Information, Misinformation, Changing Information & Confusion
The COVID vaccine is daily, front page news and the updates don’t sound promising. Some people are getting vaccinated, others aren’t and overall the vaccination rate has been disappointing.
What was supposed to happen?
In December, the Centers for Disease Control and Prevention (CDC) recommended a phased, group by group, approach to vaccination.
- In Phase 1a, healthcare workers and residents of long term care facilities would be vaccinated. There are 24 million people (7% of the US population) who fall in this category. (As a practicing doctor, I have been vaccinated.)
- In Phase 1b, frontline essential workers such as first responders (police and firemen), postal workers, grocery store workers and teachers would be vaccinated. Phase 1b also includes anyone age 75 and older. There are 39 million people (12% of the US population) who fall in this category.
- In Phase 1c, other essential workers, people age 65 and over, and people with chronic medical conditions would be vaccinated. There are 129 million people (39% of the US population) who fall in the category.
- In Phase 2, other people age 16 and over who have not already been vaccinated would be vaccinated.
What IS happening?
Across the United States, vaccination has been inconsistent. Many people who fall within Phase 1a have not yet been vaccinated but in some areas people who are in Phase 1c or even Phase 2 have already been immunized. Many people age 75 and older are still waiting and some states are doing better than others. Some people report that they got the vaccine promptly while others haven’t heard any instructions yet or are needing to wait hours in line.
Why is the COVID vaccine distribution so uneven?
When a person gets the vaccine depends very much on where a person lives and receives health care. One reason is that decisions are made at every stage as the vaccine moves from the manufacturer to the states and from the states to the health care systems.
- The federal government makes weekly decisions about how much vaccine goes to each state, territory, major pharmacies (Walgreens and CVS) and various entities such as the Veteran’s Health Administration. If statistics show that supplies are still not fully used at any one place, a decision is made about how much more vaccine is sent out. The result is that supplies vary from place to place.
- Every state and territory develops its own strategy about how to distribute the vaccine. States are not required to follow the original CDC recommendations regarding phases. For instance, some states have decided to change the age requirements or have decided to focus on certain populations. Each state also decides how much is distributed to various vaccination sites based on factors such as location, storage capacity, distribution ability and population base. As a result, different healthcare systems receive different volumes of vaccine. A person living in one area or state and receiving care in one health system may not receive the vaccine at the same time as a similar person living in another area or receiving care in another health system.
- Health care providers can also make decisions about who to prioritize for vaccination based on local factors. For instance, one health care system may decide to focus on patients age 65 and older with high-risk indications while another system may decide to emphasize patients age 75 and older including those without chronic conditions.
- Every health care system has needed to figure out how to inform patients. Various approaches have been used including TV, news, website announcements, emails, phone calls and regular mail. People who do not check email, including many older people, can end up being left behind.
Adding to the confusion, the CDC, on January 12, expanded criteria for early immunization to include everyone age 65 and older. The reasoning was that vaccination has proceeded too slowly and that the emphasis on targeting healthcare workers and long term care facilities was slowing down the overall vaccination rate.
If I’m a family caregiver, will I be given priority?
There is not a clear answer to this question. In my opinion, family caregivers are essential healthcare workers but this is only an opinion and a guideline has not been established. I’ve heard various reports. One healthcare system stated that a family caregiver was not on the priority list. Another healthcare system provided the vaccine when the caregiver came with the older patient.
When will I get my vaccination?
There is not a clear answer to this question but healthcare systems and states are making it a priority to reach people. Here are some important considerations:
- Information from a friend may not apply to you since procedures vary by individual factors, location, and health system. Information from another person may just increase stress.
- People have been finding ways of moving to the front of the line. This usually requires extra effort, sometimes a big effort. Just remember that moving to the front of the line frequently means someone else needs to wait longer.
- Don’t get scammed. Remember that it is not legal for any provider to receive payment to expedite vaccination. Any request for payment to do this is a scam.
- At this point, very few PCP offices are equipped to manage or expedite vaccination.
- In the weeks and months ahead, the process is very likely to improve. Vaccination does not provide instant protection and being first in line only offers small advantage. That is why the CDC emphasized vaccinating the highest risk people first. There will be enough vaccine for all of us.
To find out what is happening in your state, try these websites:
My next report will be about the vaccination itself and what happens after that. One thing I want to say right now: Even after the vaccine, you need to continue wearing a mask, hand washing, and physical distancing. BUT, the vaccine WILL make a difference in your life.
Warmest Aloha and stay well,
PS. I’m here to support you. Be connected, stay strong.