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Health care vaccine finally headed for small providers in Rochester

Health officials worry new 65-and-over eligibility will reward those with the fastest Internet connection, not the neediest

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The Mayo Clinic’s Gonda Building in downtown Rochester. Forum News Service file photo
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ROCHESTER, Minn. — After weeks of building frustration, unvaccinated Rochester-area dentists, optometrists and other independent health care specialists will finally begin receiving shots for COVID-19 next week.

That's according to Dr. Melanie Swift, Mayo Clinic's director for employee vaccination, who clarified some information within the rapidly changing landscape for vaccine eligibility and supply during a news conference Thursday, Jan. 21.

"Beginning next week on Monday, Jan. 25, Mayo Clinic, Olmsted Medical Center and Olmsted County Public Health will begin vaccinating workers in Phase 1a, Priority 3, a group that includes all remaining community health care personnel who can't telework," Swift said.

"This includes dentists, dental practice workers, hospice workers, optometrists, audiologists, speech language pathologists, rehabilitation services, mortician labs and funeral directors."

Neither Mayo nor Olmsted Medical Center had been provided vaccine by the state for use among independent health care professionals in the community, a group that as outpatient providers, were technically categorized as priority three in the first phase of the rollout.

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As residents of a town dominated by the state's largest health care employer, front line Rochester-area independent health care specialists found themselves in a bottleneck behind thousands of Mayo employees with only indirect patient contact, but who drew a paycheck from an employer designated only for distributing vaccine internally.

There are an estimated 4,000 independent health care personnel in the Rochester area. Tending to this final mass of skilled professionals so late within the window for health care workers had become a point of division in recent weeks.

It stemmed, however, from government guidance that effectively prioritized those working in large organizations directed to administer vaccine internally.

Lacking guidance telling them otherwise, and with Mayo having worked through much of its priority three staff, the city's two health centers and county administration finally pooled vaccine for the outpatient specialists on their own.

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Dr. Melanie Swift

"We have been vaccinating within the state direction to do so for staff working in health care on site," said Swift. "We've met with our regional partners because we want to find a way to vaccinate people who are working in health care who are not our employees."

Swift said Mayo is now directing 1,000 doses allocated for its employees to community health care personnel, as will be Olmsted Medical Center and the Olmsted County Public Health.

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"We have not received vaccine from the state specific for them," Swift said, "and we have no other options. We want them to all to be vaccinated. We're all the same page, with the same goal. So I'm really excited we are able to do that starting next week."

Vaccine for those over 64 with fast Internet, not the sickest

This late attention to dentists comes amidst major disruption caused by opening eligibility to all aged 65 and older. Against all previous advice, the federal government last week announced that states should begin offering vaccine to everyone over 65.

The change forced skeptical Minnesota health officials to either reluctantly sign on, or face charges of slowing the flow of vaccine and allowing a backlog.

In Minnesota, Swift said, the rule change added 500,000 new vaccine recipients to the demand side of the ledger, just as it was getting ready to absorb 385,000 new recipients age 75 and older. All of it while the state receives just 60,000 doses a week.

"It's a huge challenge," Swift said of the new advisory. "This is a tremendous increase of people who would be eligible, and across a very broad range of risk. What happens when we have far more demand than supply is, we really run the risk of inequity in distribution."

In other words, Swift said, flooding the market with too little product will mean a Darwinian scramble, one in which the well-positioned will get shots first, often before those at greater risk.

"When it becomes a very competitive process for the public, the people who get first in line for vaccine are the best-connected, with the fastest internet connection — the people who are the most privileged."

"That's really not what we want the program to be about. We want to be able to reach the people who are at the greatest risk. We want to reach the people who may need help accessing vaccine, who may not speak English or be connected to a health care provider."

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Bucking this trend, Mayo plans to vaccinate along a stepped process that prioritizes the very old and with underlying conditions. Mayo cannot vaccinate patients in this category yet, however, and can only vaccinate its own employees and the program beginning Monday for invited health care workers in the community.

Seniors will need to access an appointment through one of the nine points of dispensing across the state. A limited number of those slots will be made available each week, beginning at noon Tuesday, Jan. 26, at the state's Find My Vaccine (https://mn.gov/covid19/vaccine/find-vaccine/index.jsp) webpage. Swift said the rush underway to get such an appointment has unleashed scam artists who are contacting those over 65 to over to sell them a spot in line.

"No one can do that," she said. "Don't fall for it. If you do hear anyone offer you that, please report it to the Minnesota Department of Health."

So far, the State of Minnesota has received roughly 300,000 doses that are available for shots, of which 246,000 have been administered.

3 tips for getting ready for vaccination

  1. If your provider has a patient portal, make sure you sign up for it and turn on your notifications. This is how you will be contacted when you are eligible.
  2. Have a working email that you check is linked to this portal, and if your portal is old, update the email. "If you have an old Yahoo email account you never use anymore, and that's where your health care provider's messages go, fix that," says Dr. Melanie Swift, head of the Mayo Clinic vaccination program. "You need to be able to be alerted."
  3. Know the big three websites: that of your health care provider, your county public health department, and the Minnesota Department of Health Find My Vaccine page.

For now, MDH is the only place the public can make an appointment for a vaccine. As more community vaccine sites open up, the sign up may be offered through those sites.

Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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