Nick Bloom and Hollie Maloney, certified pharmacy technicians, prep syringes of the Pfizer COVID-19 vaccine before opening the doors on the first day of the Northern Light Mercy Hospital mass vaccination clinic at the Portland Expo on Tuesday. Maloney said they were prepping around 500 doses for the day. Brianna Soukup/Staff Photographer

State officials said Wednesday that they are “exploring all viable options” to expand COVID-19 vaccinations, and Maine’s two largest health networks said they have plenty of capacity to ramp up vaccinations should the Biden administration dramatically increase vaccine shipments.

In a call with governors on Tuesday, White House officials urged states to begin making preparations to administer even more COVID-19 vaccine doses in the coming weeks. President Biden then set an even more ambitious goal, predicting that the United States will have enough vaccine to inoculate all adults by the end of May, a full two months earlier than anticipated.

But the timing of those larger federal shipments to states is unclear, and the president’s directive Tuesday telling states to prioritize school staff for vaccination could put a further strain on vaccine supply in Maine.

“If the federal government does not increase the supply of vaccine in March to match the increased number of people made eligible under the new directive, Maine’s newly established time frame to vaccinate Maine people age 60 and older may slow,” Gov. Janet Mills’ administration said in a news release. “The administration is not making adjustments to its time frame yet as it awaits further information from the White House.”

Mills administration officials said the focus is on adding high-volume vaccination sites and launching additional initiatives in rural communities to reach Mainers who cannot travel to clinics.

“Maine continues to take steps to expand vaccine availability, including standing up large-scale vaccination sites, most recently this week in Portland and Sanford, that are prepared to expand capacity with any increase in the supply of vaccine from the federal government,” Jackie Farwell, spokeswoman for the Maine Department of Health and Human Services, said in response to questions.

Biden’s vague prediction of a windfall of vaccines in the coming months buoyed hopes for a return to some level of normalcy by summer. But there are also concerns in Maine and nationwide that COVID-19 cases have begun to rise again after falling dramatically for weeks.

The Maine Center for Disease Control and Prevention reported 147 new cases on Wednesday as well as two additional deaths. But the state’s positivity rate is creeping up and the seven-day average of new cases rose to 170 on Wednesday, compared with 142 two weeks ago.

At the same time, Maine anticipated receiving more than 55,000 vaccine doses this week – its most so far – thanks to shipments of the newly approved Johnson & Johnson vaccine. But it was unclear Wednesday how many total doses Maine would receive next week because the federal government had not announced any allocations from Johnson & Johnson.

The Mills administration did not provide specifics about the number of additional mass-vaccination sites or drive-thru clinics, which will now be easier to stage with the single-dose and more shelf-stable vaccine from Johnson & Johnson. But Farwell said such options “remain part of our planning efforts as we await further information from the federal government about any increased vaccine supply for Maine.”

“We will continue these efforts and explore all viable options, including additional assistance from the Maine National Guard, as we await further information from the federal government about the announcement that it has secured enough vaccine to vaccinate every American by the end of May, including whether and when this will result in increased supply for Maine,” she said.

Representatives from MaineHealth and Northern Light Health, meanwhile, said their health care networks, which have carried out the vast majority of vaccinations to date, are poised to administer additional shots once the doses are available.

“We have set up the physical infrastructure and staffing required to do 25,000 shots per week,” MaineHealth spokesman John Porter said. “That is in place now.”

MaineHealth expected to receive about 10,000 doses this week from the Maine CDC, allocated to the mass-vaccination clinics in Scarborough Downs and Sanford as well as to smaller clinics around the state.

Northern Light’s mass-vaccination clinic at Cross Insurance Center in Bangor expected to deliver about 3,000 shots this week and could handle up to 5,000 without requiring major changes at the arena, said Dr. James Jarvis, senior physician executive in charge of COVID-19 response. Northern Light also launched another high-volume clinic at the Portland Expo on Tuesday, and another at the former Pier 1 store at the Maine Mall on Wednesday, and smaller hospital-based clinics are discussing expansion options, including potentially adding vaccination days.

“We built out facilities in order to handle large volumes of people,” Jarvis said. “That’s what we wanted to do and we wanted the only limiting factor to be how much vaccine we had on site.”

Maine has yet to begin inoculating teachers and had just begun to focus its vaccination campaign on residents age 60 or older under the age-based eligibility system the Mills administration announced last week.

Nearly 157,000 Mainers 60 or older had received at least one shot as of Wednesday, representing about 55 percent of that age group, with the vast majority of those shots going into the arms of people over 70. Overall, 17.6 percent of the state’s population had received at least one dose with 9.5 percent considered fully vaccinated.

That places Maine in the top half nationally in terms of getting shots into arms. But Maine’s vaccination rate, while climbing, is not increasing as quickly as many other states. Bloomberg’s vaccine tracker ranked Maine 20th – behind all other New England states – on Wednesday in terms of the percent of the population that has received at least one dose, down from fifth or sixth nationally two weeks ago.

The pace of vaccinations in Maine is expected to increase markedly as additional pharmacies begin offering shots.

On Tuesday, the Hannaford supermarket chain began scheduling appointments for later this week and next week at 35 pharmacies around the state. Additional Hannaford locations will be added as vaccine doses become available. Age-eligible Maine residents can also attempt to schedule appointments at more than 70 Walgreens, Walmart and Sam’s Club pharmacies around the state.

That may change, at least temporarily, after Mills announced Wednesday that those pharmacies should give exclusive priority to teachers and child care workers following the directive from the Biden administration. Federal guidelines say states should now prioritize teachers under the pharmacy program, but other eligible categories can use it as well.

Some visitors to Hannaford’s online scheduling tool – hannaford.com/pharmacy/covid-19-vaccine – were greeted by messages telling them that no vaccine appointments were available on Wednesday. Hannaford spokeswoman Ericka Dodge said the scheduler is updated in real-time as appointments are made and that it will make only as many appointments as the number of doses available.

“The online scheduler has been opened and is kept current by location/geography and by dose availability,” she said. “As vaccine becomes available, in its limited supply, appointments will open up.”

The number of people who have preregistered for vaccination with MaineHealth, meanwhile, had topped 90,000 as of Tuesday, with the majority of those people falling between 60 and 70.

“We are still taking registrations of any age … and if someone gets a vaccination or appointment somewhere else, please call the line and follow the prompts for cancellation,” said Porter, the MaineHealth spokesman. “It smooths out the process for us.”

Rising case numbers and the spread of new variants are causing concern nationwide, however, which underscores the importance of accelerating vaccines.

The seven-day daily case average stands at 170, a slight increase from 142 cases two weeks, or one incubation period, ago. That, coupled with an increased positivity rate this week, suggests the decline in cases might be leveling off. This time last month, daily cases averaged nearly 300 and new cases peaked above 600 per day in mid-January.

Since the pandemic reached Maine, there have been 45,091 confirmed or probable cases of COVID-19 and 705 individuals have died, according to data tracked by the Maine CDC.

The number of people hospitalized with COVID-19 in Maine dropped to 67 on Wednesday, including 24 in critical care and eight on ventilators. Hospitalizations had been falling dramatically since peaking at 207 people on Jan. 13, but over the last 11 days, the number has leveled off and has ranged from a low of 62 to a high of 75.

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