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Across New York State, medical providers in recent weeks had the same story: They had been forced to throw out precious vaccine doses because of difficulties finding patients who matched precisely with the state’s strict vaccination guidelines — and the steep penalties they would face had they made a mistake.
On Saturday, state health officials responded to the outcry over discarded vaccines by again abruptly loosening guidelines as coronavirus cases continued to rise.
Now, medical providers can administer the vaccine to any of their employees who interact with the public if there are extra doses in a vial and no one from “the priority population can come in before the doses expire,” the new guidelines read. A pharmacy’s “store clerks, cashiers, stock workers and delivery staff” could qualify, the guidelines said. California last week took a similar step.
This is the second time in two days that Gov. Andrew M. Cuomo’s administration has loosened the restrictions around who can get vaccinated in New York State. On Friday, the governor announced that medical providers could vaccinate a wider range of essential workers, including teachers, as well as New Yorkers 75 years and older starting as early as Monday. That same day, the governor also expanded the types of medical professionals that can administer vaccines to include licensed practical nurses, pharmacists, dentists and podiatrists.
The new, more forgiving guidelines highlight the difficulties the state has had in balancing the need to vaccinate vulnerable populations quickly with the imperative to prevent fraud and favoritism in the vaccine distribution process.
Marc Molinaro, the executive of Dutchess County, north of New York City, and a critic of the governor’s vaccine distribution effort, said the new rules were “a smart move.”
“They’re unwinding little by little a tangled mess,” he said.
A spokesman for the state health department said the new guidelines are the culmination of a weekslong process.
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“This guidance lays out and clarifies what we have been discussing with hospitals for weeks regarding how to maximize their doses to make sure that no vaccines are wasted,” said the spokesman, Gary C. Holmes. “We want no confusion and want to make sure that everyone understands the procedures.”
As the state was loosening vaccination parameters, the city and its partners continued to build out facilities where the vaccine will be administered and flesh out the processes for New Yorkers to sign up for the shots.
On Sunday, the union representing public schoolteachers said it had reached agreements with health care providers for its members to receive the vaccine and would rapidly compile a list of all teachers seeking vaccinations, prioritizing those who work in school, rather than remotely.
The city also launched a website on Sunday that allows residents to type in their addresses to find nearby vaccination sites.
Neil Calman, whose Institute for Family Health has had to discard unused vaccine doses, hailed the latest rule changes, even as he argued for yet more loosening of the regulations to allow for vaccinations of at-risk patients with conditions like diabetes, obesity and heart disease who are younger than 75 years old.
“We’re seeing them in our office, and it just seems like we’re turning them away today just so we can call them back in a week and say, ‘Now you can get your vaccine,’” Dr. Calman said.
The new guidelines speak to the challenges of administrating a mass vaccination program in a country whose health care system includes public and private hospitals, pharmacy chains and clinics. At least one of the nonprofit medical providers tasked with vaccinating marginalized populations is under fiscal distress because of the pandemic.
Callen-Lorde, a medical provider that serves L.G.B.T.Q. populations, is anxious to ramp up its vaccination program and hopes to schedule appointments for all of its patients who are 75 or older by the end of the week. But its hopes of vaccinating its transgender and HIV-positive clients may well be hampered by a shortage of money and nurses.
“The biggest item that hasn’t seemed to be addressed so far is that funding piece,” said Peter Meacher, the organization’s chief medical officer.
The need for a large-scale mass vaccination campaign is only heightened by a new, more transmissible variant of the virus arriving in the country.
Last week, Mr. Cuomo announced the discovery of the new variant in Saratoga Springs. Since then, the state has discovered at least three additional cases of the strain, including one in Nassau County, which borders New York City.
“We have to assume the U.K. variant is in New York City, and that raises the stakes on everything,” said Mark Levine, the New York City councilman who chairs the health committee.
On Saturday, 151 New Yorkers died from the coronavirus. New York State has received more than 1.2 million doses of the vaccine, according to a Centers for Disease Control and Prevention database. More than 400,000 New Yorkers have received their first dose.
On Sunday, Brad Lander, the councilman representing the Park Slope neighborhood of Brooklyn, toured a mass vaccination site the city just opened at Brooklyn Army Terminal in nearby Sunset Park.
Seeing the site in person made him “a little bit hopeful,” Mr. Lander said. But, he added, “We need so much more infrastructure than we have.”