In a move that surprised and upset some of its own employees, Oregon Health & Science University has offered the Pfizer-BioNTech COVID-19 vaccine to all of its staff and students, including those who are working from home and others who may not meet the CDC definition of frontline healthcare personnel.

The teaching hospital made the vaccine available to its staff and students without regard to their risk of exposure to the virus, as doses remain relatively scarce in Oregon.

More than half of the frontline healthcare personnel in Multnomah County have yet to be vaccinated as of Friday, and Oregon’s vaccine rollout has lagged other states and Gov. Kate Brown’s stated expectations.

Related: Why has Oregon’s COVID-19 vaccine rollout lagged behind other states?

Other groups at elevated risk for exposure to COVID-19, including prisoners and food processing and agricultural workers, are weeks or months away from being eligible for the vaccine. Just over 1% of Oregonians have been vaccinated so far.

Yet while the vaccine is scarce, some hospitals in Oregon have a surplus and have struggled to get the COVID-19 vaccines into people’s arms as quickly as they arrive, with more shipments coming each week.

The Oregon Health Authority, meanwhile, released a policy update directing vaccinators to focus on efficiency and maximizing the number of vaccines given. That guidance does not further clarify whether people working in administrative roles in health care with no increased risk of exposure should be considered in the initial phase of vaccine distribution, known as 1a.

The CDC’s definition of healthcare personnel, quoted in Oregon’s vaccine distribution plan, includes some, but not all, administrative staff. It states that health care personnel eligible for the initial first round of vaccination includes “persons not directly involved in patient care but who could be exposed to infectious agents that can be transmitted in the health care setting,” with people providing laundry, security and billing services as examples.

Oregon’s vaccine distribution plan emphasizes that 1a health workers are those “who have the potential for direct or indirect exposure to patients or infectious materials.”

Related: OHSU statement on its COVID-19 vaccination policy

Who should get it first?

OHSU made the announcement that anyone could be vaccinated in an internal message sent to staff on Sunday that also unveiled a new system for signing up.

“With the latest COVID-19 forecast showing another surge projected in just a few weeks, we must act must act now to change the trajectory of the virus and increase the number of Oregonians who are vaccinated,” the message read.

“We are finishing up vaccination of our health care frontline, which means that we are opening up vaccine scheduling to all employees and learners. You may now schedule yourself using the links below through Wednesday, Jan 6, even if you fall outside the waves 1-6 category.”

OHSU had previously created a system of six waves of employees who would be vaccinated sequentially based on their risk of exposure to COVID-19 and the importance of their work.

The first five waves included all healthcare personnel, critical support staff and administrators with regular work on campus.

“In recognition of the urgency of vaccinating all members as quickly as possible, we will not be prioritizing or sub-prioritizing members going forward,” the message announced.

A day after OHSU changed its policy, Brown said the Oregon Health Authority was moving too slowly distributing the vaccine and announced a new target of 12,000 vaccinations per day.

Related: Oregon vaccine rollout too slow, says Gov. Kate Brown

Connie Seeley, OHSU’s chief administrative officer, serves as Brown’s special advisor for COVID-19 vaccine implementation.

OHSU did not make anyone available for an interview and did not answer written questions about their vaccination program, including why employees able to work from home had been included. In a written statement, a hospital spokeswoman defended the decision to vaccinate all staff and students and said it had approval from the state.

“Because we moved to quickly and efficiently vaccinate priority groups, we were then able to begin to offering vaccinations to all employees and students with approval from OHA – as of 8 a.m. Friday, Jan. 8, OHSU has received 19,250 doses and administered 14,068 vaccines,” said spokeswoman Tamara Hargens-Bradley.

The Providence Health System has also given the vaccine to staff who are not at any risk of patient exposure. Kaiser and Legacy Health, meanwhile, told KGW News they were only focusing on frontline health workers.

The announcement blindsided some health care personnel at OHSU who work on the main campus, were still waiting for their vaccination and had been told they would be notified by their managers when it was their turn to get vaccinated. According to comments posted on an internal employee forum, it set off a rush of employees trying to sign up for available slots online that some likened to the “Hunger Games” series or trying to get tickets to the hit Broadway musical “Hamilton.”

Apologies, frustrations

Some employees who are working from home and had signed up to be vaccinated posted on the forum, apologizing and asking if they could give away their time slots to colleagues who needed the vaccine.

News of the email quickly spread to members of the public. Amanda Blum, 44, is a technology strategist who lives in southeast Portland. Blum has an autoimmune disorder, Pemphigus vulgaris, that requires her to be on an immune-suppressing drug. Her condition, along with being overweight, puts her at a higher risk for COVID-19.

“They’re prioritizing people who just have no business getting it right now,” Blum said.

Blum said because of her immune-suppressing drugs, she has spent the past 11 months in total isolation, working from home, without any in-person human contact. She is eager to be vaccinated. Blum isn’t expecting to be near the front of the line.

“Every time I saw one of my physician friends get it, I was thrilled for them. They need it,” she said.

But she was taken aback to learn that friends and neighbors who work for Providence and OHSU and have no interaction with patients are being vaccinated.

“One of my friends pinged me. They log institutional gifts for a healthcare company. They were apologizing to me. I was like, I’m happy for you and also furious,” she said.

“Why is nobody pushing back against OHSU and Providence and these groups that are doing it?” Blum asked. “I think it’s negligence, and I’m furious at OHA, for not putting their foot down.”

In a media briefing this week, reporters asked Oregon Health Authority Director Patrick Allen about health system staff with no specific risk of exposure to the virus receiving the vaccine. Allen replied that he had recently learned that people who aren’t yet eligible for the vaccine under state and federal guidelines were receiving it.

Related: Teachers ask Oregon governor for vaccine, resources, before in-person classes resume

“We have become aware of vaccinators vaccinating staff, going beyond the 1a category definitions, which are really people at risk of patient contact,” he said.

Allen added that the problem was “quite a bit more widespread,” than he initially thought, and said OHA would be issuing guidance to stop the practice.

OPB requested a copy of that guidance and received it yesterday. It included no further clarification of whether administrative personnel or health system employees working from home should be included in the 1a round of vaccinations.

“OHA encourages those administering vaccines to ensure that COVID-19 vaccines are being administered efficiently and effectively.” Anyone included in Phase 1a, Groups 1-4 are eligible for vaccines at this time. The most important priority right now is to get as many people in Phase 1a vaccinated as possible,” the agency said.

The agency said it will be publishing additional guidance on vaccine eligibility today.

Editor’s note: OHSU waited until after this story had published to provide OPB with a written statement, which you can read in full here. It details OHSU’s plans to hold drive-through vaccination clinics and make the COVID-19 vaccine available to other community health workers, first responders, and dental providers in the coming weeks.