s subcommittee meeting, health leaders plan to finalize Phase 2 based on input from Friday’s meeting.

Health leaders are tasked with creating an operational plan for Phase 2, including planning for additional volume if the federal government supplies more than the state’s current expected allotment.

The latest meeting of the subcommittee comes amid a probe of the R.I. Attorney General’s office, who announced it is examining whether the state’s distribution of vaccines has resulted in any legal violations, as hospitals recently expanded eligibility to include people who don’t work directly with patients.

The inquiry, which a spokesperson for the office said is “not an investigation,” comes in the wake of news that the state’s largest hospitals started offering vaccines to some low-risk people with varying levels of involvement at the facilities. The group includes board members, trustees, administrators, people working remotely, and many others who don’t interact with patients.

Thursday, both hospital networks responded further about the criticism.

Care New England President and CEO Dr. James Fanale — whose hospital network includes Kent, Butler and Women and Infants — pushed back on the scrutiny and criticism, saying the board members who received vaccines at his organization are volunteers and thus eligible.

Lifespan spokesperson Kathleen Hart said Thursday the hospital prioritized staff and providers at the highest risk before “receiving clearance a couple of weeks ago” to offer shots to others, such as board members.

“Every employee is important to the operations of the system,” Hart said in a statement.

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