My family has been in isolation for a year. We have two high-risk family members. We’ve known staying put could save our lives and would help prevent the spread. We were told to be patient. We thought people on the front lines deserved the vaccine first. We thought when the time came, Maine would prioritize people with underlying medical conditions for the COVID vaccine and make it safer for us to reenter the world. We were wrong.

Maine’s COVID vaccine rollout has been a tragedy from the beginning. It has benefitted the privileged and crossed serious ethical lines. MaineGeneral’s board members and financial donors were offered early access. So were all MaineHealth employees, many who weren’t even on the Maine CDC vaccine schedule. Mainers watched those in power protect their own first, including out-of-state contracted employees. Meanwhile, Mainers waited, and some died.

When “ordinary” people were eligible to get vaccines, access wasn’t equitable. The system favored privileged senior citizens who had access to the internet or hours to sit on the phone. Those with money, time, and ability drove hours to get a vaccine. Mainers without internet access, without time, the wherewithal to endure the process, or chronic homecare needs were out of luck. The Maine CDC and DHHS recognized the shortcomings but didn’t devise a plan to make access more equitable. How about a vaccine rollout by first letter of last name? Or call-in days for appointments based on last name similar to the system Maine adopted for unemployment? Apologies for a lack of equity do nothing to help those harmed most by the system constructed that excludes them.

Last week, Gov. Janet Mills announced an age-based plan for the COVID vaccine, completely disregarding federal CDC recommendations to prioritize those “with underlying medical conditions which increase the risk of serious, life-threatening complications from COVID-19.” Instead, Maine focused on the number of COVID-19 fatalities. Citing data about illness and fatality erroneously excludes those who are at increased risk of infection because of their medical conditions in the first place and increases the risk of our most vulnerable. The fact that my son and my husband haven’t had COVID and are still alive has nothing to do with their ages. It has everything to do with our extraordinary safety precautions. To properly test the theory of age and medical conditions, we’d have to expose those with underlying conditions to COVID and determine rates of illness and mortality. We’re not about to do that. So, at best, the data is inadequate. It should not form the basis for how we protect those identified as high risk.

My youngest son has type 1 diabetes. Over 140,000 Mainers have diabetes. Studies show they’re at risk for severe outcomes with COVID. A young teacher with diabetes, who depends on income and health insurance, now has to wait for a vaccine based on age. Any high-risk person is in the same boat. But because not enough people from different age groups have died, Maine will not prioritize them. So, do we need more people to die to prove it? Or are we saying, “Congratulations to all the high-risk folks who’ve stayed alive a whole year! Your reward for staying alive is, you no longer need vaccine priority!”

Protecting those with medical conditions, the disadvantaged, and minorities is Maine’s challenge. The state’s official announcement is disturbing. An official from Northern Light Health asserts that the aged-based approach uses the vaccine “efficient[ly],” in part because it “removes unnecessarily complex barriers to vaccination, such as determination and verification of eligibility in categories other than age.” Prioritizing the medically disabled hinders efficiency. They are an impediment.

From the beginning, the rollout has been messy. Maine has failed to implement equitable solutions. We’ve witnessed gross abuses of power by some entrusted with vaccine distribution. Now we have an age-based vaccine rollout that deprioritizes those with underlying health conditions, and negatively impacts minority populations that are already disproportionately impacted by COVID. Risks increase exponentially for minorities with underlying medical conditions. Someone pointed out to me this was likely an “unintentional” oversight. Racist policies often are unintentional — all the more reason to acknowledge them and intentionally create systems that are equitable.

Maine’s most vulnerable need the Mills’ administration to understand the difference between equality and equity. Based on Maine’s previous vaccination schedule, I thought Mainers with medical disabilities had advocates in government who were looking out for them. They don’t. I’m begging the Mills’ administration to prioritize all Mainers with high-risk medical conditions.

Hilary Koch, of Waterville, is Maine #insulin4all chapter leader, T1International.


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