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California opens coronavirus vaccination for more than 4 million residents with high-risk health conditions and disabilities on Monday, allowing people aged 16 to 64 to book appointments if they have a range different medical conditions, such as cancer, diabetes, kidney disease and severe obesity. .
While many worked to document their illness so they could get an appointment as quickly as possible, the California Department of Public Health said at the end of this week that documentation would not be needed. To “protect confidentiality”, immunization clinics will require people with qualifying conditions to “sign a self-attestation indicating that they meet the criteria for high-risk medical conditions or disability” before receiving their injection.
For memory:
4:40 PM, Tue 13, 2021A spokesperson for San Diego VA told the Union-Tribune that the health system began offering the vaccine to all patients with underlying high-risk medical conditions on March 4, but later said that the actual date was March 10. This story has been corrected to reflect that update.
Although San Diego County officials said on Wednesday that special instructions on how to document health conditions would be forthcoming by the end of the workweek, a spokesperson clarified on Friday afternoon that the the county’s approach would be consistent with that of the state.
Vaccines for people with high-risk illnesses or disabilities
Vaccination regulations that go into effect in California on March 15 state that people between the ages of 16 and 64 can be vaccinated if they suffer from any of the following health conditions:
- Cancer, common with a weakened immune system
- Chronic kidney disease, stage 4 or above
- Chronic lung disease, dependent on oxygen
- Down syndrome
- Strong organ transplant, leading to a weakened immune system
- Pregnancy
- Sickle cell anemia
- Heart disease, such as heart failure, coronary artery disease, or cardiomyopathies (but not hypertension)
- Severe obesity (body mass index ≥ 40 kg / m2)
- Type 2 diabetes mellitus with hemoglobin A1c greater than 7.5%
Those who are considered to be at high risk of “serious illness or death”, or for whom infection “will limit an individual’s ability to receive the ongoing care or services essential to their well-being or survival “, Or for whom” providing timely COVID care will be particularly difficult due to the individual’s disability “may also be eligible.
Officials said on Friday that access to inbound doses for those who qualify for immunizations for people with disabilities and health concerns are most likely to have access to appointments through their providers. regular medical care who already have information about their conditions on file.
San Diego County’s largest health systems said this week they were already preparing to proactively contact those whose records show vaccinations are now approved.
“I’m super excited, I’ve thought a lot about moving to the next phase,” said Dr Amy Sitapati, primary care physician at UC San Diego Health. “We are heartbroken to watch and refuse people in a younger age group who are really at significant risk, like my patient with pulmonary fibrosis on oxygen.”
The change comes at a time when demand for vaccines far exceeds supply. And as with previous changes in vaccine eligibility, the expansion raises new questions about how to identify, notify and prioritize people with any of the comorbidities identified by the state and county.
Sitapati is part of the UCSD team that is grappling with these issues for patients in the healthcare system, of which approximately 50,000 to 80,000 are entering eligible categories soon. She helped create an Eligible Patient Registry that identifies and categorizes patients based on electronic patient records. Patients will receive email and SMS notifications by Monday that they are eligible for the vaccine and will gradually receive invitations, phone calls or messages through UCSD’s MyChart patient portal to schedule an appointment for a vaccine.
“We really know our patients better than anyone,” Sitapati said. “If I go to a medical director or some other doctor, in their minds they already know their highest 1 percent, their 5 percent of people who are sick and who need to be vaccinated.”
Among those at the highest risk of severe COVID-19, the UCSD registry prioritizes patients living in socio-economically disadvantaged areas, as measured by the state’s Healthy Places Index.
Several other health systems are also contacting patients or will soon be doing so. On Monday evening, Scripps Health began notifying its more than 100,000 eligible patients through the healthcare system’s own electronic system. These patients have been given a letter they can take with them to county-run vaccination sites to verify eligibility and will be asked to make appointments through Scripps starting March 15.
Some of the first patients to be invited for appointments will be patients with cancer, chronic obstructive pulmonary disease (COPD) or who have had an organ transplant. Dr Ghazala Sharieff, the healthcare system’s chief medical officer for clinical excellence and experience, warns that it will take time to get through the latter group.
“With a very unreliable supply chain we’re going to really frustrate people,” she said.
A spokesperson for Sharp HealthCare said the system plans to contact its patients by email on Friday and that they would be encouraged to make appointments at one of the sites managed by Sharp across the county – including La Mesa and Chula Vista. vaccine superstations.
Kaiser Permanente also began contacting members with underlying health issues last Friday. The supplier cares for 636,000 San Diegans, but a spokesperson was unsure how many of them would soon be eligible for the vaccine.
A local health care system has already moved to the next group: the San Diego Veterans Administration. VA spokesperson Christopher Menzie confirmed that the system vaccinates patients 45 years and older, as well as those with high-risk conditions defined by the Centers for Disease Control and Prevention, noting that the system has 39,000 patients of this type. The VA began offering the vaccine to all patients with serious health conditions on March 10 and notified them via text messages, emails, phone calls and mailed letters.
The San Diego Union-Tribune has asked county spokesperson Mike Workman for clarification on why the VA may have started vaccinating groups of patients who are not yet eligible in the rest of the region.
“They get a direct vaccine and may be able to work through the levels faster,” Workman said in an email. “They don’t go through the state. They have a separate allowance system, just like the military. “
Those with serious underlying medical conditions already have a baseline level of stress on vital organs and tissues, says Dr. Davey Smith, head of infectious disease research at UCSD. This makes them particularly vulnerable to complications from COVID-19.
But not all states weigh various pre-existing conditions equally, leading to a patchwork of policies, as a New York Times survey shows.
Do you have type 1 diabetes? Then you can get the vaccine in Alaska and Iowa, but not in Idaho, and only in some cases in California. And although cystic fibrosis patients are not eligible in the Golden State, they can get the coronavirus vaccine in Illinois and Montana, among others.
The state-to-state eligibility difference could evaporate by May 1, when President Joe Biden plans to make all Americans eligible for the vaccine. In the meantime, new cases of the coronavirus continue to decline across the United States, although at a slower pace in recent weeks than in the first few weeks of the new year.
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