Maine’s plan to distribute vaccine stresses racial equity, health care workers and the elderly

Maine’s system for distributing an eventual COVID-19 vaccine will prioritize racial equity and protecting health care workers and the elderly, according to a plan the state submitted to the federal government on Friday.

If there’s a sufficient supply, Maine says it would have the capacity to vaccinate 80 percent of the state’s 1.3 million people within 12 weeks of when a vaccine becomes available.

When fully ramped up, Maine would be giving about 130,000 shots weekly, according to the plan released by the Department of Health and Human Services on Friday. Giving most Mainers their COVID-19 shot will be a massive undertaking that will involve thousands of health care workers, state agencies, all of Maine’s hospitals and health care networks, pharmacies, public health nurses, schools and workplaces.

“Here in Maine, we are planning for the arrival of a COVID-19 vaccine, whenever that might be,” Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said during his Thursday news conference. “Right now, we don’t know when that might be. But the day a vaccine is approved will not be the day COVID-19 comes to an end. It won’t make COVID-19 magically disappear overnight. Vaccines take time.”

No vaccines have yet been approved, but several are in late-stage trials, including vaccine candidates being developed by Massachusetts-based Moderna, Inc. and New York’s Pfizer, Inc. A vaccine could possibly be approved by the Food and Drug Administration as early as late November, but it would take at least several more months before the vaccine would be widely available.

The U.S. Centers for Disease Control and Prevention required each state to file by Friday a distribution plan outlining how it will get a vaccine from a manufacturer to doctors’ offices and into patients’ arms.

“Maine is committed to working with the health care sector and stakeholders across the state as we plan for the receipt and distribution of a vaccine when one becomes available,” Gov. Janet Mills said in a statement. “While there is work to be done, the submission of this document represents a positive step forward. My administration will continue its collaboration with others as we build on our state’s COVID response and plan for an eventual vaccine.”

According to the 77-page plan, the strategy focuses on equity – because Maine’s minority communities and those with certain health conditions have been disproportionately affected by COVID-19 – accessibility and flexibility. State health leaders say the plan needs to be flexible so it can be adapted to work with the vaccine that makes it to the finish line first. For instance, some vaccine candidates need cold storage and two doses.

“Distribution will present a challenge because at this time we don’t know which of the vaccines in development that ultimately receive approval will have heat stability,” Shah said. “Will they require a minus 70 degree freezer, or a normal freezer?”

Shah said that’s just one of the distribution challenges, but nevertheless, they are working out scenarios based on the vaccines currently in late-stage trials.

Maine’s minorities make up about 5 percent of the state’s 1.3 million people, but 25 percent of the COVID-19 cases. The pandemic has sickened more than 5,800 people in Maine and claimed 145 lives.

“Racial and ethnic minorities have experienced rates of disease that far exceed their representation in the population as a whole. Other groups, such as seniors and people with serious chronic medical conditions, have also been disproportionately affected. The plan includes strategies to ensure these groups are successfully vaccinated,” the Maine Department of Health and Human Services said in its news release.

The plan prioritizes which groups will receive the vaccine first, although at this point it’s unknown how long it would take to move through each of the four phases.
• Phase 1 would include health care workers in high-risk settings, those in congregate settings and some essential workers.
• Phase 2 would distribute the vaccine to people with underlying health conditions, school staff, correctional facilities, and seniors, although the plan did not specify an age range.
• Phase 3 would include further broadening to more populations, such as young adults, children and people who work in higher-risk industries or essential jobs who weren’t previously offered the vaccine.
• Phase 4 means the vaccine would be available to all Maine residents.

“We will need an approved vaccine and federal support, along with answers to many outstanding questions, but stand ready with our partners to incorporate a vaccine into Maine’s effective strategy against COVID-19,” Jeanne Lambrew, Maine’s health and human services commissioner, said in a statement.