Amid vaccine shortages and changing prioritization guidance from the federal and state government, Michigan Medicine has administered more than 51,000 COVID-19 vaccine doses since mid-December.
The health system is closely following state guidelines as it distributes vaccines, recently completing vaccination of most of those who fall into the state’s first priority group, Phase 1A.
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To date, all U-M employees defined by the state as essential workers under its second priority group, Phase 1B, have been invited to make an appointment for their vaccination.
At U-M, workers considered as frontline essential workforce in Phase 1B include child care workers, K-12 education workers, Division of Public Safety and Security personnel not included in Phase 1A, residence hall staff, food service workers, environmental services and custodial staff, and certain maintenance personnel. Across all three campuses, fewer than 500 individuals fall into this category.
The vast majority of campus employees fall into later priority phases and, under current state guidance, will be eligible to receive vaccine in Phase 1C or Phase 2. The timing of those phases is dependent on vaccine supply and determined by the state.
Although campus employees may be considered essential to the functioning of the university by their department or asked to work onsite, only those in the roles listed above fall into the essential worker category in Phase 1B as defined by the state of Michigan.
In January, the state expanded the current vaccination phase to include all people age 65 and older. Michigan Medicine is vaccinating established patients and employees in this group as vaccine becomes available. Of the more than 51,000 vaccine doses Michigan Medicine has delivered — with Feb. 2 marking the 50th day of vaccine distribution — about 4,500 have gone to Phase 1B essential workers and individuals 65 years of age and older, as both first and second doses.
Vaccine supply has been extremely limited nationwide and as a result, Michigan Medicine has received fewer doses each week than it has the capacity to administer, getting sometimes as few as 1,950 doses in a week. With adequate supply, Michigan Medicine has the capacity to administer up to 24,000 doses each week.
The limited supply forced Michigan Medicine to significantly reduce vaccine clinic operations. The state estimates that completing Phase 1B will take months.
“We understand the frustration and anxiety of everyone who wants to get vaccinated as soon as possible. Unfortunately, we have not been able to receive enough doses to administer vaccines at our capacity,” said Sandro Cinti, professor of internal medicine and one of the co-leads of Michigan Medicine’s COVID-19 Vaccine & Therapeutics Task Force.
The state is distributing a higher percentage of its received vaccine supply to county health departments and pharmacies to better reach high-risk populations and engage a regional approach to vaccination. Michigan Medicine is partnering with local health departments and other health care systems across the region to expedite vaccine delivery for every dose received.
All Michigan Medicine employees have been invited to receive a vaccine. About a month ago, health systems across the state were asked by the Michigan Department of Health and Human Services to extend the definition of Phase 1A to include anyone who is critical to the continued provision of health care infrastructure. This included individuals who may not work in direct or indirect patient care areas or work on-site in the clinical setting but who must be well in order to keep the front line functioning.
The state has identified health care systems as critical infrastructure. All Michigan Medicine employees are essential to the functioning of the health care system, even though these individuals may work remotely. For example, staffing the hospital depends on Human Resources personnel hiring and training new nurses, while information technology workers are required to sustain operations to maintain electronic health record systems.
When Michigan Medicine expanded the definition of Phase 1A to all employees, the state of Michigan had not yet moved into Phase 1B, and state directives were to use at least 90 percent of received vaccine within seven days.
“We believe every dose administered contributes to the overall safety of our community and have continuously administered over 90 percent of vaccines allocated to us by the state within the week,” Cinti said.
“Our goal is to administer as many vaccines to the community as quickly and safely as possible, and to maintain alignment with the state and other health entities to reach our highest risk populations and slow the devastating spread of COVID-19.”
Bruce Frier
What provision is being made for emeriti faculty?
Barbara Bradley
“The state estimates that completing Phase 1B will take months.” — This is extremely frustrating and discouraging news for those of us who fall into Phase 1C or Phase 2. It is very difficult to sit back and watch folks brag about getting their 2nd doses already when the vast majority of people are months away from that milestone.
Don Winsor
I do not understand why Michigan Medicine is using a lottery; randomizing within groups. The evidence strongly supports that risk of severe complications or death increases monotonically with age. Thus, the maximum reduction in deaths and in burden on the health system would come from using a strictly age based system within groups. For example, offer to all age 75+, and when the supply/demand balance permits, change that to 74+, then 73+, etc. Using a lottery strikes me as ethically questionable at best given the evidence is so clear that more lives would be saved in going by age.
Erdogan Gulari
Michigan medicine seems to explain why they used all the vaccines for themselves instead of distributing on a need basis.
Nilton Renno
It appears that faculty interaction with students are not considered to be a risk. Why is teaching college students face-to-face less risky than teaching high school students?
Debra Phelps
Age does have a factor in outcomes for Covid. So do other health factors. Younger people may have suppressed immune systems, kidney disease and other severe health conditions.
I keep wondering why those 65+ aren’t triaged for their health risks not just their age. Someone who is 65 could have more health risks than someone who is older.
Don Winsor
Debra, thank you; I fully agree. I should clarify my comment. I do not think age should be the only factor; I completely support efforts to prioritize based on specific medical risks. I just think that lotteries should never be used; age should always be used at least as a criteria of last resort (rather than randomization).
Daniel Atkins III
I was shocked when I read: All Michigan Medicine (MM) employees have been invited to receive a vaccine. How can MM justify vaccinating a 25 year old IT worker at home over say, a ninety year old patient? If this was State policy then MM should have pushed back and done what they think best. So what was done was done., Now, especially with limited supply, change the 1B prioritization based on age as suggested above by Don Winsor. I agree it is an ethical question. MM has an electronic medical record system that could now be used to priority based at least on age. A colleague has computed that at the current rate of vaccinating 750 first doses per day, it will take 560 days to vaccinate the remaining Phase 1 patients.
Daniel Atkins III
And the EPIC EMR system could also be used to help priority on medical risk as mentioned by Debra.
Marie Mcknight
Funny how my 80 year old parents, one of which is being treated at MI MED for cancer have not received their invitation for the vaccine from UM yet, but were able to get it after only two weeks of arriving in FL, meanwhile still no invitation…
Sean Caron
I heard through the grapevine that some IT staff at U-M ITS are getting appointments even though that job classification is not called out here in this article or in Blue Queue as being Phase 1B essential. Meanwhile, people working in departments doing the exact same job don’t get the same consideration. And as some have mentioned here, is it really right that people doing back office work 100% at home are getting classified as 1A and 1B anyway? This whole vaccine distribution fracas stinks all around but it doesn’t help that it feels like there is a real lack of equity and transparency in how available doses are being allocated.
Nicholas Lee
Funny how it says “ To date, all U-M employees defined by the state as essential workers under its second priority group, Phase 1B, have been invited to make an appointment for their vaccination” when in actuality Resstaff have not been contacted at all about this. Glad the university prioritizes looking good to the public rather actually doing what they say. Leaders and the best?
Leila Kawar
By Feb 2, Michigan Medicine had delivered 46,500 vaccine 1st and 2nd doses to its “expanded” definition of the Phase 1A group (out of 51,000 total doses that it had delivered by this date).
It appears that if K-12 teachers and seniors over age 75 in Washtenaw County currently have long waits to be vaccinated, then part of the reason is that Michigan Medicine used all of its initial supply on its own employees…including a large number of employees who do not interact with patients.
Apparently, it was not the only research hospital who acted this way: https://www.nytimes.com/2021/01/10/health/coronavirus-hospitals-vaccinations.html
Barbara Garavaglia
The University has also added non-frontline remote employees outside of the health system in certain categories such as IT, Finance, legal, Communications, Media to Phase 1C along with other vulnerable populations such as people with serious lung diseases. Again, the university is prioritizing favored remote employees over vulnerable populations and other UM employees who have been working in person throughout the pandemic. Librarians and library staff are another example of UM employees who have been exposed to infection risk by having to work in person to provide students a place to study since the fall semester. Yet, they are also in the lowest UM priority for vaccines. And, as with Phase 1B, vaccines for the vulnerable will be through the lottery while non-frontline UM employees will be able to easily make appointments.
I agree with previous comments about the significant problems with the randomized lottery system the university has decided to use for vulnerable populations and other Michigan Medicine patients. It is extraordinarily disturbing and upsetting that access to a vaccine that will prevent serious illness and death for the vulnerable is being managed through a lottery–a system that gambles with people’s lives. It leaves vulnerable people feeling as though their lives and survival are of lesser value as they wait in an information void for a possible “invitation to make an appointment” that might take months. And, once the random “invitation to make an appointment” arrives they’ll undoubtedly have problems getting an appointment especially if the university begins to vaccinate non-frontline employees in Phase 1C before they’ve vaccinated the vulnerable in Phase 1B.
Daniel Atkins III
It appears that Michigan Medicine may be getting an even smaller share of the vaccine in the future. See https://content.govdelivery.com/attachments/MIEOG/2021/01/29/file_attachments/1676273/1.29.21%20Michigan%20Vaccine%20Strategy.pdf
Deborah Moore
Finally, an explanation why so many elderly people aren’t getting vaccinated in Washtenaw County if they are unlucky enough to be Michigan Medicine patients. It’s a dispiriting choice that Michigan Medicine made to prioritize its own workers, irrespective of age and where they work, over its patients.
I drove to NYC to see my homebound 99-year-old mother and spend time with her. Within 4 days I had an appointment for a vaccination and received one as part of an eligible group over 65. What a contrast to Michigan Medicine!
Christine Anderson
I completely agree with the comments about the ethics of a lottery based selection system. My mom is 94 and needs to be in assisted living or at least home care. She gets her primary care from MM Geriatric clinic–the only message we are getting is “don’t call us, we will call you”. It is ridiculous, she is putting off needed health care because she can’t get a vaccine and we can’t help her because we can’t ask questions about it.