January 27, 2021 

Dear Governor Brown: 

As the Local Public Health Authority for Oregon’s most populous county, we share your goal to administer vaccines quickly and where they will make the most difference. To us, that means focusing first on the people who if exposed to COVID-19 are most likely to suffer serious illness and die, as well as protecting the health system caring for them. With so painfully few vaccines available, we are asking you to prioritize saving lives. That requires strong equity considerations for vaccine administration now. And it requires right-sizing public expectations. 

We have been deeply concerned that the expanded list of eligible vaccine recipients you outlined on Friday, Jan. 22, does not take into account the sheer size and diversity of the Portland metro area. The public has been led to believe that eligibility equals access. But expanding eligibility has only increased public frustration, and the very real competition for a scarce resource threatens to undermine the resolve Oregonians have demonstrated in responding to this pandemic. It also makes it likely that those people with the least influence and access to health care will wait the longest. 

We sincerely appreciate that in a phone call today to Chair Deborah Kafoury, you indicated more vaccines would be allocated to the Portland metro area beginning the week of Feb. 1. Specifically, the state directed 17,000 additional doses for the high priority Phase 1A eligible group for the week of Feb. 1, in addition to the 15,000 doses already earmarked for educators that week. 

Going forward, we ask for a continuous and sufficient allocation of vaccines to the metro area. The Tri-County region is the healthcare, education and economic hub for the state, with a greater number and proportion of people in Phase 1A and other groups, including populations most impacted by the virus. 

We ask you to support our efforts to reprioritize eligible groups within Phase 1A, based on risk, to ensure we reach:

  • Individuals with intellectual or developmental disabilities or who receive in-home services for other medical or disabling conditions, and their caregivers
  • Traditional health workers who provide in-person services 
  • Health care interpreters who provide in-person services 
  • Home health providers 
  • Long-term care facilities not covered through the federal pharmacy program
  • Long-term care facilities covered by the federal pharmacy program but not yet scheduled and that have reported recent outbreaks 
  • Other congregate care facilities outlined in Phase 1A 

As we move through Phase 1A, educators and beyond, we ask that you continue to earmark some vaccine doses specifically to Local Public Health Authorities to cover the gaps experienced by vulnerable residents most at risk. This will enable those Public Health Authorities to reach people with limited access. We’ll determine who those individuals are by evaluating: 

  1. Local impact data (e.g. use ZIP codes of areas of the County most impacted)  
  2. Geographic placement of where vaccine clinics are, through epidemiology (for Multnomah County, this is East County) 
  3. Category definitions broad enough to include critical community partners (e.g. SUN school contractors in educator categories) 

Finally, we ask that you treat the state holistically, moving counties ahead in a more uniform way so metro area seniors who live in multigenerational households, for instance, are not penalized for living in a region with more health providers, more educators, and more vulnerable and underserved populations. 

We appreciate your understanding and dedication to these very critical issues. 

Thank you,

Chair Kafoury

Commissioner Meieran

Commissioner Jayapal

Commissioner Vega Pederson

Commissioner Stegmann