Maine will introduce a new set of performance measures to take a closer look at COVID-19 vaccine providers when it comes to how fast they are shooting in a move that could change where doses are shipped across the state .
The state has not yet defined the measurement group, said a spokesman for the Department of Health and Human Services in Maine, but a Tuesday Memorandum to providers indicated that they will be used to help clinics improve performance or lead the state to send vaccines elsewhere.
It was welcome news for representatives of pharmacies, hospitals and independent doctors, who were convinced that each new metric would show their ability to handle more doses. Experts said that while assessing the speed at which providers are delivering shots is valuable, the state should consider the amount of time people need to be vaccinated and parity factors.
Our hospitals are ready, willing and able to do much more than we have now, said Steven Michaud, president of the Maine Hospital Association. The more we get, the more we can administer.
Short national supply also depends on the whole distribution effort. While all vaccine-distributing groups are demanding more doses, it is unlikely that all those who perform well will see an immediate condition in vaccines because of these changes.
In Maine, two hospitals have been criticized by the state for the way they distributed some vaccines. MaineHealth, the state’s largest health care system, was hit by Gov. Janet Mills for vaccinating consultants and non-patient staff, while MaineGeneral Health in Augusta provided vaccines to a small group of older donors as part of a clinic prove.
Right now, Mainers over 70, people with conditions that make them vulnerable to the virus plus residents and employees of the long-term care institution, health care workers and first responders are eligible for vaccines. Attorney General Aaron Freys warned providers Tuesday that misuse of doses could result in their taking. New state guidelines for providers providing performance measurements were issued shortly before this warning.
Maine also faces equality questions. The high rate of non-response has made it difficult to determine how many people of color are getting the vaccine here. Some had to drive for hours. Distribution has been cut counterintuitively across the state, with Aroostook County moving rapidly across the state from part of the vaccinated population before being overtaken by Sagadahoc and Cumberland.
State officials have said no dose has been wasted. But they released one politics on Tuesday indicating countries may use residual doses to vaccinate eligible Mainers on waiting lists, people between the ages of 65 and 69, and vaccine clinic staff, with older seniors first.
There are also various metrics to consider when evaluating the success of states in delivering vaccines. Maine administered 78.6 percent of the total doses taken, ranking it among the nationwide packaging, according to Bloomberg News. But at least 13.2 percent of its population has received at least one dose, with only five states immunizing the most.
Director of the Maine Center for Disease Control and Prevention Nirav Shah warned reporters Tuesday not to rely on a metric, saying he thought there was a discrepancy in the way the state and federal CDCs were reporting the data.
What he was seeing for the most part is that doses are coming into the state, we are taking them to providers who are putting them into arms by the thousands a day, he said.
The state has also moved doses if it does not think vaccines are moving fast enough. It took thousands of vaccines from Walgreens and CVS Health, the chains that vaccinated long-term care institutions under a federal program and delivered them to independent pharmacies. Last week, he did not send any doses to the chains because he determined they had enough doses.
Joe Bruno, CEO of Augusta-based Community Pharmacies, said his employees have demonstrated their ability to get vaccines quickly, often pulling 12 doses from a vial and vaccinating hundreds a day. His company has been part of the state’s efforts to vaccinate long-term care facilities and Mainers over 70 years old.
We have no stretch as big box stores do, he said.
But Dan Morin, a spokesman for the Maine Medical Association, said he hopes the new metrics will encourage the state to send doses to independent providers who have been left out of the vaccination program so far. Shah has said the state prioritizes distribution based on which providers have a demonstrated ability to deliver a high amount of shots.
Morin said his group has worked with the state to develop a consortium model by allowing those providers to partner with larger organizations, an effort says the state will help distribute vaccines in rural areas.
We could not have been happier that the state has implemented more responsibility, he said.
Shooting is not the only metric the state should look at, said John Gale, a health care researcher at the University of Southern Maine and president of the National Rural Health Association. He needs to monitor how long it takes people to take pictures by the time they are eligible and how many doses providers have left each day, he said. They will demonstrate how effective a provider is, but will also shed light on entry issues such as travel or weather.
Maine should also look to see if a racial demographic appears to be receiving a disproportionate amount of vaccines and track daily changes in the number of vaccines distributed, said Jennifer Nuzzo, an associate professor at the Johns Hopkins School of Public Health at Bloomberg.
She noted people over 70 being vaccinated as an example. A slowdown in that population could mean travel challenges requiring the state to open clinics in rural areas, she said. Or maybe the rest do not want it, showing that the state has achieved saturation for one population and it is time to open vaccines for another group.
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