Utahns 75 and older will be first in line for COVID-19 vaccine in next phase of rollout

Employment in food services and other industries “no longer being considered” as a factor.

(Leah Hogsten | The Salt Lake Tribune) "I won't feel 100% safe until this all of this is over," said Riley Swain, 32, serving patrons at Harp and Hound, a pub in Ogden on Monday, but he said he's OK with letting those 75 and older get the coronavirus vaccine before he does. Gov. Gary Herbert's COVID-19 Unified Command on Monday, Dec. 28, 2020, adopted recommendations for Phase 2 of Utah's COVID-19 vaccine rollout, which includes removing food and restaurant workers from the list of people eligible to receive the vaccine early.

Utahns age 75 or older will be the first people to receive the COVID-19 vaccine in the next phase of the state’s rollout, Gov. Gary Herbert and the Utah Department of Health announced Monday — but so-called “essential workers” in food and restaurant industries are no longer on the list.

As the state moves into Phase 2 of its vaccination plan, expected to start as early as mid-February, Herbert said in a statement, “it simply makes the most sense to vaccinate those who are at the highest risk for hospitalization and death first.”

Advocates for Utah’s restaurant industry, whose workers initially were considered candidates for Phase 2 because their jobs require them to interact with the public, are vowing to fight to get earlier access to vaccines to “essential workers” in food industries.

Dave Morris, president of the Utah Hospitality Association, acknowledged that health care workers should get the vaccine first. “Once you get past those guys, what industry has been more affected by COVID-19?” he said.

If doctors and nurses are the first people getting the vaccine, said Morris — who owns Piper Down and the Handle Bar in Salt Lake City, the Ice Haus in Murray, and Harp & Hound and Funk & Dive in Ogden — “the second one is probably the person who brings you a burger and a beer. … Shouldn’t your bartender be considered a front-line worker? The answer is yes.”

UDOH officials argued the numbers back up a policy to give the vaccine first to the elderly. The department reported that the hospitalization rates of people between 65 and 84 years old are more than three times the rates for people 45 to 64 — and the rates for people 85 and older are five times greater. People 65 and older also make up 77% of the 1,219 Utahns who, as of Monday, have died from COVID-19.

“We have seen older adults bear the most severe burden of disease in our state, and across the nation,” Rich Saunders, UDOH interim executive director, said in a statement. “These individuals are far more likely to be hospitalized, to need intensive care, and to pass away from COVID-19.”

Herbert and his COVID-19 Unified Command group adopted the recommendations from UDOH’s prioritization advisory group — an informal panel of more than 30 leaders and experts in multiple fields that has been meeting this month to suggest the order in which the vaccines should be distributed.

Members of the advisory group last met Dec. 22, by teleconference, when they sent some recommendations to the Unified Command group, which is handling the state’s COVID-19 response.

Arlen Jarrett, regional chief medical officer for Steward Health Care and a member of the advisory group, said a person’s age “certainly takes into consideration who’s at most risk, and it takes into consideration who’s most likely to get admitted to the hospital if they get COVID. If we vaccinate those people first, we’re probably saving more lives and easing up the hospitals’ burden so that they’re not overwhelmed.”

The first phase of the vaccine rollout, which is expected to last into February, is organized in three waves: Front-line health care workers first, then staff and residents of long-term care facilities and health care workers outside hospitals in the second wave, followed by teachers and public safety workers — police, firefighters and others — in the third wave. UDOH estimates some 267,000 Utahns will be eligible to get their shots during Phase 1, though some may opt out.

Phase 2, which is forecast to start in February or March and run into early summer, is expected to cover a wider swath of the state’s population, including: People over 65, people with underlying medical conditions, tribal communities, minority and ethnic communities, people experiencing homelessness, and the incarcerated.

In Monday’s announcement, UDOH said “an individual’s employment status in certain industries is no longer being considered” for a place in line for the vaccine in Phase 2. In earlier discussions, people who must work outside the home — such as in food service, restaurants and grocery stores — were one of the groups considered eligible for Phase 2.

“Focusing on age will do more to reduce infections and alleviate hospitalizations than any other category of individuals as we continue to administer vaccinations,” Gov.-elect Spencer Cox, who as lieutenant governor led Herbert’s COVID-19 task force, said in a statement.

Balancing needs

But Michelle Corigliano, executive director of the Salt Lake Area Restaurant Association, said Monday that the association “will fight to get hospitality workers a priority for the vaccine.” Corigliano added: “Our industry has been hit too hard for us to be on the bottom of the list. We must gain back the public trust that we lost from the government’s focus on our industry.”

Corigliano said that “focus” on the restaurant and bar industry included more health regulations, penalties and mandated closures than other industries.

Melva Sine, president/CEO of the Utah Restaurant Association, said Monday she and her group had met with Herbert, imploring him to put food handlers and other “front-facing” workers in the Phase 2 group.

Sine said she told Herbert that restaurants were one of the industries hardest hit by the pandemic, and “that vaccination being available … is a really fast way to create consumer confidence.”

Beyond the 75-and-older group, further recommendations for the order of who will get vaccinated first in Phase 2 are still being discussed. Before Christmas, members of the advisory group said the priorities for which groups would get the vaccine before others were fluid.

“It gets a little more in focus the closer you get to it,” said Rep. Raymond Ward, R-Bountiful, a state legislator and physician. “People are wanting levels of detail, and it’s like we’ve just got to get three more steps down the road with the first part [of the rollout] before we can even conceive the second part.”

“Nothing is really set in stone yet,” Jarrett said last week. “They’re developing a skeleton for how the state wants to recommend the Phase 2 rollout should go.”

The panel considering the order of those groups includes health care professionals, staff from UDOH and other agencies, representatives of county health departments, members of the Utah Legislature, and leaders in business, education and civic groups.

“It’s been a very thoughtful group,” said Heidi Matthews, president of the Utah Education Association, the state’s largest teachers union, who is on the panel. “It’s been very organized, with a lot of time for people to raise concerns and clarifications. I feel a great consensus out of this.”

Trying to strike a balance between groups — one that’s both fair and workable — is a tricky task.

“There’s a danger when you get a large group together, and … somebody happens to think [that] this group’s important [or] that group’s important — and you make this big chart about rankings and categories and things,” Ward said. That can happen, he added, “without stopping to say, ‘We don’t have a way to exactly measure all those things.’”

Any system set up to distribute the vaccine, Ward said, “needs to be relatively simple, otherwise you can’t hardly even follow it. It falls apart when you try to implement it.”

Jarrett agreed. “It quickly becomes apparent that if we make it too complex,” Jarrett said, “no one will understand it and no one will know when it’s their turn.”

That complex problem, Jarrett said, is “complicated by not really knowing a timetable for when the vaccine will be available. … If we had this many [doses], we’d do it this way, and if we had that many, we’d do it that way.”

In Phase 1, Ward said, the groups of people getting the vaccine were relatively easy to find. “Say it’s a hospital staff. That all happens at the hospital,” Ward said. “How about a nursing home? We have teams of vaccinators [to go into nursing homes], and even that is more complicated than you think.”

In Phase 2, Ward said, “you can’t do that. Those pipelines are way too small to get to a larger group that’s spread throughout the community.”

‘How complicated do we want to make it?’

Before Herbert and the Unified Command adopted their recommendations, panel members were reaching a consensus, Ward and Jarrett said, around using age as a prime factor for who would get the vaccine first in Phase 2.

“Largely, it’s just going to be by age,” Ward said. “To say, ‘How complicated do we want to make it?’ This is a way, at least, we know we can implement it this way and that it really will work, and largely we’ll get the highest risk of death and hospitalization first.”

Matthews — who pushed a recommendation, one Herbert implemented earlier this month, to move teachers and school staff into Phase 1 — pointed out that the difference between being at the front of the Phase 2 line and the back of the pack may not be too long if the state gets sufficient doses of the vaccine.

“Focusing on our high-risk groups, there’s still going to be other phases that are being implemented at the same time,” Matthews said. “Things are going to be happening simultaneously.

Jarrett said the Unified Command has “an awesome responsibility. … Everybody is asking to be first, and everybody is wanting to know why someone was chosen ahead of them.” Ward added, “no matter what decision is made, almost everybody will be mad.”

Two panel members, doctors with Intermountain Healthcare and University of Utah Health, declined to comment through spokespeople at their respective hospital systems, deferring to UDOH.

Jarrett, who oversees medical operations at Steward’s five Utah Hospitals, said it’s been exciting to be involved in helping Utah through “a once-in-a-century event. … The pandemic tunnel has been long, and this light is shining bright at the end of that tunnel, with the vaccinations,” Jarrett said. “It’s a very historic event, and we’re part of that.”

Making recommendations about the vaccine rollout, Jarrett said, beats the alternative.

“This is a good thing we get to do, to figure how to get the vaccine out,” Jarrett said. “It’s better than figuring out how to take care of overwhelmed hospitals.”