Maine Adopts Age-Based Approach to Expanding Vaccine Eligibility

February 26, 2021

Governor moves to age-based vaccine eligibility to continue focus on older Mainers most at risk of dying and to ensure speed and efficiency of vaccination effort

In an effort to save lives and ensure that health care providers can efficiently and quickly vaccinate as many people as possible, Governor Janet Mills announced today that Maine will adopt an age-based approach to expanding vaccine eligibility. As a result, beginning next Wednesday, March 3, 2021, Maine will expand eligibility for the vaccine to those 60 years and older.

The update to Maine’s vaccination strategy, decided in consultation with the Maine Department of Health and Human Services and the Maine Center for Disease Control and Prevention, reflects recent scientific data indicating that age is among the strongest predictors of whether an individual is likely to get seriously ill and die from COVID-19, even more so than risk factors such as underlying medical conditions.

For example, in Maine, 98 percent of deaths from COVID-19 have been people aged 50 and older. The death rate among people with COVID-19, when compared to Maine residents under age 50, is eight times higher for those in their 50s, 23 times higher for those in their 60s, and 214 times higher for those aged 70 and older. The relative risk of morbidity and mortality associated with age exceeds that of having cancer, lung disease, or a disability. At least four epidemiological studies have found that, even when considering a range of underlying medical conditions, age is a strong predictor of death or severe COVID-19 disease. This approach maintains Governor Mills’ strategy to distribute and administer vaccines in order to protect the most vulnerable - those most at risk of dying from COVID-19.

The straightforward strategy also replaces the prospect of complicated eligibility rules based on types of work and medical conditions that would be difficult to implement and verify. Such rules could inadvertently slow down the process of getting shots into the arms of Maine people, a critical goal to limit the spread of new COVID-19 variants. Instead, this clear approach provides a greater measure of certainty and predictability that allows all Maine people to know when they will be eligible for vaccination and is easier to implement and verify for health care providers.

The planned schedule, which is subject to change depending on fluctuations in vaccine supply including an acceleration if supply increases, is as follows:

  • March 3: Eligibility expands to residents age 60 and older
  • April: Eligibility expands to age 50 and older
  • May: Eligibility expands to age 40 and older
  • June: Eligibility expands to age 30 and older
  • July and beyond: Ages 29 and under, including children pending authorization of a vaccine for them

“Throughout the pandemic, my fundamental goal has been to save lives and protect our most vulnerable people. A review of recent data by the Maine CDC indicates that age is a significant predictor of whether someone will become seriously sick or is more likely to die if they contract COVID-19,” said Governor Janet Mills. “Taking that into consideration, along with the clarity, predictability, and relative ease of implementation, I believe this approach is the best option to save lives and ensure the vaccine can be administered to as many people as quickly and as efficiently as possible. We are undertaking the largest mass vaccination effort in history, and I am grateful to Maine people for their understanding and patience as we make adjustments to reflect the latest science and get shots into arms as quickly as we can.”

“Efficiency, equity, and science continue to guide our vaccination strategy,”?said Dr. Nirav D. Shah, Director of the Maine Center for Disease Control and Prevention.?“The research that has been published in recent months consistently and strongly shows that age matters when it comes to COVID-19 risk. As we work toward vaccinating all Mainers, from oldest to youngest, it remains critical that Maine people continue to wear face masks in public, stay at least 6 feet apart, and avoid non-essential gatherings with people who don’t live with them.”

“Simply vaccinating by age will increase our rate of shots in arms, helping us to win the race against the COVID-19 variant taking hold in Maine and look forward to a summer in Maine that, with masks and social distancing, can resemble normal,”?said Jeanne Lambrew, Commissioner of the Maine Department of Health and Human Services.?“While eligibility is extending to those in their 60s, we continue to work with health care providers and community partners to help those within that population who are the oldest, who are otherwise at risk or disadvantaged, or who may struggle to get to a vaccination site or access online appointments.”

“Clinical studies show that age is the strongest predictor of hospitalization and death from COVID-19, and we support the governor’s decision to expand vaccination eligibility to those aged 60 and over,” said Joan Boomsma, chief medical officer of MaineHealth, the state’s largest integrated health system. “The incidence of serious illness and death increases with age, and prioritizing in this way is a straightforward and sound way to allocate vaccine to those most at risk.”

“Northern Light Health welcomes this adjustment to Maine’s COVID-19 vaccination plan,” said James Jarvis, MD, physician leader for Incident Command, Northern Light Health, and director, Clinical Education, Northern Light Eastern Maine Medical Center. “Not only does this approach serve to vaccinate our largest vulnerable population, it also ensures that our state will remain leaders in efficient use of the vaccine. This approach provides vaccine facilities with clear guidance on who is to be vaccinated at each stage. It also removes unnecessarily complex barriers to vaccination, such as determination and verification of eligibility in categories other than age. In the end, with a limited supply of vaccine, efficiency and ease of operations will serve our communities and fellow Mainers better than any other approach allowing us to vaccinate all Mainers faster.”

“Ninety-five percent of COVID-19 deaths in the U.S. have occurred among people 50 or older. AARP Maine strongly supports the continued vaccination expansion to broader age-groups in our state,” said Lori Parham, AARP Maine State Director. “Individuals over 50 have been impacted more than anyone else by the coronavirus, and we will continue to work with Governor Mills and her team to ensure every Mainer who wants a vaccine can easily access it in their community.”

As part of the update to the vaccination strategy, Governor Mills also directed the Maine Department of Health and Human Services and the Maine Department of Education to provide in the coming weeks vaccination opportunities dedicated to pre-K-12 school staff who are eligible for vaccination within the age categorizations. This planning is underway to ensure a streamlined opportunity for the education workforce, and school staff can expect to receive information from the Departments of Education and Health and Human Services on when and where these opportunities will be provided. The Governor hopes that by providing dedicated opportunities for vaccination for teachers within their age categorizations, Maine can further protect school staff and provide more consistency for schools in terms of staffing moving forward. In the meantime, the Mills Administration has purchased 250,000 BinaxNOW rapid antigen tests that it has prioritized for schools, and child care providers, to expand regular testing and support in-person learning.

“Maine teachers, staff, students, and school administrators have worked hard and well this last year to follow public health guidance and promote effective learning, including in-person learning, said Pender Makin, Commissioner of the Maine Department of Education. “Holding dedicated vaccination clinics for eligible teachers and school staff will help to keep them and their students in the classroom.”

“The MEA appreciates that the Governor has heard us and that she recognizes the important role of our dedicated and hardworking educators and their heroic efforts to continue providing instruction and support for Maine’s students despite these extremely challenging times,” said Grace Leavitt, President of Maine Education Association. “We understand how difficult this is for everyone. Having educators prioritized within these bands by providing dedicated vaccination opportunities to expedite their receiving a COVID-19 vaccine will provide additional safety for our educators, our students, and our communities.”

“The Governor’s continued prioritization based on age, in recognition of the increased risk, is prudent and commendable, and we are so grateful for the addition to this plan to provide vaccination opportunities for school personnel, just as soon as they are eligible,” said Eileen King, executive director of Maine School Superintendents Association. “We will work with superintendents and the Maine DOE to support this creative solution to getting our school staff vaccinated, further protecting their health and safety while they are providing for their students. This will help as schools continue to abide by the required framework to keep everyone safe.”

“The vaccination timeline announced today is welcomed news to our school communities and the school boards who have been advocating for and supporting the safe operations of Maine schools,” said Steve Bailey, Executive Director of Maine School Boards Association. “The continued prioritization of those most at risk, combined with this practical approach to vaccination opportunities that are dedicated to our education workforce, will further support the healthy and safe operations of schools and protect our neighbors.”

The Federal government is responsible for purchasing and distributing vaccines to states, an allocation which is based on a state’s census population. Like every state, Maine has adopted a phased approach to its COVID-19 vaccine strategy because of the limited supply it has received from the Federal government. Through the week of February 23, Maine has received 227,215 first doses of COVID-19 vaccines. Through a separate Federal program, the U.S. Centers for Disease Control and Prevention has also distributed 13,280 first doses of the vaccine to pharmacies in Maine.

Maine’s began vaccinating in mid-December with the authorization of the first vaccine and focused on vaccinating health care workers and long-term care residents and staff. Governor Mills expanded eligibility in mid-January to include emergency first responders, public safety personnel, critical COVID-19 response personnel, and older Mainers, beginning with those 70 and older. These individuals continue to be eligible for vaccination. The previous approach then proposed that the next groups to be vaccinated would include people age 65 and older, then those with underlying health conditions, and then frontline workers. Today’s update replaces these previous, unimplemented phases with an age-based approach.

Maine continues to direct providers to prioritize vaccination of those most at risk of harm from COVID-19 as well as those who may face barriers to vaccination. This includes but is not limited to older Mainers who have not yet been vaccinated, age-eligible people with medical conditions or disabilities that put them at risk, and older people of color who have been disproportionately affected by COVID-19.

The expansion of eligibility to those 60 and older beginning next Wednesday is based on 30,080 first doses of COVID-19 vaccine coming to Maine from the Federal government during the week of March 1. This does not include doses of Johnson & Johnson vaccine that will be distributed to Maine if the U.S. Food and Drug Administration (FDA) grants the vaccine emergency use authorization. It also does not include a separate vaccine allocation to Walmart and Walgreens. Additionally, Maine has now vaccinated 60 percent of all residents aged 70 and older with first doses, including over 75 percent of this age group in Sagadahoc and Cumberland counties.

To date, Maine has administered 328,357 doses of COVID-19 vaccine. 217,667 people, or 16.19 percent of residents, have gotten first doses with 110,690 people, or 8.23 percent of residents, having received both doses.

Despite having the oldest population in the country by median age, Maine, adjusted for population, ranks second lowest in the nation in total hospitalizations; third lowest in total number of cases, and fourth lowest in number of deaths from COVID-19, according to the Maine Department of Health and Human Services. The state’s testing volume is seventh best in the nation and the state’s positivity rate over the past fourteen days is second lowest in the nation. Additionally, according to Moody’s Analytics and CNN Business’s “Back to Normal Index”, Maine is best in New England, and 18th best in the nation, in returning to pre-pandemic economic activity.

All eligible Maine residents are required to make an appointment in advance of receiving the vaccine. Because it takes time to implement changes in eligibility, newly eligible people should hold on calling for appointments until next week. For information on Maine’s COVID-19 vaccination strategy, visit: maine.gov/covid19/vaccines, which includes a list of vaccination sites across Maine with information on scheduling options.

Although vaccinations have begun, COVID-19 remains a serious public health crisis and Maine people should continue to heed all health and safety protocols, including wearing masks, staying home if you feel sick, practicing physical distancing, washing hands often, and avoiding gatherings.