Oregon struggles to match other states’ standing orders as COVID-19 vaccine access stalls

Gov. Tina Kotek on Thursday said she’s trying her best to ensure affordable access to the COVID-19 vaccine for Oregonians, pushing back on criticism that other Democrat-led states across the nation have been more efficient at providing quick inoculations and support for providers before an expected annual spike in respiratory illnesses.

Kotek’s explanation traces back to U.S. Health and Human Services Secretary Robert F. Kennedy Jr.’s efforts to reshape the federal vaccine advisory panel that pharmacists and doctors prescribing the immunization in Oregon and elsewhere rely on for guidance about safety and risks regarding a particular shot. Kennedy fired all members of the panel in June and has since appointed vaccine skeptics to the committee, which is set to meet on Sept. 18-19 and discuss the shot.

Questions around access to the vaccine came to a peak at the end of August, when the Food & Drug Administration announced tightened restrictions that limited the vaccine to people aged 65 or older or those with an underlying health condition that would risk severe illness. Days later, Oregon joined Washington, California and Hawaii to form a “West Coast Health Alliance” aimed at safeguarding vaccine access regardless of shifting federal policies.

Oregon pharmacies began requiring prescriptions under guidelines from the state’s Board of Pharmacy that defer to the Centers for Disease Control and Prevention’s advisory panel in adherence with state policy. But in the meantime, other states such as Massachusetts, Washington and Pennsylvania have offered a variety of solutions, including requiring insurers to cover the shots, allowing pharmacists to defer to mainstream medical groups’ guidance and issuing a standing order allowing pharmacists or nurses to inject the shot.

In a statement Thursday afternoon, Kotek spokesperson Lucas Bezerra said the governor is frustrated with the federal government’s narrower eligibility and lack of clarity, which has created “a patchwork-like environment for something as basic as vaccine access.” He said the current rollout has fomented demand for the vaccine without an efficient way for Oregonians to access it at a pharmacy with no prescription.

Bezerra noted Washington’s standing order guaranteeing vaccine access without a prescription to individuals ages 6 months and older through a pharmacist or nurse, for instance, was not practical to replicate in Oregon, which doesn’t have a state law giving the governor broad authority to issue similar orders.

“Oregon does not have the same authority, but there may be indirect pathways that allow for an action of this kind,” Bezerra said. “The governor has directed staff to urgently develop ways to mitigate this disruption, with all five agencies working diligently with the governor’s office, to come up with solutions that are the least disruptive, and have the lowest cost, for Oregonians hoping to get the pinch this respiratory virus season.”

In the meantime, doctors, pharmacists and patients across the state have remained frustrated as some locations have canceled appointments and walked back promises of not needing a prescription. The Oregon Board of Pharmacy has advised that patients will need prescriptions, but doctors in Oregon are also hesitant to issue them due to a lack of clear guidance and liability protections from the state and federal government, the Oregonian/OregonLive reported Tuesday.

The pharmacy board completed rulemaking by August to be able to respond promptly to forthcoming guidance from the Sept. 18-19 vaccine advisory meeting. The agency told the Capital Chronicle that it was originally set to only be able to meet and respond by December, posing what it called “an impossible timeline for respiratory season.”

“We believe there is a misunderstanding of Board actions and the processes to authorize pharmacist administration of vaccines without a prescription,” agency staff wrote in an unsigned statement. “It is important to understand that no protocol for the 25-26 COVID-19 formulation existed prior to or after FDA approval.”