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Who’ll get Texas’ first COVID-19 shots? Hospital, nursing home, EMS, home health workers top the list

A state health department panel also adopts seven standards to guide rationing of what at first will be limited supplies of vaccine.

Updated at 4:20 p.m.: to include latest number of providers who’ve agreed to receive vaccine and administer shots.

AUSTIN — Hospital staff members working directly with coronavirus patients and workers in long-term care institutions serving vulnerable populations should be the first state residents to receive vaccines for COVID-19, a Texas health department panel has recommended.

On Monday, Gov. Greg Abbott hailed the issuance of a priority list for who should receive initial shots from a limited supply of vaccine, beginning as early as next month.

Abbott also praised the panel for embracing seven standards to guide rationing decisions, such as initially placing priority on health-care workers and workers essential to the state’s economy, but also protecting at-risk groups of people and recognizing “health inequities” and Texas’ considerable geographic diversity.

The standards and a definition of health care workers were adopted in recent days by the Expert Vaccine Allocation Panel, a group of 17 advisers, including legislators, that state health commissioner Dr. John Hellerstedt created last month.

“These guiding principles established by the Expert Vaccine Allocation Panel will ensure that the State of Texas swiftly distributes the COVID-19 vaccine to Texans who voluntarily choose to be immunized,” Abbott said in a written statement.

Among the guiding principles are a desire to make data-driven decisions based on public health, be open about rationing decisions and seek feedback from the public.

After protecting health-care and front-line workers and vulnerable populations, the fourth principle is “Mitigating health inequities due to factors such as demographics, poverty, insurance status and geography.”

In the U.S. and Europe, three COVID-19 vaccines have been developed that are up to 90% effective, if not more, in preventing infections without serious side effects. On Monday, AstraZeneca and the University of Oxford released results from clinical trials in the United Kingdom and Brazil. Its U.S. study, which was paused in early September, resumed Oct. 23.

Pfizer and Moderna have vaccines that, while further along in the regulatory approval process, require storage in subzero temperatures. The Oxford-AstraZeneca one does not.

In defining health-care workers who would be at the front of the line, the Texas panel created two tiers.

“Tier 1” prioritizes hospitals, long-term care providers, emergency medical services and home-health and hospice care.

At hospitals, the first recipients should be “physicians, nurses, respiratory therapists and other support staff (custodial staff, etc.),” followed by clinical staff providing laboratory, pharmacy, diagnostic and rehabilitation services, the panel recommended.

At nursing homes, assisted-living facilities and state supported living centers, the first doses of available vaccine should go to “direct care providers,” followed by doctors, nurses, personal care assistants, custodial and food service staff.

EMS workers “who engage in 9-1-1 emergency services like pre-hospital care and transport” and home health and hospice care workers “who directly interface with vulnerable and high-risk patients” round out the first tier.

“Tier 2” is outpatient settings where health-care providers are treating patients exhibiting COVID-19 symptoms. This includes at clinics, doctors’ offices, freestanding emergency medical care facilities, urgent care clinics and community pharmacies. Under a recent decision by President Donald Trump’s administration, large pharmacy chains are to receive direct shipments of vaccine from the federal government, separate from the state’s supply.

Also in the second tier would be public health and emergency response staff members who are “directly involved in administration of COVID testing and vaccinations;” medical examiners, embalmers and funeral home workers handling the bodies of Texans who die of COVID-19; and school nurses.

Nearly 3,700 health care providers and institutions in 221 counties have signed up to receive shipments of vaccine and administer the shots, said Chris Van Deusen, spokesman for the Department of State Health Services. Adding in the pharmacy chains, there will be at least 6,000 sites across Texas where health-care professionals will be giving shots, he said.

Robert T. Garrett, Austin Bureau Chief. Bob has covered state government and politics for The Dallas Morning News since 2002. Earlier, he was a statehouse reporter for three newspapers, including the Dallas Times Herald. A fifth-generation Texan, Bob earned a bachelor’s degree from Harvard University. He covers Gov. Greg Abbott, the state budget and CPS and foster care.

rtgarrett@dallasnews.com /bob.garrett.39 @RobertTGarrett
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