EIRMC COVID-19 vaccination

James Williams, director of pharmacy at Eastern Idaho Regional Medical Center, prepares doses of the Pfizer COVID-19 vaccine for staff last month.

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Bucking CDC guidance issued last month, Idaho’s vaccine planning panel recommended on Friday that Gov. Brad Little let people 65 and older start receiving COVID-19 shots in the next phase of vaccinations.

Currently, Idaho is vaccinating its top-priority group: Health care workers and residents of long-term care facilities. The state hopes to finish up that group by the end of January, but that’s only if the 130,000 necessary doses of vaccine arrive in time.

Idaho’s health department expects the next vaccine phase to begin in February. The state had already said that frontline essential workers, such as first responders, K-12 teachers and prison employees, would be vaccinated in the next phase. But the Idaho panel on Friday was presented with the question of what age range they should allow to also access shots in this phase.

The Centers for Disease Control and Prevention recommended people over 75 years old should get the vaccine in the next phase. Some states have diverged from the federal guidance, allowing vaccines to all people over 65 years old.

Within the question of who gets the vaccine first, vaccine planners are grappling with several other questions. How do you make access equitable to people most likely to be exposed to the virus, and to those most likely to die, while protecting critical infrastructure?

“Although older adults might be less likely to get infected” than younger people, “10 to 20% of the time they have disease severe enough to require hospitalization,” said Kathryn Turner, deputy state epidemiologist. She also said older people are much more likely to die from COVID-19.

Seniors pushed state officials on the issue this week, following a timeline released in late December that showed Idahoans over 65 but younger than 75 would start accessing the vaccine in April. In a letter to the editor in the Idaho Press on Wednesday, 70-year-old Meridian resident Robert Earl asked Little to do “the right thing.”

“We have done our share and remained inside as much as possible, wore masks, socially distanced, and washed our hand frequently during the day! Now we are being asked to do way more to be alive to receive the vaccine shot months away,” Earl wrote.

Considering people 65 to 74 years old distinct from people 75 and older is significant, both in the numbers of doses needed and in their coronavirus risk.

Raising the age brings estimates for people who can access shots in the next phase from 331,000 to 507,000. The risk of hospitalization and death due to COVID-19 is higher for people 75 and older than they are for 64 and older. But, data and some medical leaders say, the group of people straining hospital resources the most includes everyone older than 65.

“In my mind, at 65, the hospitalization rate increases, mortality increases,” said Dr. David Peterman, CEO of Primary Health Medical Group. “… I believe our job is to keep people away from the hospital.”

“The majority of the problem is in that age group, and we need to decrease the problem we’re having with hospitalization,” said Dr. Randall Hudspeth, director of the Idaho Center for Nursing.

Just before 25 members of the 32-person panel voted to reject the federal guidance, Mel Leviton, director of the Idaho State Independent Living Council, said all people over 65 years old are “the ones getting really thrown under the bus” if hospitals in the state have to ration care.

Little will make an announcement about the panel’s recommendations next week, according to Press Secretary Marissa Morrison Hyer.

To prioritize limited resources, the Crisis Standards of Care plan directs doctors to score patients by their likelihood of living. Age is one of the factors.

“If we get to Crisis Standards of Care, that’s what they’re looking at,” Leviton said.

On Friday morning, the state coronavirus website said about 27,000 Idahoans had received the vaccine. It appears that over 1,000 people had received their second dose; the state says over 28,000 doses have been administered. Those official numbers likely under-represent vaccine administrations in the state because reporting can be delayed by 72 hours.

To date, Idaho has received 67,875 doses of COVID-19 vaccines from Pfizer and Moderna.

Idaho health officials expect the state to receive 19,450 vaccine doses each week, with the same amount for second doses being reserved each week. State immunization director Sarah Leads said that could change, with president-elect Joe Biden’s administration announcing Friday that it will send both first and second doses to states simultaneously.

Reporter Kyle Pfannenstiel can be reached at 208-542-6754. Follow him on Twitter: @pfannyyy. He is a corps member with Report for America, a national service program that places journalists into local newsrooms.

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