AUSTIN -- Lobbying to get to the front of the line for a COVID-19 vaccine in Texas is underway.
Leaders representing major industries -- airlines, energy, food processing, even Uber and DoorDash -- are asking Texas to give their workers early access to the limited supply of shots. Also calling for priority are teachers unions and groups representing people with diabetes, cystic fibrosis and other serious medical conditions.
Some sectors -- such as convenience stores, dialysis centers and freestanding emergency rooms -- have had employees transmit pleas for special consideration that were worded identically.
But as an accounting of the requests obtained by The Dallas Morning News on Wednesday underscores, there are far more hands being raised than there are vials to plunge a syringe into.
The competition for a spot at the front showcases the tough decisions ahead for state officials setting the list. Texas’ first doses are reserved for roughly 1.9 million front-line health workers and residents of long-term care facilities. The next group has not yet been finalized.
Should it be the elderly and people with chronic medical conditions, who are more likely to develop deadly cases of COVID-19? Or essential workers -- such as bus drivers, grocery store clerks and teachers -- who must interact with the public and risk infection on the job?
The decision rests with state health commissioner John Hellerstedt, who is receiving guidance from a 17-member Expert Vaccine Advisory Panel of public health experts, lawmakers and state officials.
“We are trying to follow the epidemiology of who is really getting sick and where we can have the biggest impact the quickest,” said David Lakey, vice chancellor for health affairs and chief medical officer at the University of Texas System and a member of the panel.
“It is a balancing act,” he said. “As you move those groups up, you push other people down.”
A flood of people have submitted letters, comments or questions to the panel, which Hellerstedt created nearly two months ago.
A spreadsheet compiled by the Department of State Health Services shows that through Tuesday, about 300 individuals and groups, including four state representatives or their staff members had commented or sent in queries.
A sampling of entries conveys lobbying of a kind that for Austin would be humdrum, were the state not in the grip of a pandemic that already has killed nearly 24,400 Texans:
- Drivers for the ride-sharing service Uber and food-delivery app DoorDash have been indispensable during the pandemic, wrote high-ranking executives for the two companies. Uber’s 180,000 Texas drivers “have been a lifeline to their communities,” transporting health care professionals to their hospital job sites, bringing meals to people socially distancing at home and helping keep restaurants afloat, said Uber chief executive Dara Khosrowshahi. Both firms asked for drivers to get shots as early as possible.
- Rep. Richard Raymond, D-Laredo, wrote that the panel shouldn’t overlook health care professionals who help the hard of hearing. On Wednesday, the lawmaker told The News he wanted Hellerstedt’s advisers, “in case they hadn’t,” to think about the audiologists, the hearing-aid fitters and others. Citing his late grandfather, a former oilfield worker who had “tremendous hearing loss,” Raymond explained, “I know how important it is to safely help people with hearing loss.”
- The Electric Reliability Council of Texas, which manages the electricity-transmission grid for almost the entire state, pleaded for 210 of its 750 employees to be as near the front of the line for shots as possible. It’s critical to keep the lights and ventilators running, and the 210 highly skilled technicians being nominated “are unable to work from home or in isolation from others due to the large amount of sensitive information that comes through the ERCOT Control Center,” wrote president and chief executive Bill Magness.
- Allen Fire Chief Jonathan Boyd wrote, “I respectfully request that for the purposes of initial vaccine allocation the Allen Fire Department be considered with the same regard as a hospital within Collin County.” Department spokeswoman Teresa Warren could not be reached to elaborate.
- TV and radio stations’ reporters, videographers and support personnel should be considered essential, leaders of the Texas Association of Broadcasters wrote. Oscar Rodriguez, the group’s president, explained in an email to The News that other frontline workers and medical personnel and medically fragile Texans ought to have first priority. But broadcast journalists “are out in the field reporting about health care workers and patients, and meeting with people in essential businesses, covering rallies, protests and public events,” he noted. “In addition, we singled out master control operation technicians and engineers servicing our transmission facilities and studios.”
While Hellerstedt’s advisory panel has been meeting for weeks, members deliberate behind closed doors, offering the public little insight into whether the lobbying efforts are working.
The private meetings are meant to encourage open conversation about potentially thorny topics, said department spokesman Chris Van Deusen.
“It kind of requires an ability to have a really open and blunt, at times, dialogue,” he said. “We didn’t want them to feel constrained.”
A federal advisory panel is making its own recommendations on which groups of Americans should receive shots first, but states do not have to follow them.
Texas, like many others, is reserving its early vaccines for frontline health workers and long-term care residents. A few states are giving other groups early access too, including members of law enforcement and people who are incarcerated or living in homeless shelters.
Public health experts say states will likely set different lists depending on their needs. Prioritizing the elderly and the sick could reduce the pressure on hospitals, while putting teachers first could help get students back into classrooms and restart the economy, said Mark McClellan, director of the Duke-Margolis Center for Health Policy at Duke University.
“I think you’re going to see differences emerging across states,” said McClellan, who also serves as one of Gov. Greg Abbott’s medical advisors. “In my ideal world we prioritize people who are higher risk and in these harder hit workplaces and settings.”
Texans over age 65 make up a majority of the state’s COVID-19 deaths. But older people who are retired may be able to quarantine.
Black and Hispanic Texans, who have been disproportionately affected by COVID-19, are more likely to work in essential jobs that can’t be done from home, according to state data.
It’s not yet clear how many doses of COVID-19 vaccines the state will receive over the coming months. Both the Pfizer and Moderna vaccines require two shots, spaced three or four weeks apart.
Roughly 9.5 million Texas have high-risk medical conditions, 3.9 million are over age 65 and 3.2 million work in essential jobs, according to earlier state estimates. Some people fall into multiple categories.
For December, Texas expects to receive 1.4 million doses of coronavirus vaccine from the federal government. But there are 1.6 million medical personnel and nearly 300,000 long-term care facility residents the state wants to vaccinate before anyone else gets the life-protecting shots.
Some of the pleas and comments logged in the spreadsheet would add some people to the designated definitions of front line health care workers and vulnerable Texans in settings almost as hazardous as long-term care, such as foster care, prisons, youth lockups and group homes for people with intellectual and developmental disabilities.
Superintendents, teachers unions and some elected officials pushed for educators to have priority.
The Texas Classroom Teachers Association wrote to the panel, as did several private school groups that asked for their educators to get shots at the same time as public school teachers. Vaccinating school staff would cause fewer disruptions for students, Monty Exter, a lobbyist with the Association of Texas Professional Educators, said in an interview. Right now, if a teacher is exposed to COVID-19 and has to quarantine at home, instruction often must shift online since substitutes are in such short supply.
“You’re shutting down a whole classroom and so that makes school reopening quite a bit more challenging,” he said.
Also peppering an advisory panel on state vaccine distribution with pleas are state agencies, such as the prison system, and advocates for foster kids, Texans with kidney disease and specialty health care professions that were omitted from the initial priority list -- such as procurers of organs for transplants and fitters of prosthetic limbs.
Nearly a dozen physicians requested priority for dialysis patients, who have a much higher mortality rate from COVID-19 than the general population, said Dr. Geoffrey Walker, a Dallas area nephrologist and a medical advisor for American Renal Associates.
Texas is home to more dialysis patients than any other state, much of it driven by diabetes, he said.
“Everybody wants the vaccine, I understand,” Walker said. “But I think dialysis patients will get the priority because they are a high risk group.”
