ROCHESTER, Minn. -- Mayo Clinic Rochester, the state's marquee healthcare brand and an employer often viewed as never going without when it comes to access to medicines and treatments, has yet to offer COVID-19 vaccine to thousands of its employees, and likely will not do so for months to come.
The health system, like all other providers, is heeding the state's step-wise prioritization program targeting those most in need, one that is about to offer shots to a sprawling group of the newly-eligible recipients.
Having vaccinated 77 percent of its seniors and 2 million Minnesotans for the virus, the state's vast health care network is now inoculating legions of food plant workers, public-facing essential workers, adults over 44 with one underlying condition and residents between 16-44 with two.
That's a group estimated to include 1.7 million people, or almost a third of the state. The state has already offered vaccines to its nursing home residents and staff, health care workers, educators and seniors, with the latter going to the oldest and sickest first.
But because this process all kicked off with healthy, front-line hospital workers of all ages, a belief briefly took hold that when it came to the coveted medicines, as a distributor of early vaccine, Mayo may not have bound itself to the same eligibility criteria as everyone else.
It did not help that stories arose of competing medical centers elsewhere across the country having failed to prevent personnel with connections and limited need from jumping the line.
In late January, the New York Times reported that vaccine had been too-generously distributed among employees of several elite academic hospitals in New York and Boston. Among the less-than-needy coastal professionals whose employers got them vaccinated before their time, the story mentioned "a 20-something who works on computers," and a "young researcher who studies cancer."
Though these same positions have been denied early vaccine at Mayo, a similar narrative was soon given life in southern Minnesota. It featured letters to the editor as well as news reports that Mayo had provided vaccines too liberally in-house, or was "wrapping up" shots for its workers while front line independent providers in the region went without.
The reports cited shots given to Mayo volunteers, credit union employees, hard hats on job sites and staff working a shuttered fitness center. State health officials called the stories "concerning," but the clinic responded that it had acted in good faith while navigating ambiguous eligibility guidance and after assessing risk for every job on its 40,000-person Rochester payroll.
With vaccine distribution now quickening and the state targeting May for all adults being offered shots, the question of who got a vaccine and when is fading, and may soon be in the past. But experts say playing by the rules with vaccination prioritization matters, given the ongoing challenges of eliciting shared sacrifice with a rampaging pathogen.
"Every time somebody learns that ... someone connected gets to go to the head of the line," writes medical ethicist Dr. Arthur Caplan in a recent column, "they start to think that they can try that, because others aren't waiting or being patient."
Today, a significantly smaller percentage of Mayo employees have been vaccinated than the state's seniors, with the numbers showing the clinic is far from fully vaccinated and yet essentially done with prioritized access according to state guidance.
As of March 15, 63% percent of Mayo Clinic staff in Rochester had completed both shots, according to Clinic spokesperson Heather Carlson Kehren, a figure equal to roughly 80 percent of eligible staff.
"All Mayo Clinic staff who meet the Minnesota Department of Health criteria as a patient may receive vaccine," Carlson Kehren says. "This includes non-clinical support staff who cannot telework and those who exclusively telework."
In other words, working at Mayo gets you no closer to getting a shot these days than does a job in food service. Actually, with food service workers in the latest group being prioritized, it gets you less.
Teleworking and waiting
David Rider works in the IT group at Mayo Clinic. He lives a few blocks from St. Mary's Hospital, and like thousands of other employees capable of working off-site, has not gone in to the office since March 2020.
Asked if he has ever been offered the shot by Mayo, the husband and father of two doesn't have to think hard.
Though COVID-19 immunity has been obtained by doctors, nurses and other on-site personnel up and down his street, Rider says he's not stewing about his waiting game in the shadow of the state's largest private employer.
"I'm ready any time they want to offer it," he says. "Of course I'd like to have it, but I also think people who are more high risk than me and can't work at home should get it before me."
"In my group, I think it was universally the view that, 'If I'm ahead of a teacher, there's no way that's right.''"
Rider's wife is in the same boat. Ellen Goode, a professor of epidemiology at Mayo, works in quantitative health sciences, where she studies the genetic epidemiology of cancer, also while working from home since March of 2020.
Like her husband, Goode also believes she will likely only get immunity once the state gets around to vaccinating everyone else in her age and health status.
"I am happy not to have it," she says. "I am kind of trusting the system and the priorities and I figure my employers at Mayo will let us know if we've gone on the list."
Both are signed up for the state's vaccine connector. Both are in their early 50s and in good health, a status that likely pushes their eligibility after the category that follows the oversized category now getting appointments.
May seems possible, but they are OK if it turns into June.
Neither of them have heard much internally about when their turn will come.
"It's been communication on the website, through articles and things you can look at," Rider says. "I haven't gotten any great expectation of a timeline. I don't know of any of my colleagues who have been vaccinated."
Goode says she recently was offered an opportunity to begin working on campus, but even that didn't include an elevator ride up into the health system's gleaming on-campus vaccine distribution center.
"They said they understand if we don't want to go back until we are vaccinated," she adds. "Some people go in unvaccinated and wear masks, they are choosing to do that. For me, its been working out better just to choose to work at home for the time being. I do yoga in the morning and the afternoon."
"I have a window now," Rider adds. "I used to have a basement office. So I'm happy to see the outside now, it's good for my disposition."
Brian Cook, 57, lives and works in IT at Mayo from his home just up the road, and falls into the same category -- too digitally based to be on campus, too young to get vaccine for his age, too healthy to get it for his vulnerability.
"I'm totally fine with waiting because there are tons of people not at Mayo, people who work at Starbucks or wherever, that I'm totally fine with them getting it first," he says. "There are people that need it sooner than me."
He says he knows one person in IT at Mayo who has been vaccinated, and that was through their status as a caregiver to a child with special needs. "They got vaccinated through the county," he says. "It had nothing to do with Mayo."
"I feel very fortunate that I have a steady job. So many people are going through harder things and so many people who have jobs have to face exposure. So I've kind of been like, when it's my time, it's my time."
"Not vaccinated, that's correct," says Rick Van Ert, a neighbor in his 50's who works in health education content services at Mayo.
"As far as I know, I become eligible through the state guidelines as a patient," he says. "I think there are a lot of people working face-to-face with patients, and a lot of people in the community who need it more than I do at this point."
He's also been working from home since early March 2020. He says it's going well but he misses the social connection of working on site.
The wait hasn't been without want.
"Leaders have to take some push back sometimes," Cook says. "You can see questions sometimes, like, when are we going to get our vaccine?' Then they have to address that."
Having come close to taking a job out east at one point in his career, Cook believes the clinic is unusual in its field nationally, given its commitment to principles that if press reports are correct, were always not heeded by medical centers in Manhattan.
""I've been here for over 30 years now," he says. "No institution is perfect, but my experience has been that Mayo tries walking the talk about these things. There's a consistency there that I've seen, and I think it's playing out here. You know, this is what we've said, this is what's right for the community."