MONTPELIER — Health Commissioner Dr. Mark Levine hinted broadly Wednesday at a COVID-19 vaccine distribution system that will prioritize older Vermonters, make use of centralized locations to distribute shots, and make concerted efforts to reach the state’s Black, indigenous and person of color community.
Levine, appearing Wednesday at a joint hearing of the Vermont House and Senate’s Health and Welfare committees and the House Human Services Committee, said more details would be provided at the Scott administration’s next COVID-19 briefing on Friday.
But he said the state would continue to focus on protecting human life, assuring schools remain open for in-person learning, and helping the state’s economy recover.
“Our North Star right now is saving lives,” Levine told lawmakers. “We are not mincing words about that at all.”
Over the past several COVID-19 briefings, Scott, Levine and Agency of Human Services Secretary Mike Smith have outlined plans to deliver the vaccine according to five-year age bands, starting with those 75 and older. They’ve cited data showing the overwhelming majority of COVID deaths in Vermont have been persons 65 and older, and said focusing on those Vermonters first will address the 125,000 residents at greatest health risk.
From there, the state will focus on persons with underlying medical conditions, and on persons in the Black, indigenous, and person of color (BIPOC) community, Levine said.
The state is envisioning a registration system, reachable online and by phone, which residents can use to find out when and where they will be vaccinated.
While central locations are being considered for vaccination sites, Levine cautioned that the possibility of allergic reactions makes patient monitoring paramount. “We’ve got to have a strategy that allows for safety,” he said.
The state Department of Health’s district offices and larger centralized sites are possibilities for vaccination sites, he said.
State Rep. Taylor Small, D/P-Winooski, represents a district where a significant COVID-19 outbreak affected immigrants and persons of color during the summer. During Wednesday’s hearing, Small asked Levine how the state plans to assure equity for that population.
While Levine didn’t provide specifics on how the state will assure equity for BIPOC Vermonters, he outlined the potential approach, and the need for it.
“There’s no way we can not assign some sense of priority to that population,” Levine said. “It’s a matter of how we do it and how we fulfill expectations we should fulfill.”
He said BIPOC Vermonters have experienced infection rates 3-4 times that of white Vermonters, and have experienced a higher hospitalization rate (but not a corresponding higher death rate).
However, Levine said the approach cannot be one size fits all. While some BIPOC communities are generally older, recent immigrants who came here as refugees, tend to be younger, and are more likely to live in close quarters with older family members.
The outreach will include education, interpretation services for non-English speaking residents, and efforts to assure access to vaccines — possibly, with pop-up vaccination sites within those communities, Levine said.
So far the state has distributed about 25,000 doses of vaccine, Levine said. He remains frustrated by the limited number of doses the state is receiving weekly from the federal government, as well as the timing of those deliveries. Levine said Scott and other governors met with Vice President Mike Pence on Tuesday to discuss the supply needs.
“This [presidential] administration. on the way out the door, is hoping to accelerate the amount of vaccine feeding into the states,” Levine said. “We could use a heck of a lot more than 8,000 doses a week … we have the capacity to deliver way more than that if we could only get our hands on it.”
Levine said there’s also desire in Washington to distribute more doses to states that are succeeding at distribution. With Vermont remaining a national leader, Levine expects that the state’s supply of doses will increase.
At the current pace of supply, it would be March before the state began vaccinating persons ages 70-74, he said.
The U.S. Centers for Disease Control and Prevention’s vaccination guidelines list step 1b as “people aged 75 years and older and non–health care frontline essential workers” and step 1c as “people aged 65–74 years, people aged 16–64 years with high-risk medical conditions, and essential workers not included in Phase 1b.”
The trouble with that, Levine said, is that it builds expectations that the state can vaccinate all of those people at once. It cannot.
“Governor Scott is a person I respect tremendously for knowing what a Vermonter would think,” Levine said. “He thinks, and I believe, that simplicity is important when embarking upon a complex program.”
State Sens. Ginny Lyons, D-Chittenden, and Ruth Hardy, D-Addison, asked whether teachers should qualify as a priority category, given their one-to-one contact with children.
Levine said nothing in the state’s decisions should be construed as a lack of respect for teachers. But in “not trying to set unrealistic expectations for a scarce resource,” he indicated the state is committed to focusing on older Vermonters and those with underlying health conditions such as COPD, emphysema, heart disease and immunocompromised persons.
By sticking to the plan, and if supplies increase as anticipated, the state will get to teachers “faster than anyone imagined,” Levine said.
Levine said school nurses were included in the first tier of vaccine recipients, and he understands how teachers deal with children’s health issues regularly. “My daughter in another state cleaned up her share of vomit” as a second-grade teacher, he said.
But as of now, teachers are not included as health care workers.
“We tried to be strict and specific” that the health care worker group had to be patient-facing, Levine said. “It’s not super popular, but that’s how the line has had to be drawn.”
Lawmakers praised Levine at the start and end of his presentation for the role he and the Department of Health have played in Vermont’s COVID-19 response. In turn, Levine said he was thankful for the support of state government, and for Vermonters who have been willing to follow the guidance.
State Rep. Bill Lippert, D-Hinesburg, told Levine that he would be receptive to further updates from Levine on the Health Department’s resource needs. “Do not be shy in bringing forward a clear message to us as to what we can provide to you and the Health Department to protect Vermonters,” Lippert said.