Facing a “fourth wave” of COVID-19, Oregon will drop eligibility restrictions for COVID-19 vaccinations April 19, up to two weeks earlier than planned.

President Joe Biden directed Tuesday morning that states should open inoculation appointments to everyone age 16 and older.

Oregon had previously planned to drop all eligibility restrictions by May 1, with some counties possibly offering appointments as early as April 26.

Gov. Kate Brown said Oregon would drop limits on April 19 but until then, it would continue to prioritize vaccinations for people with underlying medical conditions, essential workers, and communities underserved during the pandemic.

“We are locked in a race between vaccine distribution and the rapid spread of COVID-19 variants,” Brown said.

The move comes as infections and hospitalizations have started to rise after a long decline since January.

The state has reported over 400 cases per day in the past week and has seen rising numbers of hospitalizations, despite having fully vaccinated over 777,000 of the state’s estimated 2.8 million adult residents.

An Oregon Health & Science University forecast released last week estimated the current spike will lead to an average of 1,000 cases per day by next month.

Evidence of the virus rebound was also found in the latest infection risk level ratings for Oregon’s 36 counties, issued later Tuesday.

After a steady trend of counties moving lower in the four-tiered risk ratings, the report this week showed a number of counties with infections on the rise, requiring a return to tighter controls on activities, gatherings and dining.

While COVID-19 deaths have continued to stay lower than previous peaks, health officials have remained concerned about possibly more virulent variants of COVID-19 spreading across the country and into Oregon.

Health officials are worried about highly contagious and potentially more lethal variants of the original virus that has killed 2.86 million people around the globe, including 556,000 in the United States.

Oregon has maintained some of the lowest infection rates and death totals in the nation, but has still reported just under 2,400 deaths.

“Impending doom,” is how Dr. Rochelle Walensky, director of the Centers for Disease Control, last week described the combination of spreading viruses and relaxed safety habits by a pandemic-weary public.

The CDC has singled out one variant originally found in the United Kingdom — B.1.1.7 — as the main version of the virus hitting about two-thirds of the country. The Oregon Health Authority has reported 19 cases of the U.K. variant in Oregon, but believes there are many more.

Biden’s announcement on Tuesday is the second time a White House directive has changed Oregon’s phased vaccine eligibility timeline.

Brown and the OHA had originally set July 1 as the earliest date that a long series of priority groups would be finished and the vaccine could be offered to anyone that wanted a shot.

On March 11, Biden issued a directive that states drop all barriers to eligibility no later than May 1 as a way to speed-up vaccination rates. Oregon condensed the timeline for its eligibility groups to meet the deadline. Brown said it might even be possible for some counties to open eligibility as early as April 26.

The new April 19 deadline will only impact Oregon and a few other states. A majority of states already allow all residents over 16 to be vaccinated and only two — Oregon and Hawaii — had announced plans to lift the final barriers on May 1.

The Biden administration has pushed for ramping up vaccinations, saying at least a third of adults in the nation have received at least one dose of vaccine and three million shots were going into arms every day.

Brown and Oregon Health Authority Director Pat Allen have said the greatest impediment to widespread inoculation is supply of vaccine.

Over the past week, Oregon has questioned the federal allocation process state officials believe could be short-changing the state on vaccine allocations.

“My office will work closely with the White House to ensure Oregon receives our fair share of federal vaccine supplies, so we can continue with a fast, fair, and equitable vaccine distribution process,” Brown said.

The White House announced Tuesday that 150 million shots have been administered since Biden took office on Jan. 20. He had promised to get 100 million shots into American’s arms by his 100th day in office, April 30.

Oregon health officials said it had injected over 2 million doses of vaccine into the arms of Oregonians. Most of the shots are for the two-dose Pfizer and Moderna vaccines.

The one-shot Johnson & Johnson vaccine has accounted for just over 50,000 shots in Oregon. It remains in limited supply nationwide due to a botched processing system at a subcontractor in Baltimore that ruined 15 million batches that had to be destroyed. Doses currently offered are the correct mixture.

Several weeks of falling infection numbers had led the state to relaxing limits on eating at restaurants, holding public events, and limiting the number of customers allowed in businesses at one time.

The rise in numbers will lead to the return of some restrictions. Brown announced on Tuesday that the most extreme limits would only go into effect if more than 300 people with COVID-19 are hospitalized and the number increases 15 percent or more over a 7-day period.

As of Tuesday, Oregon hospitals reported 205 patients with COVID-19.

The Grant County Health Department and Blue Mountain Hospital announced in a joint press release that residents in Long Creek, Monument and Dayville can roll up their sleeves Thursday, April 8, for the one-shot Johnson & Johnson vaccine at various times and locations.

The health department and hospital will be at the Long Creek Community Hall from 9-10 a.m and then the Monument Senior Center from 11 a.m. to noon. Later in the day, they will be at the Dayville Community Church from 2-3 p.m, according to the press release.

Those interested in making an appointment to receive the vaccine can email vaccine@ccsemail.org with name, date of birth, phone number, address, any chronic health conditions and which location they plan to attend. If unable to email, call 541-575-0429.

Under the new rules, three counties qualify as extreme risk, but will be at high risk restriction levels: Josephine, Klamath, and Tillamook.

Five counties — Baker, Columbia, Lane, Polk and Yamhill — are in the two-week caution window allowed when a county drops into a lower level, only to rebound in the next period back to a higher rate. They are allowed two weeks to reverse the trend before higher restrictions are applied.

Lower (15)

Baker

Crook

Gilliam

Grant

Harney

Hood River

Jefferson

Lake

Lane

Malheur (moved from moderate)

Morrow

Sherman

Wallowa

Wasco

Wheeler

Moderate (7)

Clatsop

Columbia

Polk

Umatilla (moved from high)

Union

Washington

Yamhill (moved from lower)

High (11)

Benton

Clackamas (moved from moderate)

Coos: (moved from extreme)

Curry: (moved from extreme)

Deschutes: (moved from moderate)

Douglas

Jackson

Marion

Lincoln (moved from moderate)

Linn (moved from moderate)

Multnomah (moved from moderate)

Extreme (3)

Josephine (moved from high)

Klamath (moved from moderate)

Tillamook (moved from moderate)