As 84-year-old Barry Hoffman watches the public rollout of the coronavirus vaccine, all he wants is an acknowledgment that he exists.
Hoffman, of Cape Elizabeth, moved to Maine about a decade ago, leaving his longtime primary care doctor in Boston. He only sees a cardiac specialist in Maine. And after nine months of social distancing, staying at home and playing it safe, he fears that when it comes time for his vaccination, he will be forgotten.
“My big question is, who knows about me? What do I do now? Just sit back and wait?” Hoffman said last week. “I’d like an acknowledgement that I exist, and then get some notification that I’m here and I’m waiting. I don’t mind waiting, but I just want to make sure I don’t fall through the cracks.”
At the moment, Maine is still following federal guidelines that place Hoffman into tier 1B in the state’s vaccination plan. That plan includes people age 75 and older as a second group to receive vaccine doses, behind front-line medical workers and people living in congregate care settings like nursing homes and assisted living facilities. Also in the 1B group are essential workers, including police officers, firefighters, grocery store employees and others.
While the state is considering upending that order and moving the seniors ahead of essential workers, as some other states have chosen to do, Hoffman is forced to wait and to wonder when and how he will get the vaccine.
“I’m telling my patients to be patient,” said Dr. James W. Jarvis, a family medicine doctor at Northern Light Health’s Eastern Maine Medical Center in Bangor who is directing the statewide health care network’s COVID response, a team of several hundred people, he said.
“A lot of people want to know where they are on the list, but unfortunately there is no list, because timetables are still up in the air,” Jarvis said. “We know there will be very good announcements as to who or when they will be getting a vaccine.”
Jarvis suggested that the state could use a system based on birthdays or last names to figure out how to vaccinate the population. But once again, those decisions have not been made yet.
And with vaccine shipments and rollout moving more slowly than anticipated, Hoffman and many of his peers are getting antsy, and with good reason. Estimates for when 1B vaccinations will begin are squishy, and late January to February has emerged as a likely timeframe. But for anyone above the age of 70 in Maine, the calculus of waiting is obvious and frightening.
Of the 347 COVID-related deaths as of Thursday, 296 were of people age 70 or older, or 85 percent of fatalities here. When you include people age 60 and older, the figure is an overwhelming 96 percent. A caveat to those numbers is that many of them, about half of those who died, lived in congregate care settings.
Maine remains the nation’s oldest state. Of the roughly 1.3 million residents, 107,000 are age 75 and older. When you count people age 65 and over, that figure balloons to 260,000 people, or nearly 20 percent of the population, according to recent U.S. Census estimates.
The federal Centers for Disease Control and Prevention recommended that the first vaccines go to elders in congregate care and front-line medical workers, so the state’s health care system still has the capacity to treat COVID patients along with everyone else who gets sick or injured from other causes.
Maine public health officials say they are doing everything to organize the rollout as quickly as they can to reach older Mainers living at home. So far, the Maine Center for Disease Control and Prevention has hewed closely to federal guidelines that put people age 75 and up on the same footing as police officers and grocery store workers, and ahead of their peers age 65 to 75 – but even that edict is not set in stone.
Other states, including Florida and Texas, have moved to prioritize people age 60 and older, and in many Florida counties, seniors in wheelchairs, leaning on walkers and covered in blankets have waited outside for hours in line at vaccine sites, trying to secure their first dose.
Details about the rollout to older Mainers are still being worked out, but the Maine CDC said recently that the state will likely rely on primary care physicians or other medical professionals to notify their older patients when they are eligible for vaccination. Those details will be announced in the coming weeks through the state’s news media.
The waiting for clear guidance has done nothing to calm the nerves of people like Jacqueline Lessard, who is 74 years and three months old, meaning she will have to wait even longer to receive a vaccine if the current standards hold. Lessard typically spends winters in Florida – if she were there now, she could be one of those thousands of seniors standing in line.
But starting in late October, Lessard decided to stay in Maine and moved in with her 99-year-old mother in Augusta full time to help her through the winter. Her mother’s doctor has said that at 99, COVID is almost certainly a death sentence. Which puts even more pressure on Lessard to minimize her risks of getting sick, and making sure that she and her mother receive the vaccine as soon as possible.
“I know it’s very difficult to go through this (process of deciding) who’s going to have it and who’s not going to have it,” Lessard said. “I understand fully (that) first responders and medical people need to be first in line. I used to work on a rescue, I understand. When I hear that … cashiers are going to get it ahead of the elderly, that leaves me emotionally drained.”
Lessard has been trying to get answers for days about what the plan will be, she said, and she is attempting at every chance to apply pressure to public officials, however tiny the push. She first called a local aging agency, and then the Maine CDC and the Department of Health and Human Services. She tried finding the phone number of Dr. Nirav Shah, the Maine CDC director, to vent her frustration.
When a reporter told her it’s the federal CDC that decides how many doses are doled out to each state, Lessard didn’t miss a beat. “Do you have a number for them?”
Armand Bouchard, 81 and his wife, Anne, 80, said they want better communication from health officials about what they know and what they don’t know about who will be vaccinated and when.
“Will someone call me one day and say, ‘Hey, your name just came up, be at this place at 10 o’clock tomorrow morning’?” Armand Bouchard said. “Maybe they’re not at this point, but if they’re not, they should say so. At least we’d know. And if it turns out they know I won’t be getting anything until March, then I’ll write it on my calendar in March with a question mark.”
The Bouchards, from Harpswell, said they have received a notice from their health care provider, Martin’s Point Health Care, that they would be notified when the vaccine becomes available. But it’s only a slight comfort, he said, because “I don’t know how much information they actually have.”
Geriatrics specialists and family medicine doctors say they are hearing these same questions over and over, but they have few good answers yet.
In general, older people have a generally positive view of health care and of vaccines. They’re used to taking medication and vaccines, including those given mostly to older adults for illnesses such as pneumococcal pneumonia, shingles, and the annual flu variant. They are also less likely to spend time on Facebook than people in their 50s and 60s, many of whom consume baseless internet conspiracy theories that have undermined confidence in vaccines, said Dr. Cliff Singer, chief of Geriatric Mental Health and Neuropsychiatry at Northern Light Health and president of the Dirigo Maine Geriatrics Society, a group of 78 geriatric practitioners and gerontologists.
“They grew up when polio was a concern,” Singer said. “They grew up and saw childhood illnesses diminish because of healthy vaccination rates.”
Singer said he understands the argument to vaccinate the elderly first, but agrees with the state’s prioritization plan.
“This obviously (is) an area rich with ethical debate,” Singer said. “But you need essential workers to care for older adults. I think the Maine CDC has the prioritization right.”
He added that older adults will get vaccinated in the near future, but they’re not at as high a risk as people who are in “congregate care living settings, or people taking care of them in those settings.”