Last week, President Biden set an ambitious goal to make all adults eligible for a COVID-19 vaccine by May 1. Though Oregon officials initially said the state timeline would not change until the federal government provides more vaccine doses, Oregon Health Authority Director Patrick Allen told “Think Out Loud” on Wednesday that all Oregonians 16 and older will be eligible to get vaccinated against COVID-19 by May 1.
Below is a complete transcript of that interview, edited for clarity.
Dave Miller: This is “Think Out loud on OPB.” I’m Dave Miller. Last week, in his first primetime address to the nation as president, Joe Biden made a bold claim.
President Biden (on tape): Tonight, I’m announcing that I will direct all states, tribes and territories to make all adults — people 18 and over — eligible to be vaccinated no later than May 1. Let me say that again. All adult Americans will be eligible to get a vaccine no later than May 1. That’s much earlier than expected. Let me be clear. That doesn’t mean everyone’s gonna have that shot immediately, but it means you’ll be able to get in line beginning May 1.
DM: The next day, this past Friday, Oregon officials said they welcomed the president’s announcement but wouldn’t change the state’s current vaccination schedule until they knew that more doses were actually on the way. Patrick Allen is the director of the Oregon Health Authority. He joins us now to talk about where things actually stand at this moment. Patrick Allen, welcome back to “Think Out Loud.”
Patrick Allen: Thanks for having me back.
DM: So, you have been waiting, it seems, on more clarity about the potential increases in vaccine supply. Do you have more clarity right now?
PA: We don’t have a lot more clarity, no, but what we do have in hand today is an order from the Department of Health and Human Services directing vaccination sites to make this change with eligibility. So, we will be complying with that order and making all Oregonians eligible on May 1st.
DM: So, but it seems like you’re doing that because you got this federal order. But I imagine then, if you don’t yet have definitive word from the federal government or vaccine distributors that you’re going to have the increase in supply commensurate with that, where does that leave us?
PA: Yes, so it leaves us a little bit nervous. Um, to be fair, this administration has generally been pretty good about making good on what it has assured us we would be able to see in terms of doses. Those doses aren’t showing up yet in the three-week view that we get in the system where we allocate doses. So, there’s some nervousness around that, but at the same time, we’re also really committed to equitable distribution of vaccine. And so we’re also taking a look at the populations that we were going to make eligible on May 1st and seeing if it’s feasible for us to move those people — frontline workers, younger people with preexisting conditions — up a little bit ahead of that May 1st date so that we can we can get to them as well.
DM: But I just want to make sure that I understand this because in the deluge of daily news, I have to be honest, I had missed this. You’re saying that, as it stands right now in Oregon, every single adult is going to be eligible for the vaccine, a vaccine, on May 1st?
PA: Yes, and with the addition of the rest of the president’s sentence, which was that does not mean they’re going to get a vaccine on May 1st, right?
DM: Right. It means that everybody will have the ability to go online or make a phone call and, along with everybody else, try to get an appointment.
DM: So I want to run then another excerpt by you from the president’s speech, because it seems like an important aspect of this. Let’s have a listen.
President Biden (on tape): At the time when every adult is eligible in May, we will launch with our partners new tools to make it easier for you to find the vaccine and where to get the shot, including a new website that will help you first find the place to get vaccinated and the one nearest you. No more searching day and night for an appointment for you and your loved ones.
DM: Do you know what the president is talking about there?
PA: We have not seen any details about that as of yet.
DM: So, um, then maybe these next questions will be hard for you to answer. But do you get the sense that what he’s talking about is a complete federal system? Or is the idea that somehow the federal government would provide a template for states? I mean, I ask this because it’s been, you know, we have 36 different counties that are all doing vaccination distribution differently here. There’s been a lot of question, for understandable reasons, about the complicated nature of this. And so the idea of there being a single federal website in two months seems like a gigantic order.
PA: Yeah, and you’re asking the exact right questions in terms of what does that look like? And we don’t have a lot of visibility. I will say, though, that at the volume of vaccine that we are expecting by that May 1st date, these problems actually get easier rather than harder, because effectively you start being able to find vaccine everywhere. At that point, you find it at your local health care provider’s office. You find it at your local pharmacy and more quantity than it is now. We’ll still be operating the large mass vaccination sites that we are now at that point. And just the sheer diversity of places that you’ll be able to get vaccine make this distribution issue a lot easier.
DM: Can you give us a sense? So, the numbers that I have been looking at are that, roughly speaking, we’re at about 25,000 doses a day in Oregon going into arms?
PA: That’s correct.
DM: So, what are the numbers that you’re imagining that, ideally, we’re talking about on May 1st?
PA: Oh, I would say, double that at least, and probably a bit more.
DM: And so more than double is what seems to you right now like a feasible future in the near future?
PA: Yeah, I think that’s exactly right. We certainly know that we can administer that much vaccine. And we certainly have been given reason to believe, based on national totals by certain dates, that that amount of vaccine should be available. It really comes down to a question of exactly when is it available? We’ve heard lots of discussion about vaccine available at the end of March. Well, it makes a big difference if it means that we can order vaccine this week that will show up next week and be a usable through March 28th versus being able to be ordered next week, and we get to use it the week of the 29th. There’s a big difference over that week, and so just knowing exactly when we’re going to see things is going to matter a lot.
DM: How much clarity do you have right now about when large-scale distribution of the Johnson and Johnson — the one dose vaccine — is actually going to be in the pipeline in Oregon?
PA: Yeah, that’s the biggest unknown right now because it’s the biggest change in volume that we’re expecting going forward and we don’t see it yet. We hope we may see it tomorrow available for next week, and we certainly hope that, if we don’t see it tomorrow, that we see it next week for order the week after.
DM: But when you say that’s the biggest change, meaning the other two federally approved vaccines, you’re expecting less of an increase in those in the coming months, but if Johnson Johnson really does come online, that could be more of a game changer?
PA: Based both on its volume and the fact that it’s a single dose vaccine, that’s right.
DM: Assuming supply does increase greatly in the coming weeks, how much might that change the prioritization order that is scheduled right now?
PA: Well, so right now we’re expecting to make a variety of populations eligible on March 29th, and that’s people over age 45 with underlying conditions, agricultural workers, food processing, that kind of thing, and a few other populations. What we are exploring is the feasibility of moving the rest of the targeted populations up, and that’s primarily frontline workers and multigenerational households and then younger people with preexisting conditions. We’d like to try to move that up ahead of the first if we have the have the supply and we’re exploring that right now. But then at that point, when May 1st rolls around, if the if the vaccine is there in the volumes that we expect it to be, we actually should tip over from having way more people who want vaccine than we have supply to having plenty of supply and actually being able to focus on working on hard to reach populations, hesitant populations, people who need more education, more information and those kinds of things. And that’ll be a real different mission than the one we have right now, which is just trying to keep up with very, very heavy demand.
DM: If you’re just tuning in, we’re talking right now with Patrick Allen. He is the director of the Oregon Health Authority. I want to hear more about that pivotal pivot that hopefully is coming soon where, as you say, instead of being about supply, the focus is on demand. But focusing a little bit more on the coming weeks: as you well know, one of the biggest recent debates about vaccine eligibility has been about grocery store workers. In July, the governor wrote, “Grocery store employees are frontline workers who are risking their health to feed their communities,” but she did not make the decision to include them with the next group that’s going to be eligible, which does include farmers or agricultural workers and food processors. How was that particular decision made?
PA: Well, I think that what we do with the next population as we focus on people with underlying conditions and those conditions mean that if they get COVID, they’re much more likely to suffer very negative outcomes from it. And then we add the agricultural workers, and that’s been where some of the biggest centers of outbreaks across the state, and you can see it in places like Morrow and Umatilla County over on the coast and food processing throughout the valley, in various agricultural settings. And so we’re really trying, with the prioritization to focus on where the disease is most and where the disease can be worst.
DM: Over the last couple weeks, there has been a new system for people to actually get appointments at the mass vaccination site at the Oregon Convention Center. People can sign up with the getvaccinatedOregon tool, and then, instead of having to worry about maybe being timed out on the website or getting that just right, they sign up, then they can get an email letting them sign up for the vaccination. As I understand it right now, there is no category there on that tool currently for pre-existing conditions, but that people with pre-existing conditions are going to be newly eligible, as we’ve been talking about in just about a little more than 10 days. Will new questions be added so people with pre-existing conditions can use that particular tool?
PA: Yeah, my expectation is those new questions should go live today or tomorrow, and we’ll go ahead and push out communication to people who have already registered, asking them to come back and answer those questions to update their eligibility.
DM: So let’s turn to this pivot you were talking about before. What is your estimate for when this really does switch from being an issue of not enough supply to encouraging demand?
PA: You know, interestingly, we may already be at that pivot in a number of counties in Oregon. We’ve got probably a dozen or so counties that are now in a circumstance — and these are mostly, but not entirely, rural and remote counties — where they pretty much have got appointments available for seniors and they don’t have seniors left who want the vaccine to take up those appointments. Now, those are, as I said, mostly smaller counties. But I think we’re short weeks away from the place where the large volume of people that outstrips supply will tip over. I think it will happen probably during the month of April.
DM: What is your own internal sense at the health authority for the level of vaccine hesitancy in Oregon right now?
PA: You know, it’s geographically really, really variable. And we’re seeing this in the senior population. In the Metro area, we still have lots of seniors who want to get vaccinated and lots of demand. In more rural parts of the state, it seems to be quite a bit lower. And you’ve probably seen some surveys out there that that indicate there might be a little bit of a male/female split on that, maybe a little bit of a political split on that, but I think what we’re going to find is we’re going to find some parts of the state where hesitancy is really high and other parts where uptake is really high, and it’ll be a real kind of a patchwork across Oregon.
DM: I mean, it’s worth pointing out, and this survey is pretty old now — the one from University of Oregon. It was released in December, but at that point, those researchers found that a quarter of respondents said that they would not take a vaccine. Another third were unsure. How worried are you that, as a state, we will not get to herd immunity levels in the state?
PA: I think it’s a concern and I think it’s certainly a concern that there may be communities or regions or counties that might not get to that level. The good news is that that second group that you identified, people who were uncertain, seem to be resolving toward wanting to get the vaccine, and I think what that really is it’s people who have seen their friends, neighbors, coworkers, get vaccinated and not have problems or those kinds of things. And, you know, we see them coming out of the woodwork. We’ve been vaccinating the 1A population — health care workers and that kind of thing — since the very beginning in December, and every day we see more of them turn up that are looking for vaccine. And I think it’s that third who were questioning who are now deciding the answer is, yes, they want to get the vaccine.
DM: You know, I had phrased this as a question of now we’re still, the question is not enough supply, but soon it will be not enough demand. But I wonder if that’s too simplistic. How much of a connection do you see between the ease of getting a vaccine, say, having it being offered in your doctor’s office or in the Walmart that you’re used to going to, how much of a connection do you see between that kind of easy availability and more of a willingness to actually get the shot?
PA: Oh, it’s very strong. And particularly your doctor or nurse practitioner’s office, I think is a big piece, particularly for those folks who are maybe really hesitant or even in the category of they don’t want to get it. They’re not going to listen to a public service announcement from an athlete or a politician saying they should get the vaccine. They’re going to listen to their doctor or their nurse practitioner. We’ve done some surveys on this. That’s who is most persuasive in getting people to get the vaccine. So, when the vaccine is there and that’s the place you get it, that will really help address this hesitancy.
DM: Finally, and briefly, I want to turn to the question of schools and regulation of school opening. Six feet apart has been this this gold standard and oft repeated phrase for a year now when it comes to physical distancing. But that’s very difficult for schools to accommodate, especially if they want to have anything close to an old number of students in a classroom. A new study suggests that if children are wearing masks and taking other precautions, then three feet of distance might be sufficient. Is the Oregon Health Authority considering modifying its guidance for Oregon schools?
PA: We’re reviewing our guidance. We’re also looking closely at what the CDC says. The CDC, what they say has been, I think, misunderstood or misinterpreted by people. They continue to recommend six feet. They identify circumstances where three to six feet, if six feet isn’t feasible, could be used. They’re also reviewing that guidance right now, and we’re watching that carefully, looking at studies ourselves to look at that. And so we may yet review that guidance, but not today.
DM: Patrick Allen. Thanks very much for your time. Once again.
PA: Thank you.
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