Why Georgia lags in vaccinating teachers

210116-Atlanta- Ronald Murphey looks away as he gets his  COVID-19 vaccine during an event Saturday morning, Jan. 16, 2021, for Fulton County School employees and their spouses who are 65 and older at Mercedes-Benz Stadium. (Photo: Ben Gray for The Atlanta Journal-Constitution)
210116-Atlanta- Ronald Murphey looks away as he gets his COVID-19 vaccine during an event Saturday morning, Jan. 16, 2021, for Fulton County School employees and their spouses who are 65 and older at Mercedes-Benz Stadium. (Photo: Ben Gray for The Atlanta Journal-Constitution)

Credit: Ben Gray / Ben@BenGray.com

Credit: Ben Gray / Ben@BenGray.com

With the nationwide push to reopen schools, most states have begun vaccinating teachers, but not Georgia.

Here, teachers are farther down the vaccination schedule after state leaders moved more older Georgians ahead of them. The change has angered educators. Some have protested school reopenings as COVID-19 has infected and even killed colleagues.

There are around a million people aged 65-74 in Georgia, and on Jan. 11, Gov. Brian Kemp and his public health commissioner, Dr. Kathleen Toomey, moved them from the third inoculation phase to the first, leapfrogging teachers who remain in the second wave, known as “phase 1b.”

“Our top priority in distributing the COVID-19 vaccines is to first protect those most vulnerable to serious illness, hospitalization, or death from the virus,” a spokeswoman for Kemp told The Atlanta Journal-Constitution by email last week.

Georgia’s revised vaccine schedule diverges from Centers for Disease Control and Prevention recommendations, that advise inoculating teachers before that group of younger seniors.

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But Georgia wasn’t alone. Soon after Kemp’s decision, the administration of then-President Donald Trump urged states to accelerate inoculations of those 65 and older, said Jennifer Kates, who tracks the vaccine rollout for the Kaiser Family Foundation. By late January, 28 states had moved this youngest group of seniors from the third priority group — phase 1c — to either 1b or 1a, the first group, said Kates, the director of Global Health & HIV Policy for the Kaiser foundation.

”They didn’t move teachers out of where they were, but it meant that a much bigger group was there,” Kates said. “Before that change, a teacher would have been closer up in the line.”

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In addition to moving up young seniors into what Kemp and Toomey are calling phase “1a+,” they moved police and firefighters to the front of the line.

All groups are vying for the limited vaccine that has slowly been distributed, with rollout hampered by missteps at the state and federal level. The first phase includes more than 2 million people, said Kemp’s spokeswoman. Phase 1b — with 450,000 school employees — includes just as many, she said, adding that there is not enough vaccine for everyone in that second group.

January 27, 2021 Elberton - Elbert County High School teacher Richard Andrews receives his second dose of the COVID-19 vaccine from Tina Mewborne, LPN, as his wife and teacher Tonya Andrews (background) looks at the Medical Center of Elberton on Wednesday, January 27, 2021. Georgia has not opened COVID-19 vaccination to teachers yet, but a small school district east of Athens still managed to offer shots to any employee who wanted them. Elbert County Superintendent Jon Jarvis told The Atlanta Journal-Constitution that he sees his teachers, bus drivers and other employees as essential personnel who should be prioritized for vaccination. The state didn't see it that way, punishing the medical center by suspending vaccine shipments until July 27. (Hyosub Shin / Hyosub.Shin@ajc.com)
January 27, 2021 Elberton - Elbert County High School teacher Richard Andrews receives his second dose of the COVID-19 vaccine from Tina Mewborne, LPN, as his wife and teacher Tonya Andrews (background) looks at the Medical Center of Elberton on Wednesday, January 27, 2021. Georgia has not opened COVID-19 vaccination to teachers yet, but a small school district east of Athens still managed to offer shots to any employee who wanted them. Elbert County Superintendent Jon Jarvis told The Atlanta Journal-Constitution that he sees his teachers, bus drivers and other employees as essential personnel who should be prioritized for vaccination. The state didn't see it that way, punishing the medical center by suspending vaccine shipments until July 27. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

The CDC phasing recommendations come from a panel of experts in areas including public health, pediatrics, infectious diseases and epidemiology. The Advisory Committee on Immunization Practices weighed the collective value of keeping schools and other public services functioning against the personal toll of illness and death.

The pandemic has claimed lives at rates that rise with age. But there is a broader context: Older people tend to die in larger numbers, and the rate of deaths associated with the pandemic has been similar across age groups, starting with middle age, the ACIP observed. By mid-December, COVID-19 was involved in 9% of deaths among those 45-64 nationally and 10% for all of the older groups except 75-84, for whom the rate was 11%.

“These are really tough decisions and the state of Georgia, I think, made very reasonable decisions,” said Kates, of the Kaiser foundation. Yet Georgia’s move still conflicts with the priorities of the ACIP, which prioritized teacher safety because “everybody wants schools to be open and in-person,” she said.

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As of Feb. 11, at least 28 states, the District of Columbia, and Puerto Rico have made some or all teachers eligible to receive the coronavirus vaccine, according to a tally by education news site, Education Week.

The Trump administration never clarified why it contradicted the CDC recommendations last month, Kates said. She thinks two reasons played a role: The administration was more concerned about total deaths and it was frustrated by the pace of vaccination, deciding that an aged-based priority system would expedite inoculations. (Speeding up vaccinations was among the reasons cited by Kemp’s office for creating phase 1a+.)

“A potential third is politics,” Kates said, speculating that the 65-plus voting bloc was seen as important.

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Colin Smith, who worked in Georgia public health for a quarter century before moving to academia, was more blunt about Georgia’s rationale. “There is a political reason based on how these populations vote,” said Smith, an assistant professor in the school of public health at Georgia State University. ”Decisions are regularly made in terms of politics rather than science, in terms of public health.”

The phasing decision has played out amid disagreements about the safety of schooling during the pandemic. President Joe Biden has pledged to get more students into classrooms, and his new CDC director, Rochelle P. Walensky, told reporters Friday that it can be done safely without vaccines provided precautions such as universal mask-wearing are taken, something parents and teachers in Georgia say isn’t always happening.

Deaths among current and former Georgia educators spiked last year, according to data provided by the Teachers Retirement System of Georgia. Cause of death wasn’t included in the data, so there is no evidence COVID-19 played a role, and the number of deaths was higher in January 2020 than the prior January for both groups — before the known arrival of the coronavirus in Georgia.

It remained high throughout the year, though. Retired educators died in much greater numbers than their working counterparts, but the percentage increase over the prior year was lower for the retirees than for those still on the job. Last year, 3,428 retired educators died, according to the TRS data, up nearly 28% over 2019. Meanwhile, the number of deaths of working educators in the TRS system rose 49%, the numbers show, with 337.

On Friday, Kemp’s office announced that more than a million Georgians had received at least one dose of vaccine. A group of superintendents is working on rollout plans for when teachers become eligible, but it remains unclear when that will be. In early February, Kemp said the vaccine shortage meant it could take several weeks before they get their turn.

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Reported deaths among Georgia educators enrolled in state retirement system*

Group — 2019; 2020; increase

Retirees — 2,687; 3,428; 28%

Working — 226; 337; 49%

*cause of death not provided

Source: Teachers Retirement System of Georgia

COVID Vaccine Phases – Who’s Eligible?

CDC recommended vaccine phases:

First phase (1a) — Health care personnel, long-term care facility residents

Second phase (1b) — Front-line essential workers, including firefighters, police officers, postal workers and workers in food, agriculture, manufacturing, grocery stores, public transit and education, plus people aged 75 and older

Third phase (1c) — People aged 65-74, those aged 16-64 with medical conditions that could increase the seriousness of COVID-19 infection, and other essential workers

Source: Centers for Disease Control and Prevention

Georgia vaccine phases:

First phase (1a+) — Health care workers, long-term care staff and residents, adults 65 and older and their caregivers, law enforcement, fire personnel, dispatchers and 911 operators

Second phase (1b) — Teachers and other non-health care essential workers

Third phase (1c) — People aged 16-64 with medical conditions that could increase the seriousness of COVID-19 infection

Source: Georgia Department of Public Health

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