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April 17, 2021

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Washington state releases COVID-19 vaccination tiers, timeline through April


The Washington state Department of Health will next prioritize for vaccination anyone who is 70 years and older and those who are 50 years and older and live in multigenerational households, the department announced in a media briefing Wednesday.

Dr. Umair Shah, the state’s health secretary, said Washington has not yet approved of vaccinations in this next tier, called B1, but plans to do so sometime later in January. Officials were providing the guidance, which hospitals and industry groups have been clamoring for, so health providers could prepare and scale up vaccination.

The new guidance establishes a complex web of priority tiers and charts the state’s course through the next four months of vaccination. The announcement comes at a time when much of the nation is struggling to keep up the pace of vaccination and highlights the dual concerns of health officials, who must get vaccines into arms quickly, but also get doses into the arms of those who stand to lose the most from COVID-19 if they are not protected.

“These are really tough decisions,” said Michele Roberts, the state Department of Health’s acting assistant secretary, who said the plan is designed as an “equitable way to protect people in our state most at risk.”

Meantime, state data suggests vaccine administration continues to lag behind delivery, though the pace of vaccination has improved.

The state health department had received 522,550 doses of vaccine, between the Pfizer and Moderna products, so far, Shah said. Vaccine providers have administered at least 126,602 doses, Shah said, noting that data reporting of administration lags by about three days.

In addition to the next tier of vaccinations the department detailed through April who else would be eligible for a COVID-19 vaccine, in phases B2, B3 and B4.

The phases and who qualifies can be seen here.

Phase B2, slated to begin sometime in February, prioritizes critical workers who are over 50 and at high risk because they work closely with others, including K-12 school staff, jail or corrections workers, food processing workers and agriculture workers.

Phase B3, planned for March, includes anyone over the age of 16 who has two or more health conditions that overlap and cause concern with COVID-19.

The state is aiming for Phase B4 in April, and has included in that group high-risk critical workers of any age, as well as people and staff in congregate settings like homeless shelters, correction facilities and group homes.

Overall, the complicated system of tiers refines, and differs somewhat from federal guidelines, which suggested prioritizing those 75 and up, along with essential workers.

Roberts said the prioritization is designed to first protect seniors, who are most at risk of death or suffering from severe disease.

“We know many families take care of elders in their home and we want to make sure we’re reaching those families as well, to protect those at most risk,” Roberts said.

Roberts said the health department assessed data on risk specific to Washington state and also used feedback from the public in adjusting the state plan. Roberts said adjusting the age from 75 to 70 would be more inclusive.

“75 is a pretty high age to start with,” Roberts said, adding that using it as a bar could leave out people in some racial and ethnic groups with lower average life expectancies.

The health department plans to launch Jan. 18 an online questionnaire tool, called PhaseFinder, to help Washington residents identify when they are eligible to receive vaccine and where they could seek vaccination.

The tool will ask users questions about their age, location, occupation and living situation. Both the tool and the state’s plan rely on an honor system and for Washingtonians to faithfully represent themselves.

The state Department of Health has been regularly updating its interim plan to distribute vaccines, which was published in October and aims to ensure both equitable allocation of vaccine and maximum benefits to health and the functioning of society.

The state plan relies on a framework developed the National Academies of Sciences, Engineering, and Medicine and also guidance from an independent group of scientists advising the federal Centers for Disease Control and Prevention.

Last month, the state decided to prioritize high-risk health-care workers, first responders and residents in long-term care facilities. The health department estimates that about 500,000 people qualify for vaccination in the top priority group, called Phase 1A.

The department asked hospitals to use “clinical judgment” to provide the first vaccines for workers who are most at risk, prioritizing people who do not have a recent COVID-19 infection, those directly caring for COVID-19 patients and those performing higher risk procedures, such as intubating patients.

It also suggested prioritizing testing site staff, those handling COVID-19 specimens, high-risk first responders, health workers interacting with high-risk populations and those administering the vaccines, themselves.

Vaccine arrived in Washington state on Dec. 14., and the vaccination of health-care workers began the next day. The effort to vaccinate at long-term care facilities largely relies on a federal partnership with CVS and Walgreens pharmacies. That program launched Dec. 28 in Washington.

Public-health experts expected the early days of vaccination to be marked by logistics hiccups, with underfunded state and local public-health agencies, along with hospitals stressed by COVID-19, leading the effort to get vaccines into people’s arms. Indeed, the rollout in Washington has been uneven at times.

Early on, miscommunication between state the federal officials clouded the state’s expectations of vaccine supply, and shipments to hospitals were delayed or changed, confounding plans.

Some hospitals in rural areas report receiving an excess of vaccine for the number of people eligible in their communities for vaccination’s first phase. Meantime, many health-care providers who qualify to be vaccinated, but are not connected to a large medical system, have reported difficulty find sites to receive their first shots.

As concern grew over the pace of vaccination, the health department expanded its guidance to allow vaccine to be administered to health-care workers who are not on the front lines against COVID-19.

Gov. Jay Inslee on Tuesday said he was feeling better about the state’s pace of vaccination, citing statistics provided by several larger hospitals that suggested they had been able to administer the majority of their allotments.


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