State health officials in Texas announced Monday who will be next in line to receive the COVID-19 vaccine after health care workers and long term care residents. Instead of following federal guidelines, Texans over the age of 65 and those over 16 who have chronic medical conditions will be the next group of people offered the vaccine. This decision strays from federal guidelines which recommend people over 75 and essential workers receive priority.

The second group will include about eight million Texans who will be eligible for the vaccinations. The state is offering 1.9 million Texans in health care and those who are residents in long-term facilities first, as the federal guidelines recommend. The guidelines recommend that those 75 years of age and essential workers be the next group to be offered the vaccine. As Jazz wrote about (subscription required), those essential workers include teachers and public safety employees. Texas state health officials are going with the recommendations of a 17-member Expert Vaccine Advisory Panel led by Imelda Garcia. She is the associate commissioner for laboratory and infectious disease services for the Department of State Health Services. Dr. John Hellerstedt, the state health commissioner has the final decision on prioritization.

The decision was data-driven, according to the panel. It is to protect the most vulnerable in Texas. People who are elderly makeup more than 70% of COVID-19 cases in Texas. Adults with underlying medical conditions are more likely to develop severe cases of the virus. Garcia said, “This approach ensures that Texans at the most severe risk from COVID-19 can be protected across races and ethnicities and regardless of where they work.” The state data shows that black and Hispanic Texans are disproportionally affected by COVID-19.

Governor Abbott said that he thinks teachers should be near the front of the line. The panel of experts was heavily lobbied by leaders in major industries like airlines, ride-sharing companies, and the energy sector to be vaccinated next. No specific industries are named in the second group. Workers with chronic health conditions or who are over age 65 will qualify. It looks like that following the science will mean individual needs will come before sweeping group generalizations.

“There have been people in all of these essential industries who have had risk factors that have caused them to have a worse experience with the disease,” said Dr. John Zerwas, executive vice chancellor for health affairs at the University of Texas System.

“The thinking behind it is let’s follow the epidemiology,” he said. “Let’s get the vaccine to people who have a higher risk of a bad outcome and work our way through as much of the population as we can.”

Roughly 9.5 million Texans have high-risk medical conditions; 3.9 million Texans are over age 65; and 3.2 million work in essential jobs, according to earlier state estimates. Some people fall into multiple categories, though it’s not clear how many.

As is being reported in other places, some Texas health care workers are taking a pass on the vaccines, at least for now. So many workers at a hospital in South Texas declined their shots over the weekend that they were offered to others in the community. One person who took advantage and jumped the line was state Sen. Eddie Lucio, a Brownsville Democrat who is on the state’s vaccine advisory panel. That isn’t going over very well with some of his constituents. Doctors are blaming mistrust and misinformation for the lack of participation by medical staff.

So many workers at a hospital in the Rio Grande Valley declined the new COVID-19 vaccine that the facility offered doses to other medical workers in the region. Many showed up, but so did a state lawmaker, a police officer and a sheriff’s deputy who weren’t on the state’s priority list for vaccination.

Dr. Robert Martinez, the DHR Health chief medical officer, said hospital officials prioritized employees considered in the first tier for a dose, like hospital staff who work directly with COVID-19 patients and long-term care workers. But administrators realized not enough people eligible for the vaccine were initially going to opt to get it, Martinez said.

“You start to see similar numbers across the country, all this mistrust and misinformation,” he said.

Initially, about 40% to 60% of people who answered a hospital survey said they’d get the vaccine, Martinez said. The lower-than-expected vaccine adoption rate was first reported by The Monitor.

DHR Health didn’t want to waste the vaccine doses. After the first day of distribution, the hospital started to go “down the rung … down the ladder a little bit,” Martinez said. Hospital employees called health care workers at other medical institutions — like hospitals, nursing homes, behavioral health facilities and anyone with workers on the front lines of COVID-19 — in neighboring cities and counties in the Valley.

It will be weeks before the second group will be able to receive the vaccine. The state just began vaccinating the first group. Texas officials are planning to receive about 1.4 million doses by the end of the year.

Front line workers including teachers and their unions are lobbying for school employees to go to the head of the line. It seems to me that a distinction has to be made between those teachers who are in the classroom and those who continue to teach virtually. A common-sense approach will be needed, certainly, as long as the supply of vaccines is so limited in the beginning.

There has been a flurry of lobbying in Texas for priority access to the vaccines, including from teachers and other school employees, who expect more students to return for in-class instruction in the spring.

“We believe teachers and all of the other school employees should be given priority and we are going to be very disappointed if they are not,” said Clay Robison, a spokesman for the Texas State Teachers Association. He had not yet seen the specifics of the announcement.

There are between 600,000 and 700,000 estimated school employees across the state, Robinson said.

Governor Abbott is scheduled to receive his vaccination on-camera today.