ROCHESTER, Minn. — State health officials on Wednesday, Dec. 9, expanded on their adoption of an ethical distribution framework for COVID-19 vaccines.

Among its curiosities, for now, the distribution plan appears to prioritize a healthy, young city waterworks employee for vaccination before an aging heart patient who lives in their own home.

The state is following vaccine distribution ethical guidance developed by the National Academy of Sciences and then the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC). As outlined, Minnesota has a strategy that distributes vaccines in three phases, from the vulnerable (1), to the healthy (2), to a maintenance program (3).

The goal is to offer early limited supplies of the vaccine in such a way to maximize impact on health while maintaining stable function of essential services.

The first of these phases has already been divided into three prioritization groups (1a, 1b and 1c), with the highest priority recipients —Group 1a — reserved for health care workers and residents of long-term care.

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While the state is expected to receive enough vaccine for 183,000 residents this month, there are 500,000 citizens who qualify for designation as Group 1a. Specifically, the state has:

  • 163,000 health care workers,
  • 130,000 long-term care staff,
  • 5,400 EMS workers and
  • at least 200,000 people employed in other health care settings or who are residents of long-term care.

Because some health care workers are in closer contact with the illness than others, the state has divided Group 1a into first-, second- and third-priority recipients.

"In the first-priority group (1a) individuals in health care and long-term care were prioritized," state director of infectious disease Kris Ehresmann said during a Wednesday afternoon media call. "It looks now like 1b will be essential workers and 1c will be individuals who are 65 or older or have underlying health conditions. "

Ehresmann said because the Advisory Committee on Immunization Practices (or ACIP) group is busy evaluating the vaccines and the vaccine supply is not yet capable of fulfilling Group 1a, they have not yet issued formal guidance about how to deliver the vaccine after every health care worker and group home resident is vaccinated.

"There has not yet been a determination at the federal level for phase 1b and 1c," she said. Ehresmann added that she doesn't know how detailed the ACIP will get in dividing up the subsets of so-called "essential workers," but hopes that the CDC panel provides detailed guidance.

"It's a pretty large group, so it would be helpful if they provided granuality," Ehresmann said. "Some of the things they have mentioned are educators, electricity grid, utility workers, food supply workers, emergency responders. So you can see with each of those, they play important roles in society."

"It's mind-boggling how many parts of our society are so absolutely necessary, and how many individuals play such an important role in their work, and it's frustrating to be in a place when we're trying to parse out limited vaccine."

In either event, at this time it is possible that a sizable and varied essential worker group which likely constitutes large percentages of people at low risk of worsening outcomes, will get the vaccine before those who are living at home but vulnerable to doing badly should they contract COVID-19.

Vaccines were purchased by the federal government to be distributed free of charge to all citizens who want one and are distributed to states on a per-capita basis.

Recipients will not have to pay for the vaccine itself but the law does allow providers to charge for clinical visit or administration fee, funds that are eligible for reimbursement through insurance.

Notification procedures for telling a person they are eligible to be vaccinated have not yet been determined, as the state will be busy for the foreseeable future offering the vaccines in private health care employment venues as well as residential home settings.

Recipients will receive a card stating that they have been vaccinated.

"As for the cards, obviously this is a very important vaccine and the intent is so that the individual has documentation that they have received it," said Ehresmann. "The intent is not that it is used as a means to gain access to anything, it's just so they have that in their hands. They don't have to reach out to their health care providers to get that."

Minnesota reported 4,539 cases and 82 deaths from COVID-19 on Wednesday.

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  • Minnesota Department of Health COVID-19 hotline: 651-201-3920.
  • COVID-19 discrimination hotline: 833-454-0148
  • Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.