George Parr of Portland, manager of the seafood wholesaler Upstream Trucking, said he is happy to be next in line for a vaccination “because I’m going to Florida in three weeks.” Parr, 69 and a cancer survivor, said it makes sense to vaccinate by age because older people are more likely to suffer serious consequences if they get the virus. Ben McCanna/Staff Photographer

Gov. Janet Mills said Friday that Maine will base eligibility for COVID-19 vaccination on age moving forward, replacing a previous system that prioritized vaccine shots for individuals with high-risk medical conditions or who worked in front-line jobs.

Under the new plan, all Maine residents between 60 and 69 will be eligible for vaccination starting Wednesday. The decision provides access to vaccines for an additional 200,000 Mainers even as the state continues to vaccinate the estimated 193,000 individuals 70 and older who are currently eligible.

Looking ahead, Maine expects to make vaccines available to those 50 and older in April, to those in their 40s in May and to those in their 30s in June. Individuals under 30, including children if a vaccine is authorized for them, will be targeted in July and beyond, according to the time frame outlined Friday.

Mills and Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said the controversial decision to adopt an age-based system stems from scientific research showing that age is among the strongest indicators of serious illness or death from COVID-19. More than 85 percent of COVID deaths in Maine have been among those 70 or older, and 98 percent were over 50.

“Given that Maine does have the oldest population … this approach, which is different from the approach in other states, will benefit the most people in Maine the soonest,” Mills said during a virtual news conference. “I am trying to save lives here, trying to get shots in arms as quickly as possible. After consulting the science and weighing the many considerations, I do believe on balance this approach is the right one for our state.”

More than 16 percent of Maine’s population – or 217,667 people – had received at least one dose of vaccine, and 8.2 percent had received both doses needed to be fully inoculated against COVID-19 as of Friday morning.

Mills said the aim is to “do the greatest amount of good for the greatest number of people in the shortest amount of time.” The governor predicted an age-based system will improve efficiency by eliminating the logistical nightmares around confirming someone’s eligibility due to medical conditions or their job while providing additional predictability during the pandemic.

But the decision is guaranteed to upset many Mainers working in higher-risk front-line “essential” jobs – such as teachers, grocery store employees or restaurant workers – as well as the hundreds of thousands of residents with underlying medical conditions. While state officials announced plans for vaccination clinics dedicated solely to teachers, their eligibility to receive a shot will be based on age.

Brenda Buchanan, 63, an attorney and crime novelist, is excited that she will soon be able to get vaccinated. She had been concerned about being on a different vaccination schedule from her wife, who is 65. Derek Davis/Staff Photographer

Shah acknowledged that not everyone will be pleased with the change.

“We are charged with public health decisions, not so much individual patient decisions,” he said. “On an individual level, we recognize that this approach may leave some people hoping for more. But at a population level, keeping in mind our goal of reducing the number of Maine people who are dying from COVID, this is the strategy that we believe will get us there most quickly and, we think, most equitably.”

MAINE NOT ALONE

Maine joins a small but growing number of states or countries using age as the sole or primary criteria for vaccine eligibility.

This week, Connecticut Gov. Ned Lamont said that his state will continue using an age-based approach, although Connecticut also bumped all teachers, school staff and childcare workers to the front of the vaccination line. Nebraska also has moved away from giving people with high-risk medical conditions higher priority and, instead, will focus largely on age.

And across the Atlantic Ocean, officials in the United Kingdom announced Friday that the next phase of that country’s vaccinations will be based on age rather than on profession. As in Maine, officials in the U.K. said the age-based approach will be simpler and faster.

In so doing, Maine and other states are parting ways with the official recommendations from the U.S. Centers for Disease Control and Prevention. However, the federal government gives states broad discretion in implementing vaccination campaigns, and even that federal guidance has evolved in recent weeks in response to the latest science and the pace of vaccine production.

Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation, expects other states to also adopt age-based vaccination strategies.

“Not all states have the older population that Maine does, but I think what is appealing to this age-based prioritization is it’s simple,” Tolbert said Friday afternoon. “It’s an easy message to convey. You can work through the groups.”

That said, Tolbert said there are strong arguments to be made that people with high-risk medical conditions should be given priority as well. While Rhode Island has adopted a mostly age-based system, it also is expanding eligibility to younger individuals with five specific health conditions: diabetes, heart disease, lung disease, kidney disease or compromised immune systems.

“We are still in a situation in which we have limited supply of the vaccine, and there are far more people who need the vaccine than can get it,” Tolbert said. “So there are tradeoffs. Governors and other state officials are having to make decisions about these tradeoffs … and there are no good answers.”

APPOINTMENT GATES OPEN

Within an hour of Mills’ announcement, some health care providers began scheduling appointments next week for people 60 to 69 years old. Maine’s two largest health care networks that have carried out many of the vaccinations so far, MaineHealth and Northern Light Health, welcomed the shift.

Mainers who found themselves suddenly – and unexpectedly – on the verge of vaccine eligibility also praised the change.

Brenda Buchanan, a 63-year old Portland attorney, had expected the next phase to apply to those 65 and older. While pleased that would have benefited her 65-year-old spouse, Buchanan was concerned about being on a different vaccination schedule than her wife.

So when she learned Friday that she would be eligible as well and then received an email from her health care provider about scheduling appointments, Buchanan saw it as a step toward the couple having more freedom to get back out into the world together, even if they do continue wearing masks and ordering takeout.

“We’ve done this for almost a year,” Buchanan said. “We’ve managed to stay safe. Let’s be patient. But on the other hand, you really want to start feeling like ‘OK, I’m part of those moving toward some sort of normal life again.’ I also have family members I’d really like to see, and we’ve not been doing that for obvious reasons.”

George Parr of Portland, a 69-year-old manager of seafood wholesaler Upstream Trucking, said he is happy to be next in line for a vaccination. A cancer survivor, Parr said his company has been careful about precautions during the pandemic “because if anybody got sick at Upstream, we’d be out of business. I mean, my whole plant would shut down.”

He said it makes sense to vaccinate by age because older people are more likely to suffer serious consequences if they get the virus. While he knows people in their 30s who contracted the virus who became “very sick,” the illness wasn’t bad enough to kill them.

“But you get older, and you’re not (at your) fighting weight,” Parr said.

178 NEW CASES

The Mills administration announced the strategy shift on a day when the Maine CDC reported 178 new cases of COVID-19. While there were no additional deaths reported Friday, the Maine CDC reported 41 additional deaths on Wednesday and Thursday that were identified during periodic reviews of vital records that dated to Jan. 26.

While the number of new reported infections varies daily, the overall rate has been trending downward in recent weeks. The seven-day, rolling average of new cases stood at 155 on Friday, up slightly from a daily average of 140 cases for the week ending Feb. 18 but down from 207 for the week ending Feb. 11. Maine’s seven-day rolling average peaked at 625 on Jan. 15 amid a post-holiday surge.

The Maine CDC has tracked 44,295 confirmed or probable cases of COVID-19 since the coronavirus was first detected in the state last March. A total of 701 individuals have died in Maine after contracting COVID-19. Maine has consistently had one of the lowest infection and death rates in the country.

The number of Maine people hospitalized Friday with COVID-19 stood at 68, including 23 in critical care and nine on ventilators. That’s less than one-third of the state’s peak of 207 hospitalizations on Jan. 13.

Shipments of vaccine to the Maine CDC are expected to increase more than 8 percent next week to a total of 30,080. Additionally, Walmart, Sam’s Club and Walgreens pharmacies in Maine are expected to receive 8,980 doses.

Additionally, a panel of outside advisers to the Food and Drug Administration on Friday recommended approval of a third vaccine, developed by Johnson & Johnson, paving the way for the FDA to issue an emergency use authorization as early as Saturday. That would open the door for additional doses for Maine and other states next week.

Maine’s top-heavy age demographics, combined with the fact that federal vaccine shipments are based on states’ overall population, means it will likely take longer for the state to vaccinate its way through the oldest residents. According to the latest data from the Maine CDC, approximately 74,000 of the state’s 193,000 residents 70 and older had yet to receive their first dose of vaccine as of Friday morning, although that figure has been falling by the thousands daily.

Meanwhile, two more high-volume vaccination clinics are expected to open in southern Maine next week – one at the Portland Expo run by Northern Light Health and one in Sanford run by MaineHealth. They will supplement mass vaccination sites currently operating at the former Scarborough Downs harness racing track and at Cross Insurance Center in Bangor.

Staff Writer Meredith Goad contributed to this report.

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