A state committee responsible for recommending the order of coronavirus vaccinations narrowed its tentative list down to 60% of Oregonians Thursday, amid the first signs of tension about how best to battle historic inequities while being fair to all who need a vaccine.
The latest iteration of the 27-member committee’s recommendations would include two distinct but overlapping groups that combined total more than 2.5 million Oregonians. If the recommendations stand, they would be vaccinated after the 1.4 million or so people the governor has already prioritized for shots.
For now, the Vaccine Advisory Committee is recommending that BIPOC communities, numbering about 806,000, and people with underlying chronic conditions, numbering about 1.8 million Oregonians, get vaccinated next. They would follow health care workers, senior care residents and staff, inmates, teachers and some senior citizens who are or will soon be eligible.
The result of Thursday’s deliberations was a marginal winnowing of last week’s recommendations, which also included refugees, frontline workers and inmates.
“We have real work to do to prioritize this,” Kalani Raphael, of the Oregon Pacific Islander Coalition, said of the group’s original recommendations. “Otherwise, we’re not going to get any priority, really.”
The group will re-consider and likely further narrow and then vote on the suggestions at its next full meeting Jan. 28. The committee has until mid-February to tell the Oregon Health Authority who should be vaccinated after the governor’s priority populations.
The health authority created the group as part of Oregon’s stated 10-year goal to counteract generational racism by reshaping the health care system. The agency has said it would follow the committee’s recommendations, assuming they pass legal and practical muster as well as get the governor’s approval.
But in a reflection of the extraordinary challenge behind fighting a concept as amorphous and simultaneously concrete as “systemic racism,” one of the two proposals Thursday is already top of mind for health experts and government officials: focus on people with chronic health conditions.
The rationale presented by some of the proponents of the approach was that minorities are more likely than white people to suffer from chronic conditions that make a coronavirus infection particularly dangerous, such as diabetes, cancer or an HIV infection.
But the proposal was hardly original, given that the federal government is already recommending that people with chronic conditions be vaccinated next, along with those 65 and older. Gov. Kate Brown has decided to not prioritize people with chronic conditions, allowing teachers to get vaccinated Jan. 25 and people 80 and older Feb. 8, with more seniors to become eligible on a weekly basis.
In light of the committee’s fundamental purpose – to help launch Oregon’s battle against historic inequities – one of the committee members bristled when members proposed that people with health conditions be prioritized ahead of or instead of minorities.
When those members objected, Kelly Gonzales all but accused them of being complicit in trying to maintain white hegemony.
“We’re also dealing with our own conditioning of white supremacy as it is showing up in our decision making,” said Gonzales, a member who represents Native Americans living in cities.
Black, indigenous and other people of color were ultimately included in the list, above those with underlying conditions. It’s unclear if the committee will ultimately recommend that BIPOC communities get vaccinated ahead of people with underlying conditions.
Last week, the group began its discussions with an extremely broad list and asked the health authority to analyze how it could vaccinate: BIPOC communities, refugees, people 16 to 64 years old with chronic health conditions, people eligible for vaccines who are in jail or prison, frontline workers who weren’t already eligible, people in multi-generational homes and people under 65 living in low-income senior housing or other congregate care settings.
A health authority official started Thursday’s meeting off saying that perhaps the most practical way to meet the priorities the group outlined a week ago would be to target neighborhoods based on a combination of metrics such as demographics, prison population and occupational hazards.
That would allow the health authority to target multiple committee priorities at once, said Rachael Banks, the agency’s public health director.
That idea didn’t seem to get much traction with the group, particularly after one member pointed out that the vaccines are sensitive and getting them to the appropriate neighborhoods without wasting any doses could be a challenge.
Whatever the contents of the final list the committee sends the state, its recommendations will have to work with three fundamental obstacles: the recommendations’ legal viability, Brown’s existing priorities and vaccine availability.
To date, Oregon has administered about 254,000 vaccines out of 479,000 received.
The state has already built a long queue, including an estimated 250,000 health care workers and senior care residents and staff who haven’t yet received a shot, 100,000 preschool, day care and K-12 workers and 768,000 Oregonians 65 and older.
Oregon expects only 1.1 million vaccines doses total through February.
Still, where exactly millions of Oregonians will stand in line behind them could depend on the committee’s upcoming decisions.
— Fedor Zarkhin