Atrium canceling 97 COVID vaccinations, faces scrutiny over who’s in line next

Some Atrium Health employees, due to receive their first dose of a COVID-19 vaccine next month, will be delayed after a controversy this week over involving non-medical workers in the first phase of vaccine distribution.
Atrium officials told the observer on Thursday that up to 97 employees will cancel vaccination appointments. Based on the North Carolina Health Department's vaccine guidelines published in October, initial employees should be “health professionals and first-aiders who are at high risk of exposure due to their job duties or who are critical to the initial distribution of the COVID-19 vaccine. ”
"I can assure you that the only people who received vaccines from Atrium Health were categorized into (phase) 1a ..." said Dr. Scott Rissmiller, Executive Vice President and Chief Doctor Executive of Atrium, told the Observer. “The key is getting the most vulnerable and those on the front lines to risk their lives for the community. We bring them the vaccine so they can take care of those who need it while others wait. "
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The problem emerged after several Charlotte TV networks reported and tweeted Atrium's social media manager Katie McKiever that she had scheduled her first vaccine appointment for early January. The solemn message quickly became controversial as people tried to determine who should and should not receive the first doses of an extremely limited supply from Pfizer and Moderna.
Atrium previously submitted a list of tens of thousands of hospital workers in need of vaccinations with the North Carolina Department of Health and Human Services.
The department then reviewed and categorized the Atrium employees, including those who fit into Phase 1a, Rissmiller says.
However, in public statements, state officials said they are not individually approving vaccine recipients.
A spokeswoman for DHHS sent a statement to the observer on Thursday stating that it is the responsibility of hospitals and providers to verify that individual recipients belong to the priority group.
“As part of the Vaccine Supplier Agreement, all vaccine suppliers have agreed to follow government vaccine guidelines. In order to balance the maximum effectiveness of the vaccine with the priority needs of the North Carolinians, providers must follow state guidelines as doses are distributed across the state every week, ”the statement said.
Atrium officials also say they have revised the system's internal vaccine distribution plan so as not to exclude frontline healthcare workers from the first phase. Atrium told the observer on Thursday that it did so on Wednesday evening - when state health officials, taking into account feedback from the hospital, revised the criteria for the first phase of vaccine distribution.
However, the DHHS did not publish any new guidelines for the first prioritized population as of Thursday. On the agency's website and in the agency's 148-page immunization schedule, workers included in the first phase include “those who care for COVID-19 patients, cleaning areas that have been admitted to COVID-19 patients (and) procedures carry out with a high risk of aerosolization. "The first priority group also includes nurses, dentists, pharmacists, paramedics, workers who care for the bodies of those who have died of COVID-19, people who give coronavirus vaccines, and long-term care workers," says DHHS.
The next subgroup, Phase 1b, is expected to include healthcare workers who are not on the front lines of COVID-19 patient care or vaccinations.
In these early days, transparency regarding the vaccination process is still murky as the public and media are unable to observe the differentiated decisions in the game and who will ultimately be vaccinated on a daily basis, across demographics such as race, age , ethnicity and gender.
The state's COVID-19 dashboard now has a tab that logs vaccinations across all counties. However, the raw data offers little insight into the people behind the data. To complicate matters, the weekly allotment and estimated shipping date is unclear for hospitals and the county health department. It is therefore difficult to predict the number of vaccines in the short term.
More than 4,000 Atrium employees received their first dose Thursday afternoon, Atrium spokesman Chris Berger said. And more than 10,500 scheduled their first appointment, although that volume could change again, he said.
According to Rissmiller, Atrium has started executing its capacity expansion plans, which include moving employees from their normal positions. For example, someone who has a more administrative-centric role can switch to a patient-centric job to avoid a shortage of doctors and nurses. This also complicates questions about vaccine eligibility and priority classification.
Atrium is in almost constant communication with DHHS. Gene Woods, CEO of Atrium, spoke to DHHS Secretary Dr. Mandy Cohen, said Rissmiller.
"I think it's important to remember that this is a massive and extremely complex endeavor," said Rissmiller. "I feel really good when we are two weeks into this time ... Nobody here is trying to do something that doesn't exactly follow the intent and process, and we are committed to the community."
Gradual vaccine distribution
Rissmiller said the North Carolina incremental vaccination framework was too broad for Atrium to properly split the doses. The hospital therefore set up four separate classes in phase 1. Vaccinations for Atrium's two main classifications, which include mostly frontline doctors, are already underway.
However, the third classification, including doctors and other staff who do not directly treat COVID-19 patients, partially sparked the firestorm on social media about key workers and vaccination eligibility.
The fourth tier is for the rest of the Atrium workforce, including those who work in corporate services and work remotely (Rissmiller falls into this category).
No one assigned to these levels has yet been vaccinated, Rissmiller said.
Vaccines can't come early enough for frontline medical workers as an astounding second wave of infections has resulted in record-breaking hospital stays in the Charlotte area and across North Carolina.
The groups included in phase 1b include frontline workers with two or more chronic conditions with a high risk of exposure, healthcare workers not included in phase 1a with chronic conditions, migrant workers in shared apartments with multiple chronic conditions, or people aged 65 and over, who are incarcerated or in homeless shelters with multiple chronic illnesses and other adults with multiple chronic illnesses.
Cohen, the DHHS secretary, said the pace of vaccinations depends on how quickly doses are made and administered, and whether additional vaccines beyond Pfizer and Moderna get emergency approval. At a recent new conference, she predicted that vaccines would not be available "well into spring".
Phase 2 includes migrant workers, detainees, residents of homeless shelters and frontline workers who do not have two or more chronic diseases. It also includes people over 65 and teachers, school staff, and all adults with a chronic health condition.
School-age children and young adults are vaccinated in phase 3, which also includes key workers at increased risk of exposure without chronic diseases.
The remaining population, adults with no underlying health conditions, will be vaccinated in phase 4.
Devna Bose contributed to this report.

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