After months of pleading for doses, a handful of smaller, independent doctor’s offices received batches of COVID-19 vaccine this week as state officials consider tapping more primary care physicians to inoculate their patients.

But how widely primary care doctors are folded into Maine’s vaccination campaign will likely hinge on the pace of dose deliveries, particularly of the single-shot, more shelf-stable Johnson & Johnson vaccine.

The Maine Center for Disease Control and Prevention provided a total of 400 vaccine doses – all of them produced by J&J – to four independent primary care practices around the state this week. The shipments represented less than 1 percent of the Maine CDC’s allocation of vaccine doses from the federal government and were aimed at testing the capacity and capability of smaller practices to handle vaccinations.

The modest shipments were welcomed, nonetheless, by medical offices that have been lobbying the Maine CDC for months to incorporate primary care physicians into the state’s vaccination strategy.

“People are excited and happy to see us,” said Dr. Cortney Linville of Wiscasset Family Health, who has been part of a vocal contingent of primary care doctors talking for months with Maine CDC representatives about vaccinating their patients. “We are familiar faces. We are enjoying doing this, the patients are enjoying getting vaccinated and it feels like we are accessing people who might not be vaccinated otherwise.”

To date, the vast majority of vaccinations in Maine have been administered by pharmacies or larger hospital and health care networks such as MaineHealth, Northern Light Health, MaineGeneral Health and Central Maine Healthcare. As vaccine supplies have increased, state and federal officials have shipped a growing number of doses to federally qualified health centers located in rural or medically underserved communities.

But until this week, the Maine CDC had refused to send doses to smaller, independent medical practices, citing insufficient vaccine supply and logistical concerns given the hourslong shelf-life for vaccines once vials have been opened. In February, doctors pushed back against a Maine CDC requirement that groups of practices, called “community-based collaboratives,” have the capacity to administer at least 1,000 vaccinations a week to qualify for a share of doses.

Hallowell Family Practice was among those that tried to work with other local offices to hit that 1,000-doses-per-week figure but ultimately found it unfeasible. But Dr. Scott Schiff-Slater, one of two physicians at the practice, acknowledged that he has been “a vocal complainer” about the lack of involvement of primary care physicians, so he was excited to receive the call last week offering his office 100 doses.

Schiff-Slater said his office found that many clients 70 or older already had received shots, so the practice began calling all of its age-eligible patients. By Wednesday afternoon, most of the 100 shots had either been administered or were scheduled, but the office also was taking reservations from non-clients as well.

“It’s very exciting,” Schiff-Slater said. “I am hopeful that if we show the state that we can do this, that the state continues to get more J&J vaccine and shares them with other practices.”

Supplies of J&J doses have fluctuated wildly in the weeks since the company gained emergency use authorization from federal regulators in late February. As a case in point, the Maine CDC received 20,600 doses this week but will get only 2,500 doses next week pending the allocations to pharmacies, which have not yet been announced.

As a result, none of the four independent practices that received doses this week – Wiscasset Family Health, Hallowell Family Practice, Door To Door Doctors in Milbridge and Brewer Health Center – is slated to receive any doses next week, according to the distribution list released by the Maine CDC on Thursday.

Dr. Nirav Shah, director of the Maine CDC, said the four independent practices that received a total of 400 J&J doses this week all had “provider agreements” in place with his agency to administer the vaccine. During Thursday’s briefing, Shah indicated that the Maine CDC plans to expand that partnership with independent practices but it all depends on supplies of J&J vaccines.

“Given that significant reduction, 18,100 fewer doses coming into the state next week as compared to this week, there were a fair number of groups that got vaccine this week for whom we don’t have supply next week,” Shah said. “That included, unfortunately, independent medical providers, some independent pharmacies, some EMS clinicians. That is not desirable … I wish we had more supply coming in.”

Dr. Cathleen London with Door To Door Doctors in the Washington County town of Milbridge, said her office started by contacting patients but has since opened up its vaccination program to the public. London said her office also reached out to a local grocery, a bank and other front-line businesses whose employees might not have received a shot.

As of Wednesday afternoon, they had administered roughly half of those 100 doses and London said the phone was still ringing off the hook. London said she has encountered some vaccine hesitancy among her clients in rural, Down East Maine but also has heard from patients who aren’t comfortable going to a mass-vaccination clinic or a pharmacy for a shot.

“I think a lot of patients around the state feel that way,” London said. “They have a relationship with their doctor and they want to get it from their doctor.”

Linville, with Wiscasset Family Health, said DHHS officials told her they will be “watching you very closely to make sure you follow the rules.” She was confident that would not be an issue as her staff carefully follows the protocols at the office’s small, drive-thru vaccination operation in its parking lot.

If her office receives additional doses in future weeks, Linville said she would prioritize people who are uninsured or under-insured, lack ways to get to one of the larger clinics or face other obstacles to vaccination.

“People are really enthusiastic about getting the care,” she said.

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