On Jan. 15, Gov. Kate Brown took a parting shot at the outgoing Trump administration: She blamed a decision to move up COVID-19 vaccines for elderly Oregonians and then move them back again on the federal government's failure to deliver promised vaccine reserves.

Three days earlier, the governor had moved seniors to the front of the line for vaccines. When she learned more vaccines weren't coming, she changed the plan again: Older Oregonians would have to wait another three weeks.

"Let me be clear: This is a deception on a national scale," she said at the Jan. 15 press conference. "I am shocked and appalled that the federal government would set an expectation with the American people on which they knew they could not deliver, with such grave consequences."

The reversal comes with high stakes attached, even as other states have already begun vaccinating seniors. People over 80 account for more than half of Oregon's deaths from COVID-19, and people over 60 account for 90% of the deaths.

As of now, Oregonians over 80 will be eligible for vaccines beginning Feb. 8—after medical workers, firefighters and school teachers get the shots. The state will then lower the age bracket each week until everyone over 65 is eligible.

It's Brown's last chance to blame Trump—and keep the public's faith in Oregon's choppy vaccine rollout.

Brown's double reversal shows the immense pressure the governor faces to return life to normal from COVID-19 as soon as possible. But it also exposes the holes in Brown's plan to get vaccines into the arms of Oregonians.

Her decisions on which groups get priority for vaccines are last minute, placing sudden demand on hospitals and threatening to undermine public patience in seemingly arbitrary choices.

Most notably, Brown is pressing to return students to school classrooms by Feb. 15—and assuaging the concerns of teachers unions about that plan by giving them early priority for vaccines.

That's an approach that few other states have tried.

"Oregon is in a fairly unique standing throughout the nation in saying that teachers would be part of the Phase 1 rollout," says Courtney Campbell, director of Oregon State University's Program for Ethics, Science, and the Environment.

Campbell said "health equity" has been a primary consideration for vaccine rollout both in Oregon and nationally—but teachers didn't seem to fit that standard. Instead, Brown and Oregon's vaccine advisory committee could include additional considerations, such as saving "the most lives" and "giving primacy to fairness and transparency" to justify the choice.

"If you're going to work only with health equity, then it seems to me it's hard to justify prioritizing K-12 personnel," says Campbell.

"Personally, I'm more concerned about the decision-making process," says OSU public health professor Chunhuei Chi. "When you protect the teacher, don't forget the children; when they come home, they have parents and sometimes grandparents. To be consistent, if the school reopening to in-person is a high priority, then it shouldn't be just the teachers, it should be the parents."

Brown is undeterred.

"Many school districts across the world have figured out how to get their students back into the classroom as safely as possible," she said Jan. 15. "With the assistance of vaccines, with additional resources, and the work we're doing on the ground to ensure that school districts have rapid testing capacity, I'm confident we can do this safely."
On Dec. 23, Brown said she would vaccinate teachers after health care workers, emergency responders and nursing home residents. At the same time, she announced plans to drop her requirements that counties lower the prevalence of COVID-19 before reopening schools, and she set a goal of Feb. 15 for returning students to classrooms.

The compromise of giving teachers priority on vaccines while reopening schools as the virus continued to rage didn't placate the Oregon Education Association, a powerful interest group the governor had sided with at times in keeping schools closed.

"Our elected leaders should not and cannot allow political pressures to dictate the manner in which that data is implemented," said OEA president John Larson on Dec 23.

But older Oregonians saw a politically powerful special interest being bumped ahead of them in the line for a potentially lifesaving medical treatment.

"Given that older individuals are at a greater risk of death from COVID-19, we strongly urge you to ensure that Oregonians age 50 and older are prioritized to receive a vaccine," wrote Edward Brewington, volunteer state president of AARP Oregon, on Jan. 11. "These individuals must be given priority access to vaccines, in addition to those individuals receiving care in nursing homes and other long-term care facilities."

Then, on Jan. 12, Brown appeared to split the difference by offering both groups the vaccine. The federal government said it was opening its vaccine reserves—and Brown said she would vaccinate Oregonians over 65 beginning Jan. 23, the same day as teachers.

The Oregon Health Authority says it projected the feds would send upward of 135,000 doses. But the feds never promised Oregon that number: "Those were our estimates based on the information we had," says OHA director Pat Allen.

Offering those doses to seniors would have created an enormous demand, with less than two weeks to prepare. About 19% of Oregonians are over 65, and all 795,000 would have been eligible to receive the vaccine starting the same day.

"We were supportive but skeptical that the supply would meet this massive increase in the number of Oregonians who would become eligible," said Becky Hultberg, president and CEO of the Oregon Association of Hospitals and Health Systems.

Not all states made such drastic moves when the feds pledged more doses. Utah, for one, didn't lower its age limit, though it had already begun to vaccinate older residents.

"We don't have enough vaccine assigned to the state of Utah right now to even cover those who are 70 years of age and over, over the next several weeks," said Gov. Spencer Cox on Jan. 14, according to The Salt Lake Tribune.

Then, on Jan. 15, citing a federal betrayal, Brown returned to her previous position: Older Oregonians (outside nursing homes or institutional settings) would have to wait. Teacher vaccines will begin no later than Jan. 25.

That gives Oregon a little breathing room. But it's still not clear whether teachers will be able to get both vaccine doses before Feb. 15, when Brown hopes schools will reopen.

And hospitals noted the state has had an uneven record at planning for vaccinations to date.

"From the beginning, the COVID-19 vaccine rollout has been unpredictable. At the 11th hour, hospitals shouldered a huge part of the burden for distribution of the doses, with little outside support," Hultberg said. "The fact that the playing field keeps changing makes this work even more difficult in the midst of a pandemic, as our overburdened staffs take care of a surge of patients."

As for schools reopening, the more contagious British variant of COVID-19 has arrived in Oregon—and with it the potential for more outbreaks. But on Jan. 19, the Oregon Department of Education further eased the guidelines for reopening schools in communities, including Portland, with higher case counts.