Amid confusion over Colorado’s vaccination plan, the state health department clarified Tuesday that essential workers, including teachers, should not be inoculated against COVID-19 until after health care workers, first responders and people 70 and older receive their shots.
The state agency sent a letter to providers further illuminating Colorado’s vaccine priorities as at least two Denver-area school districts announced they would begin vaccinating teachers as early as next week — plans that those districts’ local health department said must now be halted.
It was the latest hiccup in the state’s rollout of the coronavirus vaccine, which was further complicated by Gov. Jared Polis’s announcement last week that 1.19 million more people will be eligible to be inoculated sooner than originally planned.
“I expect there to be definitely some frustration and confusion, and I don’t blame (schools),” said Karen Miller, immunization nurse manager for Tri-County Health Department, blaming mistakes in allocation on a lack of clear guidance about how to distribute the vaccines.
“In hindsight, it’s always easier to say we wish we had the guidance when the plan came out so this kind of error doesn’t happen,” she said. “Everybody is so important for the functioning of our society and these are really hard decisions to make. These are directions and directives coming from our governor’s office and state health department.”
The Colorado Department of Public Health and Environment last week added teachers, along with other essential workers and anyone 70 and older, to the pool of people who will receive their shots during the latter half of the first phase of distribution, slated to take place through the winter. But since Polis’s announcement of the change, there had been few details on how exactly the state will get the shots into more people’s arms or how those additions will be prioritized.
The logistics of administering the vaccines mostly have been left to local public health officials and other providers, such as hospitals, that are scrambling to respond to the overwhelming demand for the shots as Coloradans eager to get in line flood their phones. The state health department issued further guidance Tuesday by divvying up “vaccine responsibilities.”
Local public health agencies, health systems and other providers face multiple challenges in distributing the vaccines, including the fact that supply remains extremely limited. Counties also are still inoculating frontline health care workers, such as those who will begin getting their second doses Wednesday.
The Department of Public Health and Environment’s letter said efforts to inoculate frontline health workers likely will wrap up around Jan. 15, and, based on the current supply of COVID-19 vaccines, officials expect to finish much of the next phase — moderate-risk health care workers and first responders — by Feb. 28.
The agency also offered a “wildly important goal” of vaccinating 70% of Coloradans ages 70 and older by Feb. 28 as well. Frontline workers such as teachers and grocery store employees will follow that, with those inoculations expected to begin in late February or March.
But for older Coloradans whose age puts them more at risk from the virus, there has been little explanation as to how they can expect to be inoculated.
“We are working toward being able to announce by the end of this week ways for members of the general public who are 70 years old and up statewide to schedule appointments with hospitals and health systems,” wrote Scott Bookman, director of the Division of Disease Control and Public Health Response for the state health agency, in Tuesday’s letter to providers.
There’s likely to be a multi-pronged approach for Coloradans 70 and older to receive the vaccine, according to Tri-County’s Miller. People may be able to get it through their insurance companies, stand-alone or drive-thru clinics, community health centers, urgent care facilities or possibly even pharmacies at King Soopers or Safeway stores, she said.
School plans being pushed back
The Tri-County Health Department, which serves Adams, Arapahoe and Douglas counties, began telling its providers Tuesday to halt vaccine distribution to any essential workers under Phase 1B of the state’s rollout plan until older residents first have gained access, Miller said.
That includes doses slated for at least two metro school systems that planned to inoculate teachers in the coming weeks.
Nurses in the Cherry Creek School District got their first shots on New Year’s Day through a partnership with Centura Health. The district planned to vaccinate school social workers, psychologists, special education paraprofessionals and cafeteria workers this week, and was to begin scheduling teacher vaccinations next week.
The Douglas County School District also expected to get the vaccine to educators and other student-facing staff members, such as security personnel and bus drivers, starting as early as this week or next week through its partnership with Centura, according to a note sent to staff.
Kallie Leyba, president of the Douglas County Federation teachers union, said while it’s disappointing to have the timeline pushed back, it’s also understandable. Her qualms are “the misinformation and miscommunication.”
“Educators and families were excited to have vaccines much sooner and be able to keep our school buildings open with the support of vaccinated staff,” Leyba said, “so there is absolutely disappointment for those who work in schools and who have children in school.”
Abbe Smith, spokeswoman for Cherry Creek schools, said the district had not heard about any changes to staff members’ accessibility from its provider, Centura, but that leaders would review state guidance and make changes as necessary.
Centura is currently working with “at least 10” public districts and private institutions to distribute the COVID-19 vaccines to school-based health care staff, said Shauna Gulley, chief clinical officer. She declined to comment on why some districts were promising inoculation to teachers and employees in other positions.
State offers some additional data
The health department on Tuesday updated its COVID-19 vaccination dashboard to make public additional data about the state’s vaccine rollout, including information on how many people are being inoculated with either Pfizer or Moderna vaccines each day.
The dashboard does not include data revealing how many doses the state has received to date, which would reveal any gap between the amount of vaccine on hand and how much has been administered. However, the agency told The Denver Post that the state has received 242,192 doses of COVID-19 vaccine so far from Pfizer and Moderna.
That is lower than what the Department of Public Health and Environment expected to receive by the end of last week. Previously, the state health agency said it had expected to have received about 270,170 doses of COVID-19 vaccines though last week.
As of Tuesday, 120,510 Coloradans had received their first shot of a coronavirus vaccine, although there is a lag in that data being reported back to the state, so the number likely is higher. Both Pfizer’s and Moderna’s vaccines require two doses.
As supply of the vaccine is limited, public health and medical experts encourage Coloradans to keep wearing masks, washing their hands and practicing social distancing.
The state health department said Monday evening that providers distributing the vaccine need to focus on the groups above what it calls “the dotted line” within Phase 1B on its distribution chart before moving to essential frontline workers, such as teachers, grocery employees and postal workers.
The groups that should receive first prioritization under Phase 1B are health care workers with less direct contact with COVID-19 patients, including those in dental and home health settings; first responders; and people 70 and older.
Divvying up vaccination responsibilities
In offering more information on how to prioritize distribution of the vaccine, the state health department released guidelines on which groups in Phases 1A and 1B certain providers should concentrate on inoculating.
Local public health agencies are directed by the state to focus on vaccinating any remaining high-risk or moderate-risk health care workers and first responders. Other providers, such as hospitals and pharmacies, should focus on administering shots to people 70 and older, according to the state’s news release.
Staff and residents of long-term care facilities, which also are prioritized in Phase 1A, will be vaccinated by CVS or Walgreens through the federal government’s Pharmacy Partnership for Long-Term Care Program.
The state Department of Public Health and Environment said school nurses are considered “health care providers and are in the early part of 1B.”
Providers have been told by the state health department that they should not begin distributing the vaccine to essential workers until everyone in the groups above them are vaccinated, otherwise it could “harm our chances of having access to vaccine if we do,” said Chana Goussetis, spokeswoman for Boulder County Public Health.
“That makes it very difficult for us,” she said of schools such as the Cherry Creek district getting vaccine doses early. “What we need the state to do is to hold everyone accountable to the prioritization.”
Miller said Tri-County is still completing Phase 1A of vaccine distribution, while also starting Phase 1B. There are about 120,000 residents who are 70 and older in the agency’s coverage area, people she hopes will have access to the vaccine in about two to three weeks.
“We anticipate to get through that group by the end of February,” and then school staff would be eligible to receive doses, she said. “That might be a very optimistic estimate, but that’s our hope as long as we have sufficient vaccines available in our state.”
