Close to 20,000 doses of the COVID-19 vaccine have been administered in Maine so far, and much of the initial focus has been on frontline hospital workers. But two weeks into the rollout, providers who work outside of hospital systems are frustrated by a lack of clarity about when they’ll get the vaccine, and many are concerned they’re not being treated equitably.
The director of the state CDC, Dr. Nirav Shah has described Maine’s vaccine rollout in terms of concentric circles. In the very first circle are frontline hospital workers, followed by residents and staff of long term care facilities as well as first responders and home health workers.
Soon, he says, Maine will expand to other circles in this first phase, 1A, which includes all health care personnel. But some providers, especially those who don’t work for a hospital, say they’re in the dark about where exactly they land.
“I think they feel a little forgotten about, the independent ones,” says Dr. Karen Saylor, president of the Maine Medical Association. “That’s creating a ton of anxiety from our members who have independent practices. Even the larger independent practices. There’s no large clear direction about, ‘Who do I call, where do I go, to get myself and my staff vaccinated?’“
Maine Medical Association spokesperson Dan Morin says independent physicians support the state’s plan to vaccinate frontline hospital staff first. But he says they’ve grown restless as they watch vaccinations progress to other staff within hospital organizations and not to the outside medical community.
“Some of the outpatient independent physician practices are seeing similar physicians and staff who do the exact same job they do being vaccinated simply because of their employment status with the hospital. So there’s an inequity they see here,” he says.
Other providers, including those who work in behavioral health, also feel they’re being overlooked.
“Mental health services are almost always the last thing on the list,” says Betsy Sweet, an advocate for mental health agencies.
Some operate residential facilities, which have experienced outbreaks of COVID-19.
“It’s very similar in terms of exposure to nursing homes and probably not quite as exposed as hospitals, but close,” Sweet says. “Unfortunately in this vaccine rollout, although we have been told their staff will be included early on, we have not seen that yet. So we are very concerned.”
Behavioral health workers who provide care in an outpatient setting are also at higher risk for COVID-19, says Malory Shaugnessy, executive director of the Alliance for Addiction and Mental Health Services.
Shaugnessy says some of these workers are on the ground in communities helping people with severe mental health disorders who don’t wear masks. They’re frontline workers too, she says, and should be prioritized.
“It is hard enough in this field because we have stagnant rates, we have a hard time paying people well, keeping staff on and doing this work and feeling valued when they don’t know if and when they’re going to get a vaccination. And they’re scared,” she says.
Shaugnessy says it’s unclear whether behavioral health personnel are considered essential workers, which fall under phase 1B. A spokesperson for the Maine CDC confirmed that they are part of 1A.
Shah has said in recent news briefings that the state is working as quickly as it can to set up a system to deliver the vaccine to all health care workers in that first priority group. But the effort has been hampered by a limited allotment of doses.
“Maine has received less than what we need to make significant inroads across 1A. Our second and third week allocations of both vaccines were less than what we initially thought,” he says.
Between those two weeks, Maine received about 5,000 fewer doses than expected. Still, Shah says he hopes to begin vaccinations for health care workers outside of hospital systems within the next couple of weeks.
“It is a question of when, and not if,” he says.
While many health professionals recognize the challenges that the state faces in rolling out the COVID-19 vaccine, they say having some sense of when — and an assurance that they have a place in line — is important.
Morin says it doesn’t have to be a specific date. But he says even setting goal posts for who gets vaccinated based on the number of doses the state receives would be helpful.