NC adjusts COVID vaccine plan to prioritize older adults and essential workers
North Carolina Gov. Roy Cooper said Wednesday he would adjust the state’s vaccination priorities to move up adults 75 and older and health care workers and frontline essential workers who are 50 years old or older.
The state received its first rounds of vaccines in mid-December. Under the current Phase 1A of the vaccine distribution, health care workers who interact directly with COVID-19 patients are the first to be vaccinated, followed by those living or working in long-term congregate care facilities, according to the state’s plan that follows guidelines from the Centers for Disease Control and Prevention.
The revised Phase 1B of North Carolina’s vaccination plan would start with anyone 75 years or older. That would be followed by essential workers and then healthcare workers and frontline essential workers of any age.
Cooper’s adjustment accounts for Dec. 22 recommendations from a CDC advisory panel that calls for frontline essential workers, such as firefighters, police officers, grocery store workers and teachers, as well as people ages 75 and older be moved higher in the vaccination rollout plan.
“Vaccines will be available to everyone, but currently supplies are limited and will continue to be limited for the next couple of months,” said Dr. Mandy Cohen, the secretary of the state Department of Health and Human Services, at a Wednesday afternoon press conference, the last of 2020.
But Senate leader Phil Berger, a Republican, criticized Cooper’s vaccine distribution plan for being “overly complicated” and putting too little emphasis on age. He argued that people who are older should get the vaccine before “healthy college students.”
There could be nearly 2 million people in the state’s “1B” category, far outpacing the number of vaccines North Carolina has received so far, Cohen said. Some providers could start vaccinating in Phase 1B next week, Cohen said, with more providers gaining capabilities the week of Jan. 11.
“We are going to make sure that we’re ramping up and improving our operations as we go, but I would remind everyone that there are very limited supplies at this point,” Cohen said.
By the end of last week, North Carolina had received 323,125 doses of vaccine, including 147,225 Pfizer doses and 175,900 Moderna doses.
As of 8 p.m. Monday, 63,571 vaccinations had been administered in North Carolina, all first doses. Both vaccines that have received federal emergency use authorization require two shots to reach their full effectiveness.
North Carolina provided 34,900 doses of the Moderna vaccine to CVS and Walgreens to administer doses at long-term care facilities. Cohen said vaccinations administered by CVS and Walgreens through their partnership with the federal government are not yet included in the state’s overall vaccination number.
Another 78,000 Pfizer and 60,800 Moderna doses are expected to be shipped to the state this week.
Cohen said North Carolina can expect about 60,000 doses of the Moderna and 60,000 doses of the Pfizer vaccine each week for the next month or so.
Priorities and penalties for vaccine line
There aren’t penalties for hospitals and other health care facilities that violate the prioritization order, aside from getting a call from Cohen and DHHS. She said the administration has asked various health boards about discipline options for those who don’t follow the order for who gets vaccinated first.
“It’s not a perfect process,” Cohen said. “We need to be as clear as we can as far as priority groups going forward.”
Cooper told reporters that they are waiting to hear recommendations from the boards, but that there also could be ethical violation penalties now. He said he met with General Assembly leaders Wednesday morning about possible legislation that could add to enforcement and penalties.
“It’s really important for everybody to stick to this priority list as much as possible, and we don’t want to see people taking advantage of this because of their position,” Cooper said.
The plan received some pushback from Berger, who said the plan would result in a decline in confidence in confidence and line jumping.
“I don’t think anybody objects to providing the first vaccines to frontline health workers and people above 75 years old,” said Berger, of Eden, said in a news release.
“But I have reservations about putting healthy college students ahead of people in their early 60s who face a 10,000% higher risk of death,” Berger said. “I understand the concern that college students spread the virus – but the whole basis for that concern is they spread the virus to older people who might die. We should vaccinate those older people first.”
Berger’s office cited the United Kingdom’s plan to prioritize vaccinations by age along with other factors like health care frontline workers and those with underlying health conditions. In the current North Carolina plan, which follows the CDC plan, someone in their early 60s without underlying health conditions or jobs that put them at risk would be vaccinated after college students.
Berger said the system “puts people in their 60s dead last. It does not strike me as fair or equitable to prioritize a 19-year-old over a 64-year-old just because that 19-year-old is in prison or in college. Simplicity and common sense will improve trust in public health officials; complexity will result in line-jumping and a further decline in confidence.”
North Carolina COVID-19 spread
Last week, North Carolina updated its county alert system, which uses metrics like the rate of COVID-19 cases over two weeks, the test positivity rate and hospital impact to determine how much community spread is happening in a county.
By those metrics, 65 of the state’s 100 counties are considered red, or seeing critical community spread, while another 27 are orange, or seeing substantial community spread. Only eight counties are yellow, or experiencing significant community spread, the lowest category.
Wednesday, Cooper reiterated his pleas to follow public health guidelines around masking and social distancing.
“The latest recommendations from the White House coronavirus task force offer stark warnings for those over 65 years old or with an underlying health condition,” Cooper said, noting that the recommendation urges those groups to avoid going anywhere where people aren’t masked and to have groceries delivered.
Anticipating a surge
Public health experts have said repeatedly that they expect another surge in mid-January due to Christmas, New Year’s and other holiday gatherings. Thursday night is New Year’s Eve, and traditional celebrations striking in the new year at midnight will have to be at home only.
The state is under Phase 3, which has been extended several times and is currently set to expire on Jan. 8. That means the state is following a modified stay-at-home order, which includes a curfew from 10 p.m. to 5 a.m. There are restrictions on capacity at restaurants and bars, and bars must be outside only.
However there are many exemptions, including for essential workers, work commutes, childcare, medical needs, grocery shopping and getting food or gas.
North Carolina has remained under a statewide mask mandate since June.
When Cooper issued the last order, he explained the reasoning for the curfew as “the later in the evening you go, the larger gatherings get.” On-site alcohol sales also stop at 9 p.m., as part of the latest executive order, though Cooper later said bars and restaurants could sell mixed drinks to-go.
Cooper said people are uninhibited and closer together, creating more opportunities to spread COVID-19. He said after 10 p.m., “they just really need to go home” from both public gatherings and at other people’s homes.
This story was originally published December 30, 2020 at 2:24 PM.
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