Yet Another Change to North Carolina’s COVID-19 Vaccination Priority Plan

Published for Coates' Canons on January 25, 2021.

On December 20, 2020, I published the Coates Canons blog post May a Public Employer Require Vaccination Against COVID-19? Toward the end of the post, I outlined the priority phases of North Carolina’s COVID-19 vaccination plan, highlighting where public employees likely fell. Subsequently, in response to new guidance from the CDC, the North Carolina Department of Health and Human Services (DHHS) revised its vaccine prioritization plan and I updated that post on January 4. North Carolina DHHS has completely revised the plan again (again, in response to changes in federal guidance). The new plan gives first priority to health care workers and others with direct contact with COVID-19 patients. This is the same priority as under the previous plans. New is that the group with second priority are those ages 65 and older, regardless of medical conditions. Essential frontline workers are now in the third priority group. I have once again updated the original blog post to incorporate the new priority plan. For a summary of the new priority phases, you may either read on or link back to the earlier, updated post.

The Third North Carolina COVID-19 Vaccine Priority Plan

COVID-19 vaccinations will not be immediately available to all takers. The North Carolina Department of Health and Human Services (NC DHHS) considered the recommendations of the CDC’s Advisory Committee on Immunization Practices and the North Carolina Vaccine Advisory Committee and devised a vaccine distribution plan . The original plan has been revised a number of time in response to changing federal guidance (the “current NC Plan”). The current NC Plan, like earlier versions, calls for the vaccine to be distributed in phases based on a combination of high risk of severe illness from the virus  and high risk of exposure to the virus. This means that employers who require their employees to receive the COVID-19 vaccination will not be able to have all their employees vaccinated at the same time. You can see a representation of the current NC Plan toward the bottom of NC DHHS’s vaccine flyer here.

The current NC Plan aligns closely with CDC’s current recommendations about the priority different groups should be given. It is divided into five groups. Persons who can be vaccinated as part of Group 1 are limited to health care workers and COVID responders at high risk for exposure based on work duties or who are vital to the initial COVID vaccine response. As of the date of this post has been revised, this includes those who care for COVID-19 patients, as well as those providing cleaning services in areas where COVID-19 patients are treated; EMTs and paramedics; health care workers performing intubations or CPR; those administering intranasal COVID-tests; and those administering the COVID-19 vaccine. Of the other types of health care workers with direct patient contact who may be eligible for vaccination as part of Group 1, those most relevant to public employers include those providing behavioral health services, community health workers, dentists and dental hygienists in public health clinics, environmental services and janitorial staff, home health workers, laboratory and phlebotomy staff, pharmacists, respiratory techs, front-office administrative staff of health clinics, as well as doctors, nurses, nursing aides and assistants who see non-COVID patients. Non-health care employees who volunteer to help with the vaccination effort are also eligible members of Group 1. See the NC DHHS Fact Sheet, Deeper Dive: Group 1.

Group 2 includes anyone 65 years of age and older. There is no requirement that a person have conditions that make them more at risk for complications from COVID-19. The reason for giving people 65 and older high priority for vaccination without regard to occupation or living situation is that they are statistically at high risk of being hospitalized with or dying from COVID-19. Public employers will likely have very few employees who are in Group 2.

Only Groups 1 and 2 are active and eligible for vaccination as of the date this post has been revised.

Group 3 is comprised of frontline essential workers. Frontline essential workers are those who must work on-site at the employer’s premises (or out in the community) and who work in one of eight essential sectors, which include Government and Community Services, Public Safety, Transportation, Health Care and Public Health (to the extent not covered by Group 1) and Education. In its Deeper Dive Fact Sheet for Group 3, NC DHHS identifies frontline essential sectors and workers as those designated as essential by the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA). See pages 7 – 23 of the CISA Guidance on the Essential Critical Infrastructure Workforce, Version 4. Public employee essential workers who are eligible to be vaccinated in Group 3 potentially include:

  • all public safety workers & support staff;
  • all human services workers & support staff;
  • all utilities staff;
  • county engineers;
  • water and wastewater staff;
  • transit workers and dispatchers;
  • all public works staff;
  • all IT staff;
  • facilities staff;
  • mechanics;
  • registers of deeds and employees;
  • finance department staff;
  • planning, zoning and permitting inspectors;
  • purchasing and procurement employees;
  • jail and corrections staff; and
  • those working in the court system.

Public employers must remember, however, that mere employment in one of these sectors does not automatically make an employee eligible for vaccination in Group 3. To be eligible for vaccination in Group 3, a public employee in one of the fields listed above must be required to work on-site. Employees working remotely are not part of Group 3.

Group 4 will expand the pool of those eligible for vaccination to include all adults at high risk of exposure and at increased risk of severe illness from COVID-19. Group 4 includes anyone 16-64 years old with high-risk medical conditions such as cancer, chronic kidney disease, COPD, being immunosuppressed from an organ transplant, obesity, serious heart condition, sickle cell disease and type 2 diabetes, among others. NC DHHS also includes in Group 4 other essential workers who have not yet been vaccinated and says that CDC lists employees in water and wastewater systems, information technology, public works and traffic engineers and public health workers not vaccinated earlier in this group. Since all of these fields of work are included in the CISA definition of essential workers – who would be eligible for vaccination in Group 3, if they work on-site – it isn’t clear why they are listed here, unless it is by way of example of essential workers who may have fallen through the cracks and not been vaccinated in Group 3.

Phase 5 covers everyone else.

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Topics - Local and State Government