California’s age-based vaccination system angers people with disabilities

The new eligibility criteria, announced by Gov. Gavin Newsom on January 22, prioritize age over risk of infection. The idea was to add efficiency to an awkward and confusing deployment – because it’s easier for officials to determine age than health status or job title.

The new system “will allow us to scale up much faster to deliver vaccines to affected communities much faster,” he said Monday.

Currently, Californians eligible for vaccination are those at least 65 years of age, as well as healthcare and nursing home workers, and those working in education, child care, emergency services. , agriculture, restaurants and other food services.

But once these groups are mostly vaccinated, the criteria will change and become largely based on age. Originally, the next group was to include transport and manufacturing workers, as well as inmates – and people with health issues or disabilities became part of the group later. These groups will no longer have priority. The state has not given a timeline for when the next age groups will become eligible. This will depend on the vaccine supply, which is insufficient.

“The problem right now is procurement, procurement, procurement,” Susan Philip, acting health officer for the Department of Public Health in San Francisco, said at a forum UCSF Thursday. She said the distribution bottleneck is preventing the city from opening high-volume vaccination sites at the Moscone Center and the commodity wholesale market, both located in neighborhoods hit hard by the pandemic.

Dr Mark Ghaly, Secretary of State for Health and Human Services, said that “young individuals in professions or in situations where they are not as exposed as some of the high-exposure industries will end up waiting a bit. longer than others who have high risk or high exposure to COVID risk factors.

“There are of course going to be some segments of our population that won’t come out on top as quickly as others. We are working to make sure that communication is simple and well understood, ”he added.

People at high risk of COVID-19, but not yet 65, say forcing them to wait for the vaccine puts them at risk.

“It scares us,” said Andrew Imparato, who sits on the state’s vaccine advisory committee and is executive director of Disability Rights California.

“We don’t think the disability community is taken seriously,” Imparato said, adding that he and other disability advocates agreed that older people should be given priority to get vaccinated – but young people who are at high risk due to underlying health problems or who live in groups “should have access at this time as people over 65”

The California Department of Public Health did not respond to a request for comment on these concerns.

Essential workers, such as bus drivers and train drivers, said they should also be given priority.

On Thursday, BART Board vice-chair Rebecca Saltzman said in a meeting Thursday that she was “so disappointed” that the governor has turned to an age-based vaccination system, which brings down the public transport operators on the list.

“It’s appalling,” she said. “These are workers who have put themselves at risk every day since the start of the pandemic.” Saltzman said getting vaccinated for workers was his “number 1 priority right now.”

Ethicists say they understand why a “one size fits all” approach seems flawed for people who are excluded.

“In an ideal system, we would create a prognostic system that would estimate each person’s risk of dying from COVID first, and then passing it on. But we can’t do that, ”said Dr. Alexander Smith, bioethicist and professor of medicine in the Division of Geriatrics at UCSF, who has studied the allocation of scarce resources during the pandemic.

“We don’t have the time and we don’t have the data,” he said. “And explaining such a complex system to the public would be a monumental path doomed to failure.”

Smith noted that the Centers for Disease Control and Prevention report that people aged 65 to 74 are 90 times more likely to die from COVID-19 than people in their 20s and are eight times more likely to be hospitalized. for disease.

In short, Smith said, there is a difference between how a doctor can tailor individual treatments to patients and what a state can do during a pandemic.

“The public health measure aims to do the most good for most people,” he said. “And in a pandemic, we invoke the ethics of public health.”

That’s an argument that doesn’t suit 33-year-old Charis Hill.

“It’s like the governor doesn’t want me to live anymore, to be honest,” Hill said.

Hill, who uses the pronoun “they,” suffers from a condition called axial spondyloarthritis, which causes inflammation of the spine, causes pain and fatigue, and puts them at a higher risk of complications from the coronavirus.

“I was systematically prevented from having full access to life even before the pandemic,” Hill said. “And the pandemic has just made this experience worse.”

Hill has long been bothered by the idea that only older people face serious complications from the virus.

“This has now been turned into politics,” they said.

San Francisco Chronicle writers Mallory Moench and Aidin Vaziri contributed to this story.