Kathy Horne receives the Covid-19 vaccine at Cape Fear Valley Medical Center in Fayetteville. Melissa Sue Gerrits/ Carolina Public Press

Editor’s note: This story originally published on Feb 12. It was updated on March 5 to include new information that became available about prioritization.

As North Carolina moves towards the next phase of COVID-19 vaccination, questions linger about the logistics of the rollout prioritization, especially for the state’s frontline essential workers.

Initially, only members of the state’s first two priority groups, health care workers and people 65 and older, weree eligible for vaccination by state providers. Long-term care facility staff and residents are eligible through a federal vaccination program run by Walgreen’s and CVS. 

Beginning Feb. 24, the next group prioritized to receive the COVID-19 vaccine, frontline essential workers, became eligible for the shot. Gov. Roy Cooper announced that a subgroup of those workers, educators and child care staff, would be first ahead of other frontline essential workers such as grocery store employees and homeless shelter staff. 

Noneducation group 3 members from other industries became eligible for vaccination scheduling on March 3.

To be categorized as a frontline essential worker, individuals must “be in person at their place of work” and fall into one of the eight essential sectors, according to DHHS guidelines.

To define essential employees, DHHS uses the sectors outlined by the Cybersecurity and Infrastructure Security Agency (CISA) of the U.S. Department of Homeland Security: critical manufacturing, education, essential goods, food and agriculture, government and community services, health care and public health, public safety and transportation.  

It is unclear how local health departments or medical providers determine if a person is in fact a member of group 3.

While documentation from DHHS defines frontline essential worker categories, state officials have not implemented a system requiring individuals to prove their employment as a group 3 member in order to get a shot.

“Obviously, you’ve got to rely somewhat on people’s honesty,” Cooper said.

Identification is not required, and “individuals can self-attest to the criteria (e.g., age, job role, health status, living situation) that they qualify for in eligible priority groups,” according to DHHS Interim Provider Guidance for Vaccinating North Carolinians.

“Right now, we do not have an identification requirement,” DHHS Secretary Mandy Cohen said.

“Again, we want to make sure that we are moving things along with speed and equity here and that is what we intend to do so there’s no ID requirement, but you may have to show identification in a particular location, depending on that provider.” 

As priority status becomes tied to employment in group 3, some employers may form partnerships with vaccine providers to provide on-site vaccination clinics or designated days for particular employees to receive the shots, she said. But individuals who declare themselves frontline essential employees can receive a vaccine dose at any provider in the state.

From the clinic to the classroom

The prioritization of educators and other school staff within group 3 is a change from the vaccination plan announced in mid-January which did not prioritize any subgroups. 

“I think there has been concern about all of these essential frontline workers in a big group in group three all of a sudden crashing into the system. That would be problematic,” Cooper said. 

The move comes after public outcry about the need for students to return to schools and resistance by some educators to returning to the classroom without vaccination.

The North Carolina Association of Educators (NCAE), the state’s largest teacher organization, called for vaccine prioritization of teachers and school staff against the backdrop of debate about when and whether students and teachers should return to in-person learning.

Through its “Shots for Safe Return” campaign, NCAE activists called for Governor Cooper to move teachers and other school staff to the front of the line. 

“Twenty-six states are vaccinating educators. Why isn’t North Carolina? If 26 other states can do it, why can’t we?” Guilford County Association of Educators Vice President Kenya Donaldson asked at a gathering on Tuesday

The state has about 240,000 education sector employees, including teachers, cafeteria staff and bus drivers, Cohen said Tuesday. The state currently receives approximately 150,000 vaccine doses each week, so opening the process to educators does not guarantee spots for teachers or other child care providers.

“I want to reiterate that just because folks become eligible on February 24, it does not mean that that is the day you’re going to get an appointment,” Cohen said.

“We know this is going to be a gradual process. We know the supply is low, and you’ll see different ways in which teachers and childcare workers are going to access this vaccine.” 

Priorities after teachers

One week after educators began scheduling vaccination appointments, other frontline essential workers became eligible to register for a shot.

Defining the groups and making sure that only those eligible employees receive vaccination appointments are challenges. 

“We recognize that once you move away from age based, and get into what people do for a living, that it makes it harder,” Cooper said. 

Some industries communicated their desire to be included as frontline essential workers to the department. 

In early January, presidents of district bars from across the state sent a letter to Gov. Cooper and Sec. Cohen lobbying for all court employees and court-appointed lawyers to be categorized as frontline essential workers. 

The letter asked for the inclusion of “judges, magistrates, clerks of court, judicial assistants, District Attorneys and assistant District Attorneys, public defenders, judicial assistants and judicial clerks, trial court administrative coordinators and staff, courthouse administration and facilities staff, and those in the office of the register of deeds.” 

NC State Bar President Barbara Christy sent a similar letter asking the administration “to be mindful of the significant number of persons who are not employed by state government and are essential to keeping the criminal, civil, and family courts functioning properly.” 

Workers supporting the judicial system are included in the CISA guidance thereby meeting the first requirement for inclusion in group 3, Cohen said in a letter to Chief Justice Paul Newby. In order to qualify as “frontline” however, court personnel’s “work-related duties must be performed onsite and involve being close to members of the public or other co-workers,” Cohen wrote.

Restaurant workers, a population whose work requires close proximity to the public, also fall under group 3. 

“We have been waiting anxiously for our turn to get vaccine and so we’re just thrilled that on March 10, restaurant workers, frontline workers who’ve been working tirelessly during this pandemic for nearly a year now, will finally be able to roll up their sleeves and get the vaccine,” said Lynn Minges, director of the NC Restaurant and Lodging Association.

Before the pandemic, the state was home to 520,000 workers in the hospitality industry, she said, but the association is not seeking prioritization of their members as a subgroup.

There are currently no clinics established for restaurant employees, but Minges said they are considering ways to help workers prove their status as frontline essential employees even as it remains unclear if such proof will be necessary.

“One of the things we’re likely to encourage restaurateurs to do is … to provide a letter validating that this employee is an employee of the establishment and is deemed to be an essential frontline worker, though that doesn’t seem to be required,” she said.

“But that might be helpful to some of our workers who are trying to navigate the system and make sure that they’re not turned away.”

The state’s largest trade organization, NC Realtor, represents more than 53,000 members in the real estate industry who may qualify as essential under the CISA guidelines. The have not received notice about their status within group 3, said Mark Zimmerman, senior vice-president of external affairs.

Realtors, he said, have faced challenges in the pandemic but have been able to continue working by following safety protocols recommended to avoid transmission of the virus.

“Obviously, I think everyone in the state, including our members, would look forward to getting their opportunity to get to vaccination,” he said.

“But we will wait our our turn in line while those who are deemed more important or more essential will have priority.”

Governor Cooper and Secretary Cohen said more guidance on frontline essential worker vaccination process will be forthcoming, including a portal for employers to upload employee information.

As the pandemic continues to cripple the state, logistical challenges and concerns about priority may take a back seat to the urgent need to get vaccines administered.

 “At the end of the day, we need to get shots in arms,” Cooper said.

Laura Lee

Laura Lee is the News Editor at Carolina Public Press. Contact her at llee@carolinapublicpress.org.